New program to prevent substance abuse offered at 20 clinics statewide

A federally funded, state-administered screening and assistance program to fight substance abuse – the fourth leading cause of death in Wisconsin – is now offered at 20 clinics around Wisconsin in settings as varied as inner-city Milwaukee, the rural northwest, and two tribal health clinics.

The program, run by the Wisconsin Initiative to Promote Healthy Lifestyles (WIPHL), launched at seven clinics in March, added seven in May, and as of June 11 is operating at 20 clinics.

The program is simple and effective in early detection of at-risk or harmful substance abuse, numerous studies show. Four key questions that are included in any routine health care visit indicate which patients are at risk. Those patients then meet with on-site, trained health educators to discuss their substance use and agree together upon options for change. For many patients, this early and brief intervention-which includes one to three follow-up consultations-is enough to help them significantly decrease their alcohol and drug use, studies show.

In May alone, 14 clinics completed more than 1,600 initial screenings. Thirty-four percent of those patients scored positive for at-risk alcohol or drug use. That’s higher than the national average of 25 percent, but not surprising in a state that regularly lands at or near the top in national rankings for at-risk or harmful levels of alcohol use, says WIPHL Director Richard Brown, an associate professor of family medicine at the University of Wisconsin School of Medicine and Public Health.

"Everyone in Wisconsin is touched by alcohol and drug problems, either through their own substance use or through problems in their families and communities," says Brown. "Widespread delivery of alcohol and drug screening, intervention, and referral services would reduce the terrible suffering and enhance the quality of life throughout the state."

Over the next five years, the 20 clinics are expected to provide an initial screening to some 100,000 patients ages 18 and older. Of these initial screenings, about 25,000 people will be in need of brief intervention or additional treatment.

The WIPHL program is administered by the Wisconsin Department of Health and Family Services and coordinated by the University of Wisconsin Department of Family Medicine. It is funded by a $12.6 million grant from the federal Substance Abuse and Mental Health Services Administration.

Not only are people’s lives improved through the kind of assistance WIPHL provides, but a Wisconsin study showed that the state saves nearly $1,000 in health care and criminal justice costs for every patient receiving screening and brief intervention services. Currently only 10 -20 percent of Wisconsin residents in need of help for alcohol problems receive it.

The time to provide such assistance is long overdue, Brown notes: "For 12 years, government agencies and professional organizations have recommended that health care settings routinely provide alcohol and drug screening, intervention, and referral services to all patients. So far, few settings in the U.S. are doing so. This project is providing the training and resources that health care settings need to start delivering these services in urban, suburban, and rural settings around Wisconsin."

Out in the field, WIPHL health educators are finding that patients and communities welcome the service.

"Physicians and nurses here report that patients not only are happy to complete the brief screen, they say how much this kind of service really is needed in the community," says Lisa Cory, a WIPHL health educator at UW Health Eau Claire Family Medicine. "One patient who had been receiving significant help for alcohol relapse told me that the WIPHL screening process played a key role in getting her back on track."

Over in Milwaukee, at Aurora-St. Luke’s Family Practice Center, WIPHL health educator Birgitta Larson is hearing the same expression of need and gratitude. After an extensive conversation with a patient following a positive screen for substance abuse, the patient "seemed really impressed that a program such as WIPHL existed out of her primary care physician’s office," notes Larson.

The Wisconsin Initiative to Promote Healthy Lifestyles will add clinics in years to come, Brown said. A major goal of the initiative is to inform and support health care professionals, employers, insurance organizations, and policymakers in their efforts to make alcohol and drug screening become a routine part of health care services.

Clinics participating in WIPHL include:

Launched in March: UW Health Belleville Family Medical Clinic; UW Health Eau Claire Family Medicine; UW Health Fox Valley (Appleton); UW Health Northeast Family Medical Center and UW Health Wingra Family Medical Clinic (Madison); Family Health/La Clinica (Wautoma); and St. Joseph’s Community Health Services (Hillsboro).

Launched in May: Menominee Tribal Clinic (Keshena); St. Croix Tribal Health Clinic (Round Lake and Hertel); Aurora St. Luke’s Medical Center (Milwaukee); St. Croix Regional Medical Center (St. Croix Falls); Polk County Health Department and Polk County Human Services Department (Balsam Lake); and Amery Regional Medical Center.

Launched June 11: Waukesha Family Practice Clinic; Aurora Clarke Square Family Health Center, Aurora Walker’s Point Community Clinic, and Aurora Sinai Family Care Center (all in Milwaukee); Franciscan Skemp Sparta; and Mercy Clinic South (Janesville).