Learning How to Screen for Substance Abuse

A new program designed to teach students how to screen patients for substance use disorders has been implemented for P&S and dental students at Columbia. The program, funded by a grant from the Substance Abuse and Mental Health Services Administration, is integrated into the required curriculum over the course of all four years. 

The program aims to teach a variety of approaches to screening and brief interventions that take a nonjudgmental approach to substance use by applying evidence-based methods that have been shown to reduce rates of heavy drinking, nicotine use, and drug use among patient populations. 

Students who participate in the program are being introduced to SBIRT (Screening, Brief Intervention, and Referral to Treatment) and techniques for motivational interviewing. The program uses multiple teaching techniques, including lectures, videos, small-group discussions, role-playing, and screening of standardized patients to help students learn and practice SBIRT. Standardized patient encounters, modeled on a part of the board certification process for physicians, allow students to practice history taking and physical exam skills to prepare to see patients in clinical settings. 

The Substance Abuse and Mental Health Services Administration has funded initiatives to introduce SBIRT training nationally, although mostly for residency programs up until the past year. Increasing awareness about the impact of excessive substance use on health care outcomes across the country has prompted the agency to expand the initiative by adapting the curriculum for medical students to introduce concepts earlier in the course of a doctor’s training.

“Doctors have a lot more impact than they think they have in changing a patient’s behavior,” says Frances R. Levin, MD, the Kennedy-Leavy Professor of Psychiatry in the Division of Substance Use Disorders and the PI for the training program at Columbia. “We try to get the students comfortable with simply asking patients the questions.” 

Dr. Levin hopes to expand the program next year to residents and ultimately offer the course to students at other CUMC schools.