SBI manuals, training and continuing medical education programs, and clinical support systems for physicians are widely available from the Federal Substance Abuse Mental Health Services Administration (SAMHSA), Veterans Health Administration (VHA), National Highway Transportation Safety Administration (NHTSA), Centers for Disease Control and Prevention (CDC), specialty medical societies such as (ACEP, ACS-COT), and clinical program developers (e.g., Boston City Hospital, Yale-New Haven, Harborview, Center on Alcohol, Substance Abuse and Addiction). The Accreditation Council for Continuing Medical Education (ACCME) chose SBI as the 2007 demonstration continuing medical education program. ACCME will assist all specialty medical societies to implement CME programs for SBI during the coming year. The Centers for Disease Control, Substance Abuse and Mental Health Services Administration, National Highway Traffic Safety Administration, and National Institute of Alcohol Abuse and Alcoholism recently collaborated and funded publication of guidelines for SBI for use in all American College of Surgeons accredited Level 1 Trauma Centers in the United States.

Professional medical societies that recommend SBI: • American Psychiatric Association (APA, 1994) • American Academy of Pediatrics (Kulig, 2005; AAP, 2005) • American Academy of Family Physicians (Leawood, 2005) • American Academy of Child and Adolescent Psychiatry (Bukstein, 2004) • American Society of Addiction Medicine (ASAM, 1997) • American College of Emergency Physicians (ACEP, 2005, 2006) • American College of Surgeons – Committee on Trauma (ACS 2006) • American College of Obstetricians and Gynecologists (http://acog.org/) • AMA (1999, 2001) Federal and state health agencies that have promulgated practice guidelines that include strong recommendations for SBI: • The Veterans Administration and Department of Defense joint guidelines for substance use treatment (VA/DOD, 2002). • National Institute on Alcohol Abuse and Alcoholism (www.niaaa.nih.gov) • The Substance Abuse and Mental Health Services Administration Treatment Improvement Protocols numbers 35, 34, 32, 32, 24, 16, 11 and 3 (CSAT, various dates). • New York State Department of Health (2005). • The Michigan Quality Improvement Consortium (2005). • National Quality Forum (2005)

Major payers that have developed practice standards that include specific recommendations to use SBIs: • Magellan and ValueOptions? , the largest managed behavioral healthcare companies, published guidelines (Magellan, 2005; ValueOptions? , 2006). • WellPoint? and United Healthcare, the largest and second largest healthcare companies recommend primary care SBI (UHC, 2005, MAMSI, 2005); • National Business Coalition on Health and the National Business Group on Health recommend and monitor health plans’ SBI (NBCH, 2006; NBGH, 2006).

International health organizations and national health ministries that have developed practice standards that incorporate SBI: • World Health Organization (Babor, Higgins-Biddle, 2001a,b) • United Kingdom (2004) • Scotland (2003) • Australia (2004) • Canada (2005) • European Union 17-country collaborative guideline (Anderson et al, 2005)

The federal agencies responsible for public health and public safety recommend routine SBI: • The White House Office of National Drug Control Policy ( 2006) • NHTSA (2006) identifies SBI as one of its three strategies for reducing impaired driving • CDC convened two conferences on SBI, and is assisting businesses to implement SBI • NIAAA released a guide for primary care clinicians on SBI (NIAAA, 2005).

Seventeen medical professions recommend SBI training and the demonstration of clinical competency in SBI for professional education (AMERSA, Project MAINSTREAM).

Federal health services and major foundations are investing substantial resources in developing SBI demonstration programs: • SAMHSA, CSAT has invested more than $175 million in SBI demonstrations, and supports more than 40 courses and training programs on SBI. • NIAAA and CDC jointly awarded SBI grants to 10 academic medical centers.