Integrative Biomedical Research (Former Journal of Angiotherapy)
Integrative Biomedical Research | Online ISSN  2207-872X
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Contents Vol 7 (2)

Emergency Departments as Critical Intervention Hubs for Substance Use Disorders: Effectiveness, Barriers, and Opportunities for SBIRT Integration

Ahmed Ghanem Almukhlifi 1, Basim Othmn Naser Almarshad 1, Awwadh Saad Rashed Alshalawi 1, Saqer. Tawfiq Saeed M 1, Saleh Hulays Alharbi 1, Khalid Abdulmohsen Saad Alanazi 1, Zaid Kalaf T Alshammari 1, Sultan Mesfer Faraj Alsahmah 1, Tawfiq Saeed M Saqer 1, Jaber Abdullah M. Alanazi 1

+ Author Affiliations

Integrative Biomedical Research (Former Journal of Angiotherapy) 7 (2) 1-6 https://doi.org/10.25163/angiotherapy.7210273

Submitted: 03 October 2023 Revised: 12 December 2023  Published: 15 December 2023 

Abstract

Emergency Departments (EDs) play a critical role in addressing substance use disorders (SUDs) by serving as a key access point for intervention and treatment. They offer a unique environment for implementing Screening, Brief Intervention, and Referral to Treatment (SBIRT) strategies. This review evaluates the capacity of EDs to manage various SUDs—including alcohol use disorder, opioid use disorder, illicit drug use, and tobacco use disorder—through systematic reviews of both the clinical effectiveness and cost-effectiveness of SBIRT, while also examining barriers to its implementation. SBIRT combined with motivational interviewing has demonstrated significant success in reducing alcohol consumption and related harms, with an estimated return of $3.81 in savings for every $1 invested. For opioid use disorder, ED-initiated buprenorphine treatment significantly increases patient engagement in ongoing care, while naloxone distribution contributes meaningfully to harm reduction efforts. Interventions for illicit drug use have shown mixed results, often due to inconsistencies in implementation fidelity. Tobacco cessation efforts in EDs generally yield modest outcomes. Despite its potential, SBIRT implementation in EDs faces substantial challenges, including inadequate provider training, stigma toward patients with SUDs, and limited resources. Additional barriers include overreliance on automated screening tools and insufficient integration of policy and educational support for providers. Addressing these obstacles is essential for EDs to fulfill their potential as a pivotal component in bridging the treatment gap for SUDs and improving overall patient health outcomes.

Keywords: Emergency Department, Substance Use Disorders, SBIRT, Motivational Interviewing, Cost-Effectiveness

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