S.B.I.R.T stands for screening, brief intervention and referral to treatment.  This is not a bad idea for hospitals and even jails to engage.  The cost to society for not addressing addiction has never been fully quantified.  It is massive.  A single addict or alcoholic  has the potential to destroy families, communities and lives.  SAMHSA is behind the movement and it is showing success.

After viewing the SBIRT site http://sbirt.samhsa.gov/ I would like to share a personal account of where SBIRT would make a difference.  My son is a type 1 diabetic/ heroin addict.  He was in LA, semi homeless for 16-17 months.  He was @ Tarzana Treatment Center for two short stays including one day at Northridge Hospital Rehab Ward and a few days in jail, just preceding this series of events He was had a pre-approved 3rd re-entry into Tarzana.  That didn’t happen.  Moreover, this addict’s  addictive condition enabled him to ignore his sugar; always subject to a potentially fatal condition called keto-acidosis.  Early, this past summer, he ended up at North Ridge ER in LA, intensive care for just that.  They balanced his sugar and released him.  Intervention did not occur. He returned via ambulance a couple days later again as he collapsed in a local eatery restroom from a combination of high sugar and largely too much heroin in that instance.  Process repeated.  He received information on sugar management, a script for insulin and was released with out intervention.

During this stay he developed a blood clot from his IV.  He returned a third time to ER for a swollen painful arm a short time later.  He left with out treatment after an 8 hour wait to presumably take care of his addiction, however,  returned to ER a 4th time, because his arm was excessively swollen.  He was treated and given scripts for IV thinners and released.  Again no intervention.  No proactive support for his pre-approved status at Tarzana.  He was having trouble getting clearance for a dangerous clot from Northridge delaying his entry into Tarzana.

Sadly, day or two before he might have been admitted into Tarzana he was incarcerated in LA county Central as a result of shop lifting to get cash for heroin.  He served part of his 30 days.  Cash strapped LA county has too many of these “trouble makers” and was engaging a new early release policy.   LA Central Jail was also blind to the addiction and did not test him as his crime was not “drug related”.  This is also a problem with prop 36 applicability.  http://www.prop36.org/

Point is this.  Just one addict has imposed a cost to his family, various providers,  the community of LA, the jail system and the valuable resources of North Ridge Emergency Center of an estimated total of $25,000 in two months time.  A cost no one keeps track of or understand in its totality.  In an era of impending health care and legal reform, the success and further growth of pre-screening protocols like SBIRT would appear to be an imperative.  Please also see my website for a related version of this story in a letter to President Obama. Dad on fire

Also see the work that Senator Jim Webb is doing to impact prison and treatment policy.