The annual healthcare costs of heavy drinking in the U.S. are estimated to be $24.6 billion (Bouchery et al., 2011). Effectively intervening with hazardous, risky, and problem drinkers would reduce both their morbidity and their healthcare costs. One way to address the needs of problem drinkers is by screening for and intervening with them in primary care. It is not feasible, however, for primary care providers to provide these services. Instead, healthcare is moving towards the integration of these services into primary care using behavioral health counselors. This integration is starting to happen now both in New Mexico and nationally (Clay, 2012). Most mental health counselors though do not have expertise is addressing alcohol and drug issues. This project seeks to help address this problem by providing them with an empirically supported program that could be an adjunct to their efforts. The overall objective of this project is to develop, evaluate, and disseminate a web application called Check-up and Choices (CC). CC will be developed for use in primary care. It would tightly integrate screening for heavy drinking and drug use, a brief motivational intervention for hazardous or heavy drinkers, a moderation training protocol for less dependent problem drinkers, and an abstinence-oriented protocol for more dependent drinkers and drug abusers. The brief motivational intervention will be tailored to the patient's age. Its purpose wil be to motivate problem drinkers to change their drinking. The action-oriented moderation and abstinence protocols are cognitive-behavioral interventions (CBIs) that provide patients with the skills to maximize their chances of success with changing their drinking and/or drug use. We have already developed these elements but they are not integrated into a single program with appropriate branching between them. Nor has the content been tailored for use in primary care. This integration of behavioral health services is seen as a win-win that improves the health of patients while at the same time reduces healthcare costs. The move to integrate services is also seen as necessary to be ready for the increased demand for services that will accompany the implementation of national healthcare reform in January, 2014.
At both the local and national level, healthcare organizations are moving towards integrating mental health and substance abuse services into primary care. This web application could meet some of the needs of organizations wishing to provide substance abuse services using a stepped care model of intervention.