Innovative Care Pathways: Integrating Equitable Screening and Treatment for Substance Use Disorders in Primary Care-View Recording

Video Transcription

Video Summary

In a seminar at UC Davis, a team comprising psychiatry and primary care professionals from different institutions discussed integrating substance use disorder (SUD) screening and intervention into primary care settings. The discussion was led by Lauren Scherr, Jeremy DeMartini, and others. They introduced a pilot project aimed at early identification and management of substance misuse through systematic screening using validated tools such as the Audit-C and DAST questionnaires. <br /><br />The project, implemented in two UC Davis clinics, resulted in a significant increase in screenings—from under 1% to over 40% in some cases. Despite these improvements, barriers such as stigma, time, and resource constraints remain challenges. A “Substance Use Navigator,” Alvaro Gonzalez, plays a crucial role by providing interventions and connecting patients with resources and treatments, like motivational interviewing and cognitive behavioral therapy.<br /><br />The team highlighted the importance of normalizing screening for alcohol and drug misuse to combat stigma. Using scripted language to ensure consistent, non-stigmatizing communication is part of their strategy. The project also addresses health equity, ensuring screening is equitable across demographic variables such as race, ethnicity, and insurance type.<br /><br />The discussion included insights into the challenges faced in implementing these screenings, historical barriers like the X waiver, and the need for interdisciplinary approaches in integrated care models. Community and systemic support, alongside policy changes, are essential for the success of such initiatives. Participants expressed the hope that this model could be expanded to broader settings to enhance access to care and reduce the burden of substance use disorders.

Keywords

substance use disorder

primary care

screening

intervention

UC Davis

Audit-C

DAST

stigma

health equity

integrated care

motivational interviewing

cognitive behavioral therapy