Why WIPHL? (pronounced WIFF-el)
How we help
Launching and growing
We're all stakeholders

Why WIPHL? (pronounced WIFF-el)
The Wisconsin Initiative to Promote Healthy Lifestyles (WIPHL) is here to help the people of Wisconsin live healthier lives. And that's something we all need to work on. While our state has many achievements we can point to with pride, Wisconsin also bears some tragic distinctions:

• We regularly stand at or near the top of national rankings for high-risk and heavy drinking (CDC/BRFSS)
  
  
• Wisconsin leads the U.S. in drunken driving (National Survey on Drug Use and Health, 2008)
  
  
• Pregnant women in Wisconsin drink more than expectant mothers elsewhere in the U.S. (CDC/BRFSS)
  
  
• Binge drinking among adults is the highest in the nation and is widespread and rising among people under age 21 (UW Population Health Institute, 2007)
  
  
• One out of four Wisconsin residents engage in illicit drug use or alcohol use to a degree defined as "at risk" by the National Institute on Alcohol Abuse and Alcoholism

These behaviors are destructive for our citizens and our economy. Diseases and accidents related to alcohol and drug abuse make it the fourth leading cause of death in our state and the fourth leading cause of hospitalization.

Based on the most recent annual data available, alcohol and illicit drug use and misuse in Wisconsin had the following consequences: 2,082 deaths, 5,992 motor vehicle injuries, 16,677 hospitalizations, 126,207 arrests, and 528,000 people suffering with dependence or abuse. (UW Population Health Institute, 2007)

The economic toll of such cases: more than $5 billion each year paid by our health care, social services, and criminal justice systems--and, ultimately, by our taxpayers. (Wisconsin DHFS, Healthiest Wisconsin 2010, 2000)

How we help
Numerous studies have shown that a simple screening and referral program can provide people with the help they need and greatly alleviate the damage of risky and problem drinking and drug use.

For many patients, this early and brief intervention--which consists of one to three follow-up consultations taking 15-30 minutes each--is enough to help them significantly decrease their alcohol and drug use.

A verbal screen consisting of a few key questions that easily can be added to any health care visit effectively identifies people who are at risk for alcohol and drug abuse even at the earliest stages.

Studies show that the SBIRT program--Screening, Brief Intervention, and Referral to Treatment--is more effective than urine or breath tests and laboratory findings, which fail to pick up on signs of early problems. SBIRT serves as a preventive measure that can catch risky behaviors before patients do harm or become addicted.

People who score positively on initial questions can meet with on-site, trained health educators--trained and supported by WIPHL and based at clinics around the state--to discuss their substance use and agree together upon options for treatment.

Not only are people's lives improved; a Wisconsin study showed that the state saves nearly $1,000 in health care and criminal justice costs for every patient receiving screening and brief intervention services. (Fleming et al., Medical Care, 2000)

Launching and growing
These vital screening services are now provided through WIPHL at 23 clinics around the state, with more to be added in coming years. The Wisconsin Initiative to Promote Healthy Lifestyles, as its name implies, considers the bigger picture of a patient's health, including nutrition, exercise, weight control, and smoking, when providing services for substance abuse, recognizing that health issues are interrelated.

WIPHL considers, too, the bigger picture of a patient's life. The program is committed to serving Wisconsin residents from a diverse range of ethnic and socioeconomic backgrounds in clinical settings both urban and rural. Counseling is culturally sensitive, nonjudgmental, and respectful of the patient's own degree of interest and readiness.

The program embraces the approach of motivational interviewing, in which patients are helped to identify and strengthen their own motivations for change at a pace and in a manner they formulate with help from the health educator.

This method has elicited excellent and lasting results in decreasing and eliminating substance abuse, numerous studies show.

Over the next five years, the program will provide an initial screening to some 100,000 patients ages 18 and older; of these initial screenings, some 25,000 people will be in need of brief intervention or additional treatment.

The project is funded by the Center for Substance Abuse Treatment (CSAT) of the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), administered by the Wisconsin Department of Health and Family Services (DHFS) and coordinated by the Department of Family Medicine of the University of Wisconsin School of Medicine and Public Health.

We're all stakeholders
Not long ago, doctors didn't ask patients whether they smoked, an omission that seems unbelievable now. Wisconsin helped lead the way in ensuring that health care providers asked about smoking and provided options for quitting as part of any health care visit.

It's time we offered that same assistance for alcohol and drug problems. Wisconsin can lead the way by providing a national model for treatment in addressing one of our state's most serious health problems.

Moreover, a growing body of evidence nationwide supports the model of conducting alcohol and drug screening in primary care settings. Medically harmful alcohol or drug use by patients with chronic diseases leads to misdiagnoses, poor adherence to prescribed care, unexpected side effects from prescribed medications, poorer outcomes, and greater cost, according to a study funded by the Robert Wood Johnson Foundation (see Prism). Knowing a patient's drinking and substance use habits and history is crucial to effective treatment of other problems.

We have everything to gain from a program that has been backed by numerous studies, is inexpensive compared to other treatments--or compared to no treatment at all--and can greatly reduce the toll of human tragedy and economic loss caused by substance abuse.

Currently only 10 to 20 percent of Wisconsin residents in need of help for alcohol abuse receive it. WIPHL offers a good start in addressing that need, and plans eventually to expand its services to all patients in Wisconsin.

A major goal of the initiative is to inform and support health care professionals, employers, insurance organizations, policymakers--and, of course, Wisconsin's patients and citizens--in their efforts to make alcohol and drug screening become a routine part of health care services.