KU School of Medicine-Wichita

the patient, without expressing judgment. If the patient agrees, the physician provides treatment and/or refers to substance use disorder services. Ablah said even a brief intervention can be eective. "A 10-minute conversation with a physician is a lot. If it's done in a way where somebody doesn't feel they're being judged or being attacked, they often will have a conversation where they're not trying to defend themselves, they're willing to open themselves up with someone they trust." Ablah's part of the work centers around physician awareness and education. Rachel Brown, her co-principal investigator on the grant, is overseeing the development of an addiction medicine fellowship that's another part of PPTA. Brown, MBBS, M.Phil., is also professor and chair of the Department of Psychiatry & Behavioral Sciences. Ablah started by gathering information: interviews with 26 local physicians, residents and medical students; and a survey of Sedgwick County Medical Society members. The results tallied with medical literature on the topic, Ablah said. "Physicians have many barriers to intervening with people who have a substance use disorder, including stigma. It's a big issue." 'A 10-minute conversation' For physicians seeing patients in 15-minute increments, PPTA promotes an approach known as SBIRT, for Screen, Briefly Intervene, Refer and Treat. It starts with a two-question screening tool that a patient can complete in seconds, allowing the physician to assess the risk of substance use disorder. If they screen positive, there is an 8-10 item survey for the physician to better understand the risk. The physician then conducts a brief intervention to discuss risks and, if the patient is interested, risk reduction strategies. The physician oers to help "When you are dealing with someone who has a substance use disorder, this is not going to be generally an easy conversation and they're generally not going to be enthusiastic about changing behaviors," said Elizabeth Ablah, Ph,D., MPH, CPH, professor and vice chair in the Department of Population Health at the University of Kansas School of Medicine-Wichita. "It can be draining for a lot of providers when they're already tight on time. Some providers are feeling like 'we don't have the time to get into this, so why would I screen for something?' It's challenging, I think, for folks when they fear there will be pushback or resistance." Nevertheless, it's a problem of epidemic proportions: Nearly 18% of Kansans 18 years and older have a substance use disorder, according to a recent survey. Nationwide, it's estimated that 16.5% of Americans have a substance use disorder, yet 94% receive no treatment for it. Preparing physicians A multilayered eort called Preparing Physicians to Treat Addiction is trying to better prepare physicians to treat addiction disorders while increasing access to such care in Sedgwick County. Launched last November, PPTA is funded from Kansas' share of national opioid lawsuit settlements. 7 S Screen BI Briefly Intervene RT Refer and Treat 10 minutes "That's very exciting," Ablah said of the fellowship. "It will be accredited and rolling in 2025." "Drawing out an undiagnosed substance use disorder may be more than many physicians are ready to tackle. But it's not from a lack of caring." — Elizabeth Ablah, Ph.D., MPH, CPH, professor

• Cover