All IMA patients will be screened for Substance and Alcohol Use annually.
For patients who score moderate risk on either the Audit C (3-7 for women, 4-7 for men) or the DAST 10 (3-5):
- Provider updates alcohol/drug history
- Provider conducts a brief intervention using the following model:
- Raise the Subject
- Provide Nonjudgmental Feedback
- Enhance Motivation (assess readiness for change and challenges/motivations for change)
- Negotiate a Plan
- Dotphrase .alcoholdrugintervention
For patients with high risk substance use (6+ on DAST) or alcohol use (8+ on Audit-C):
- Consider a referral to REACH clinic (email: reach@mountsinai.org) and calls the Patient Navigator for REACH (646-951-1693) for real-time, in person warm handoff if provider is unable to address.
REACH is a primary care clinic for people who use drugs co-located at IMA. REACH is not a substance use treatment program.
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Appropriate referrals are:
- Patients with opioid use disorder seeking buprenorphine treatment
- Patients with alcohol use disorder
- Patients with other substance use disorders (cocaine/stimulant, cannabis)
We encourage providers to initiate the conversation and prescribe AUD medications such as naltrexone or acamprosate as they are comfortble with doing so.
There are no FDA approved medications for other SUDs such as stimulant or cannabis use disorder. There are other recommended behavioral therapies that REACH does not provide given that twe are not a substance use treatment program. Please instead consider a referral to the Addiction Institute at Mount Sinai.
If evening clinic, please just send the email and a patient navigator will reach out to the patient.
- Patient Initials
- MRN
- Substance(s) used in the last year
- If opioid use disorder, are they interested in buprenorphine?
- Does patient have untreated hepatitis C?
- Name of provider
- Phone number of provider
- Patient Best Phone Number
- Referral discussed with patient and agreed to appointment?
- If patient is not appropriate for REACH (for example patients with opioid use disorder seeking methadone treatment), provider refers to SW (using BPA that pops up) and calls the SW (health homes or triage- see care team in EPIC to assess if HH) for real-time, in person warm handoff. SW does brief intervention using the .alcoholdrugintervention dotphrase and if patient amenable - refers to treatments center (some options below)
Important dotphrases:
For SBIRT Intervention: .alcoholdrugintervention
For patient education: .alcoholeducation .marijuanaeducation .cocaineeducation .opioideducation .otherdrugeducation .alcoholgoalsworksheet .druggoalsworksheet