Providing InSight into America's #1 Public Health Challenge

Alcohol and drugs affect health care on a number of levels. They make it difficult to diagnose and treat patients, and they directly contribute to many accidents and diseases, and in many cases, represent a disease process themselves. But there is no universally accepted standard practice of screening for drugs and alcohol in the course of delivering routine care. So the U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration provided funding through Texas Department of State Health Services to establish a pilot program based on research and oversight from Baylor College of Medicine and University of Texas Health Science Center, to provide screening, brief intervention, referral and treatment for patients of Harris County Hospital District, with counseling services provided by The Council on Alcohol and Drugs Houston and statistical reporting provided by University of Texas Addiction Research Institute.

Documenting best practices.

Data collected from the pilot program is funneled back to the federal government for the purpose of documenting best practices and diffusing into the medical community a new approach to treating alcohol and drugs as a medical issue, with the aim of changing the behavior of all doctors and health care providers so that they all screen the same way, just as they now do for hypertension and drug allergies.

The need for simplified communications.

To be effective, this complex program needed to be simplified and communicated in a single, clear voice. We developed a comprehensive strategy to meet that critical need.

Success story.

At the end of the first two years, the program reduced Emergency Room congestion and saved the initial participating hospital system over $4 million. According to the most recent figures from from the University of Texas Addiction Research Institute in 6 month follow-up on InSight services: 94% of patients decreased drug use, there was an 86% decrease in 30-day alcohol use and heavy drinking, and 62% of those with alcohol dependence reported abstinence at six months.

In addition to decreases in drug use, attitudes of health practitioners changed. Our site used a brief motivational interviewing style of intervention and there was a significant investment in training and coaching provided by the Health Behavior Research and Training Institute for the InSight specialists. 

This model continues to be used at HCHD and disseminated to other sites in Texas for both substance use and other behavioral health problems. 

See some of the strategy implementation