title: Integrating intervention for substance use disorder in a healthcare setting: practice and outcomes in New York City STD clinics.
abstract: OBJECTIVE
  This article reports the integration and outcomes of implementing intervention services for substance use disorder (SUD) in three New York City public sexually transmitted disease (STD) clinics.
  
  
  METHODS
  The screening, brief intervention, and referral to treatment (SBIRT) service model was implemented in the STD clinics in 2008. A relational database was developed, which included screening results, service dispositions, face-to-face interviews with 6-month follow-ups, and treatment information.
  
  
  RESULTS
  From February 2008 to the end of September 2012, 146,657 STD clinic patients 18 years or older were screened for current or past substance use disorders; 15,687 received a brief intervention; 954 received referrals to formal substance abuse treatment; 2082 were referred to substance abuse support services such as Alcoholics Anonymous (AA), and 690 were referred to mental health, social or HIV awareness services. Intervention services delivered through SBIRT resulted in improvements in multiple outcomes at 6 month follow-up. Patients who received interventions had reduced SUD risks, fewer mental health problems, and fewer unprotected sexual contacts.
  
  
  CONCLUSIONS
  Delivery of SUD services in a public health setting represents a significant policy and practice change and benefits many individuals whose SUDs might otherwise be overlooked. Intervention services for substance use disorder were integrated and highly utilized in the STD setting. Further research needs to focus on the long-term impact of SUD interventions in the STD setting, their cost effectiveness, and the extent they are financially sustainable under the new healthcare law.
authors.affiliation: a School of Social Welfare, University at Albany, State University of New York, Albany , New York , NY , USA.
authors.forename: Jiang
authors.initials: J
authors.lastname: Yu
authors.affiliation: b New York State Office of Alcoholism and Substance Abuse Services, Albany , New York , NY , USA.
authors.forename: Phil
authors.initials: P
authors.lastname: Appel
authors.affiliation: c New York City Department of Health and Mental Hygiene , Bureau of STD Control, Long Island City , New York , NY , USA.
authors.forename: Meighan
authors.initials: M
authors.lastname: Rogers
authors.affiliation: c New York City Department of Health and Mental Hygiene , Bureau of STD Control, Long Island City , New York , NY , USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Blank
authors.affiliation: d The Lesbian, Gay, Bisexual & Transgender Community Center , New York , NY , USA.
authors.forename: Carrie
authors.initials: C
authors.lastname: Davis
authors.affiliation: e Mount Sinai Health System , Office of Diversity and Inclusion , New York , NY , USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Warren
authors.affiliation: d The Lesbian, Gay, Bisexual & Transgender Community Center , New York , NY , USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Freeman
authors.affiliation: b New York State Office of Alcoholism and Substance Abuse Services, Albany , New York , NY , USA.
authors.forename: Brett
authors.initials: B
authors.lastname: Harris
authors.affiliation: b New York State Office of Alcoholism and Substance Abuse Services, Albany , New York , NY , USA.
authors.forename: Shazia
authors.initials: S
authors.lastname: Hussain
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D019966:Substance-Related Disorders / Q000628:therapy*; D055815:Young Adult
keywords: Substance use disorder; healthcare setting; intervention