October 1st, 2015

Law would expand screening tool

Lawmakers and an organization dedicated to reforming the children’s mental health system in Massachusetts are working to expand a substance abuse screening tool in all public schools across the state.

According to information released in April 2014 by the Massachusetts Department of Public Health, 338 residents died because of  unintentional opioid overdoses in 2000. That rose to 668 deaths in 2012, although age was not specified.

However, the Children’s Mental Health Campaign – a statewide coalition pushing for the use of Screening, Brief Intervention and Referral to Treatment, or SBIRT, in Massachusetts public schools – points to national data that shows young people who abuse alcohol are 7.5 times more likely to use illicit drugs.

“People are using substances at higher rates and they’re doing so at an earlier age,” said Nancy Allen Scannell, director of policy and planning for the Massachusetts Society for the Prevention of Cruelty to Children, the host organization for the Children’s Mental Health Campaign, in an email.

“To end this crisis, we need to invest in prevention. Our goal is to stop substance abuse before it starts. Screening and counseling are well-established best practices for helping young people avoid substance use and getting them the help they need if a problem exists.”

Several school districts around the state already use the screening tool – Gloucester, Hadley, Greenfield, Hudson, Natick, North Andover, Northampton, and Remington – and are seeing good results, said state Sen. Jennifer Flanagan (D-Leominster), sponsor of legislation that would require all public schools to include SBIRT with other health screenings done with middle school- and high school-aged children.

“The legislation will go a long way in trying to prevent addiction, trying to help kids get treatment if it’s needed and really trying to start a basic conversation,” Flanagan said. “I think the more you talk to children and adolescents, the more you can get in their head right versus wrong and give them opportunities to prove themselves, then they do better later in life.”

It costs on average about $5,000 for a school district to implement SBIRT, according to the Children’s Mental Health Campaign.

SBIRT is used in emergency rooms, mental health settings and increasingly in primary care and school settings, said John F. Kelly, Ph.D., program director of the Massachusetts General Hospital Addiction Recovery Research Institute and an associate professor of psychiatry in addiction medicine at Harvard Medical School.

SBIRT is a standardized, brief, validated screening tool used to assess the degree of alcohol and drug use with a score that forms the basis of a conversation between a health practitioner and the person being assessed, he said. Based on the score, the practitioner will conduct an intervention – advice, multi-session follow-ups or check-ins or referral to intensive specialized addiction treatment. Those at low risk are given positive reinforcement.

Kelly said studies support the effectiveness of SBIRT with adolescents especially with alcohol use, but less so with drug use.

Allen Scannell said the use of SBIRT is not intended to focus solely on the use of opiates, but rather to reduce the use of drugs and alcohol by youth around the state. “Putting off the age of first use of alcohol reduces lifetime risk of addiction and dependence,” she said.

The legislation has yet to move to the floor for a vote.

By Rivkela Brodsky

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