A new $8.4 million federal grant to the Hawaii Department of Health aims to identify people at the early stages of alcohol and substance abuse and steer them onto a healthier path before the situation gets out of hand.
“This is great news for Hawaii because we need to stem the tide,” said Edward Mersereau, chief of the Alcohol and Substance Abuse Division, in announcing the grant. “We’re very excited that we got it.”
Hawaii has one of the highest rates in the country of excessive drinking, including both binge and chronic drinkers. According to America’s Health Rankings 2015 annual report, 21 percent of Hawaii adults drink excessively, compared to 17.6 percent nationally.
The money will go toward “Screening, Brief Intervention, Referral and Treatment,” a proven approach designed to boost early awareness, diagnosis and treatment of behavioral health problems.
“It’s similar to the regular tests that doctors want us to do on a yearly basis, to catch cancer before it progresses or to catch heart disease before it gets to progress,” Mersereau explained Friday in an interview.
“This is really to catch addiction or the warning signs of addiction before they progress into full-blown, chronic, acute addiction that takes a lot more intensive treatment and that’s much more expensive.”
The grant is intended to help reverse disturbing trends in alcohol use in the state, such as binge drinking among Native Hawaiians and the growing number of women in Hawaii who drink alcohol toward the end of their pregnancies.
Last year, 27 percent of Native Hawaiians reported binge drinking, followed by whites at 22 percent, Filipinos at 18 percent, Japanese at 13 percent and “other” at 14 percent. Men were far more likely than women to binge drink, at 26 percent vs. 12 percent.
The data come from the Behavioral Risk Factor Surveillance System, an annual telephone survey coordinated by the Centers for Disease Control and Prevention. It defines binge drinking for men as having five or more drinks on one occasion at least once in the last 30 days, or four or more drinks for women.
Meanwhile, the rate of women drinking alcohol in the last three months of pregnancy has climbed steadily to 7.9 percent in 2015 from 4.3 percent in 2000 , according to the Hawaii Health Data Warehouse.
The grant, the first of its kind for the state, covers five years. The effort will roll out at community health centers with diverse populations and demonstrated need for substance abuse treatment. It will later expand to small private doctors’ offices.
It will train practitioners to quickly assess and engage patients in interviews to motivate them toward behavioral changes or refer them to specialists for treatment as needed. Questions could include, for example, “How many times in the last month have you consumed more alcohol than you have intended?”
The plan is to try to catch people with mild to moderate behavioral problems before they escalate. The program also aims to build links between primary care providers and the substance abuse treatment system.
“My dream is that we do really low-level substance abuse screening universally, just like we do for other diseases,” Mersereau said, “so that we’re treating this as a chronic disease that can be significantly prevented and arrested, if we screen early enough and intervene early enough.”
