Benefit-cost analysis of SBIRT interventions for substance using patients in emergency departments

Brady P Horn; Cameron Crandall; Alyssa Forcehimes; Michael T French; Michael Bogenschutz

doi:10.1016/j.jsat.2017.05.003

Benefit-cost analysis of SBIRT interventions for substance using patients in emergency departments

J Subst Abuse Treat. 2017 Aug:79:6-11. doi: 10.1016/j.jsat.2017.05.003. Epub 2017 May 4.

Authors

Brady P Horn¹, Cameron Crandall², Alyssa Forcehimes³, Michael T French⁴, Michael Bogenschutz⁵

Affiliations

¹ Department of Economics, University of New Mexico, Albuquerque, NM 87131, USA; Center on Alcoholism, Substance Abuse, and Addictions (CASAA), University of New Mexico, Albuquerque, NM 87106, USA. Electronic address: bhorn@unm.edu.
² Department of Emergency Medicine, University of New Mexico, Albuquerque, NM 87131, USA. Electronic address: CCrandall@salud.unm.edu.
³ Center on Alcoholism, Substance Abuse, and Addictions (CASAA), University of New Mexico, Albuquerque, NM 87106, USA.
⁴ Departments of Sociology and Health Sector Management and Policy, University of Miami, Coral Gables, FL 33124-2030, USA. Electronic address: mfrench@miami.edu.
⁵ Center on Alcoholism, Substance Abuse, and Addictions (CASAA), University of New Mexico, Albuquerque, NM 87106, USA; Department of Psychiatry, New York University School of Medicine, New York, NY 10016, USA. Electronic address: michael.bogenschutz@nyumc.org.

Abstract

Screening, brief intervention, and referral to treatment (SBIRT) has been widely implemented as a method to address substance use disorders in general medical settings, and some evidence suggests that its use is associated with decreased societal costs. In this paper, we investigated the economic impact of SBIRT using data from Screening, Motivational Assessment, Referral, and Treatment in Emergency Departments (SMART-ED), a multisite, randomized controlled trial. Utilizing self-reported information on medical status, health services utilization, employment, and crime, we conduct a benefit-cost analysis. Findings indicate that neither of the SMART-ED interventions resulted in any significant changes to the main economic outcomes, nor had any significant impact on total economic benefit. Thus, while SBIRT interventions for substance abuse in Emergency Departments may be appealing from a clinical perspective, evidence from this economic study suggests resources could be better utilized supporting other health interventions.

Keywords: Benefit-cost analysis; Economic evaluation; SBIRT; Substance abuse.

MeSH terms

Adult
Cost-Benefit Analysis / economics*
Emergency Service, Hospital / statistics & numerical data*
Female
Humans
Male
Mass Screening / methods*
Middle Aged
Randomized Controlled Trials as Topic
Referral and Consultation*
Substance-Related Disorders / therapy*

Grants and funding

U10 DA015833/DA/NIDA NIH HHS/United States