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TIPS & TOPICS from David Mee-Lee, M.D.
Volume 6, No.1
April 2008
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In this issue
-- SAVVY
-- SKILLS
-- SOUL
-- Until Next Time

This month's TIPS and TOPICS (TNT) marks the start of our sixth year of sending our free monthly e- newsletter. That means there are five years of material on the website that you can read, download and share. The time is getting closer when you will be able to search all that material; there are consultants revamping the website as we write.

SAVVY
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There has been a lot of attention lately on Screening and Brief Intervention (SBI) for alcohol and other drug use problems. Here is why screening is important plus some developments and resources:

Tip 1

The 2006 National Survey on Drug Use and Health (NSDUH) found that 21.1 million needed (but did not receive) treatment for illicit drug or alcohol use. In the year prior to the survey, they found the following----

Of those aged 12 or older who needed treatment for illicit drug or alcohol use, but who did not receive treatment:
--> 95.5% Did not feel they needed treatment
--> 3.0% Felt they needed treatment and did not make an effort to get treatment
--> 1.5% Felt they needed treatment and did make an effort to get treatment

You can see that there is a vast population of people who could benefit from SBI and referral to treatment.

Reference:
National Survey on Drug Use and Health (NSDUH): National Findings and Results From the 2006 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration (SAMHSA). Published September, 2007. (http://www.oas.samhsa.gov/nsduh/2k6nsduh/2k6Res ults.pdf).

Tip 2

Let your primary care physician or medical personnel know that not only is it the right thing to do to screen for substance use problems, but now they can be paid for identifying and intervening. Societal discrimination and lack of training will still mean they will need your support to help patients and clients get into appropriate treatment. But this is a great start to legitimizing better assessment and intervention.

** American Medical Association created codes 99408 (15-30 minutes) and 99409 (over 30 minutes interaction) for alcohol and/or substance use structured screening and brief intervention services.

** Center for Medicare & Medicaid Services created codes H0049 and H0050 for alcohol/and other drug screening and brief intervention.

** Centers for Medicare & Medicaid Services created codes G0396 and G0397 for reporting comparable services for Medicare fee-for-service schedule (FFS) patients.

Tip 3

To further expand the continuum of healthcare to include SBI, the Joint Commission is seeking input from healthcare professionals, providers, measurement experts, consumers, government agencies and employers. Last year the Joint Commission implemented a WikiHealthCareTM application to make it easier for healthcare professionals to collaborate in the development of standards and quality improvement solutions. To collaborate with the Joint Commission on the development of SBI standards using this application, you will need to follow the steps below:

STEP #1: Register at the Joint Commission's website at the following link:
http://wikihealthcare.jointcommission.org/twiki/bin/ view/TWiki.TWikiRegistration

STEP #2: To add comments to the SBIRT Wiki process, click on or paste the link below in your browser:
http://wikihealthcare.jointcommission.org/twiki/bin/ view/Perform/ScreeningAndBriefIntervention . Once you are there you will need to enter your username and password.

STEP #3: Once you have entered the SBIRT Wiki process, you should add to the content or modify existing content.

For more tidbits on the Screening and Brief Intervention, refer to a previous edition: April 2005 edition: in Savvy & Skills

A lot of comedians make jokes about racial and ethnic stereotypes. The mean-spirited comedians are a turn- off and if they are on TV, I literally turn them off. But it was fortunate that at a live performance of Russell Peters- a comedian of Indian ethnicity, raised in Canada - there was no reason to turn him off. That would have been difficult sitting in the second front row six feet from him in a small comedy club in Sacramento, California. He was funny, insightful and good-natured in poking fun at the mostly Asians, Indians and a variety of others in the audience.
Russell made a good point that there is a big difference between your ethnicity and your culture. He was humorously relating how he was so proud to be an Indian, getting ready to bond with his Indian people until he actually arrived in India. As soon as the airplane door opened, he was confronted with sights, sounds and smells that screamed to him that he was much more Canadian than Indian.

In the heat of the US Presidential marathon, race, culture, gender, class, age, color, creed and religion have already tested our national fault lines. It's too easy to reduce people to man, woman, old, young, black, white, elitist, populist, liberal, conservative and the ongoing list of politically correct categories.

And in the behavioral health world, it's also easy to reduce people to alcoholics, addicts, schizophrenics, borderlines, sociopaths, manic-depressives and narcissists. In clinical work and in choosing a President, it's going to be important to increasingly resist reducing people to a label.

If you think you know Chinese people, you don't know me, because I'm a banana - yellow on the outside, but white on the inside - mostly anyway. I still like using chopsticks.