Key Takeaways
- Systematic screening for substance misuse in older adults identifies problems early when intervention is most successful, yet screening remains underutilized in geriatric medicine.
- SBIRT (Screening, Brief Intervention, Referral to Treatment) is an evidence-based protocol combining brief questionnaires with counseling, appropriate for primary care settings.
- Prescription Drug Monitoring Programs (PDMP) track opioid and benzodiazepine prescriptions, identifying doctor shopping and dangerous polypharmacy patterns indicating possible misuse.
- Comprehensive addiction assessment evaluates substance use history, medical consequences, psychiatric comorbidities, and psychosocial factors guiding treatment planning.
- Trust SoCal provides comprehensive geriatric addiction assessment and evidence-based treatment planning at (949) 280-8360.
SBIRT Screening and Brief Intervention
SBIRT (Screening, Brief Intervention, Referral to Treatment) is an evidence-based protocol enabling primary care providers to identify and address substance misuse. Screening involves brief questions about substance use. Positive screens prompt brief intervention (motivational counseling addressing risks and benefits of substance use) and referral to treatment specialists when appropriate.
SBIRT questions for older adults address alcohol use (more prevalent than illicit drugs), prescription medication use (opioids and benzodiazepines), and over-the-counter medications. Response patterns identify problematic use warranting further assessment.
SBIRT provides effective early identification of substance misuse in primary care. Ask your healthcare provider if they use SBIRT screening.
Prescription Drug Monitoring Programs (PDMP)
PDMPs are state databases tracking controlled substance prescriptions (opioids, benzodiazepines, stimulants). Providers and pharmacists can query PDMPs to identify patients receiving multiple opioid or benzodiazepine prescriptions from different providers—a pattern indicating doctor shopping and possible misuse. PDMP data enables early intervention before serious consequences develop.
Healthcare providers should routinely check prescription drug monitoring programs for patients on opioids or benzodiazepines. PDMP queries identify dangerous prescribing patterns.
Comprehensive Geriatric Addiction Assessment
Complete addiction assessment evaluates substance use history, pattern of use, perceived control over use, consequences experienced, medical effects, psychiatric comorbidities, psychosocial stressors, and recovery motivation. This information guides treatment planning and level of care determination.
Comprehensive assessment at treatment entry establishes baseline for treatment planning and guides individualized interventions addressing each person's specific needs.
Medical Review Board, MD, ABAM
Medical Director & Reviewer
