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Indiana Prevention Resource Center (IPRC)

Syndemics and Substance Abuse

Dr. Gassman presented as a panelist at the 4th Annual Rural Public Health Institute sponsored by the Mid-America Public Health Training Center on Wednesday, February 27, 2008. The title of the discussion was Syndemics and Substance Abuse: Developing a Systems Perspective for Prevention Planning. She spoke on secondary prevention, specifically screening, brief intervention, and referral to treatment: the Indiana Experience. Her presentation highlighted the high prevalence of risky and harmful drinking among the general population, and even higher prevalence among clients seen in a variety of health and human service settings. Alcohol consumption combines synergistically, in an unfavorable way, with an array of problems. For instance drinking contributes to the prevalence of mental illness, health problems, criminal behavior, educational failure, and child abuse and neglect. The result is that health care, judicial, educational, and other societal systems must shoulder the excess burden of these problems.


Screening, brief intervention, and, when appropriate, referral (SBIRT) were presented as a strategic approach to identify and reduce alcohol problems across an array of generalist settings (i.e. outside the substance abuse treatment sector). The full value of SBIRT is its potential to reduce problems related to risky and harmful drinking. Terry Cline, former Director of the Substance Abuse and Mental Health Services Administration, views SBIRT as an approach that will help to prevent problems from escalating and worsening, and a strategy that will involve substantially less spending in the long term. SBIRT for illicit drug use is a primary focus of current research and development.


staff writer, 8/1/2008