Implementation of a Screening, Brief Intervention, and Referral to Treatment Protocol for Treatment of Opioid Use Disorder in Post-Carceral Populations

Authors

Adaora Ede, University of Tennessee, KnoxvilleFollow
Mary Johnson, University of Tennessee, KnoxvilleFollow

Document Type

Abstract

Publication Date

12-11-2023

Abstract

BACKGROUND: Opioid use disorder (OUD) is a pressing public health issue in the US affecting marginalized populations the most. Within the correctional setting, 65% of inmates are affected with OUD, worsening health outcomes when untreated.

LOCAL PROBLEM: This evidence-based practice (EBP) project targeted justice-involved individuals with co-occurring OUD at a behavioral health clinic in Johnson City, Tennessee. This project aimed to improve outcomes related to recidivism and relapse through clinician education and the implementation of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol.

METHODS: Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) was the guiding EBP model for the project. A literature review then identified early risk assessment and intervention as best practice. Four providers and three counselors received education, and thirteen clients received the intervention. Client data from the electronic health record were compared to a control group’s using SPSS.

INTERVENTIONS: Clinicians received training and SBIRT toolkits containing screening instruments and patient education sheets. They also facilitated the post-intervention data collection in follow-up appointments. High-risk clients in the intervention group were referred for medication-assisted treatment (MAT), counseling, and/or a higher level of care (HLOC).

RESULTS: Although not statistically significant, the project produced clinically significant results such as a 35.7% reduction in relapses and a 28.6% decrease in re-encounters. In addition, compared to 28.6% in the pre-implementation group, only 7.1% of post-intervention clients were referred to HLOC, suggesting efficacy of the implementation.

CONCLUSIONS: SBIRT implementation can streamline MAT initiation and promote buprenorphine as an effective OUD treatment. Results also imply applicability for primary care providers and reimbursement opportunities when using SBIRT. Sustainability can be sought through customized education programs and methods to increase client compliance across settings. Overall, findings highlight the relevance of efforts to increase access to OUD treatment and improve long-term health outcomes in the carceral population.

Recommended Citation

Ede, Adaora and Johnson, Mary, "Implementation of a Screening, Brief Intervention, and Referral to Treatment Protocol for Treatment of Opioid Use Disorder in Post-Carceral Populations" (2023). Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP).
https://trace.tennessee.edu/dnp/101