Screening, Brief Intervention and
Referral to Treatment (SBIRT)
What is SBIRT? - answerits a comprehensive, integrated, public health approach to the
delivery of early intervention and treatment services for people with substance use
disorders and those at-risk of developing them
What does SBIRT mean? - answer-Screening
-Brief Intervention
-Referral to Treatment
Screening - answerprocedure to evaluate probability of a person having a substance
use disorder or being at risk for negative consequences due to use of alcohol/drugs
Brief intervention - answer-any time-limited effort to provide: info or advice, increase
motivation to avoid substance use, or teach behavior change skills to reduce substance
use and chances of negative consequences
-typically delivered to persons at low to moderate risk
referral to treatment - answer-when screening identifies person already having
substance-related health problems or SUD needing formal diagnosis and possible
treatment referral
-referral process facilitates access to care (including brief treatment) beyond Brief
intervention
SBIRT is... - answer-based on public health principles
-designed to reduce the burden of injury, disease and disability associated with misuse
of alcohol, illicit drugs, prescription medications and tobacco
GOALS of SBIRT - answer-encourage healthcare providers to screen and provide
advice or counseling to their patients who misuse alcohol or other drugs
-to influence risky behavior patterns and reduce exposure to the negative
consequences of misuse
-improve linkages between general community health care and specialized substance
abuse providers to facilitate access to care when needed
Why is Alcohol mostly focused on in SBIRT? - answer-hystorically, SBIRT was
developed and tested with people at risk for heavy/problem drinking
Where is SBIRT being used? - answer-primary care
-community health centers
-trauma centers
, -hospital emergency rooms
-and many more places
The components of SBIRT - answer1. screening is rapid, proactive procedure to ID
people who may have or may be at risk for having an alcohol/drug problem
2. brief intervention focuses on increasing client awareness of his/her own substance
use and motivation to change
3. referral to treatment provides clients who require more extensive treatment with
access to specialty care
Who gets screened? - answer-done with EVERYONE (universal)
-no single "right way" to screen
does screening indicate whether someone is at risk or a diagnosis for a given condition?
- answer-tells if someone is at RISK for a given condition
Screening basics - answer1. introduce the screen
2. be specific in your questions
3. make sure you are speaking the same language as the patient
4. convey non-judgmental attitude throughout screen no matter what the answers are
General Screening Guidelines - answer-items should be asked in a matter-of-fact way
-if self-administered, embed items into a broader client survey
-most important: use items that are reliable and valid! (select instrument/items best
suited to your client mix)
Commonly used screeners - answer-AUDIT (alcohol)
-CAGE (alcohol and drugs)
-DAST (drugs)
-CRAFFT (alcohol and drugs)
-T-ACE/TWEAK (alcohol)
AUDIT - answer-developed by WORLD HEALTH ORG (1982)
-excellent for identifying early signs of hazardous drinking and mild dependence
-time frame: past 12 months
-92% effective in detecting hazardous/harmful drinking
-reliable/valid across all ethnic and gender groups
CAGE - answer-Cut down on drinking
-Annoyed by people criticizing your drinking
-Guilty about drinking
-Eye opener about drinking (like hungover)
DAST - answera bunch of yes or no questions asking about drug use in the past 12
months
Referral to Treatment (SBIRT)
What is SBIRT? - answerits a comprehensive, integrated, public health approach to the
delivery of early intervention and treatment services for people with substance use
disorders and those at-risk of developing them
What does SBIRT mean? - answer-Screening
-Brief Intervention
-Referral to Treatment
Screening - answerprocedure to evaluate probability of a person having a substance
use disorder or being at risk for negative consequences due to use of alcohol/drugs
Brief intervention - answer-any time-limited effort to provide: info or advice, increase
motivation to avoid substance use, or teach behavior change skills to reduce substance
use and chances of negative consequences
-typically delivered to persons at low to moderate risk
referral to treatment - answer-when screening identifies person already having
substance-related health problems or SUD needing formal diagnosis and possible
treatment referral
-referral process facilitates access to care (including brief treatment) beyond Brief
intervention
SBIRT is... - answer-based on public health principles
-designed to reduce the burden of injury, disease and disability associated with misuse
of alcohol, illicit drugs, prescription medications and tobacco
GOALS of SBIRT - answer-encourage healthcare providers to screen and provide
advice or counseling to their patients who misuse alcohol or other drugs
-to influence risky behavior patterns and reduce exposure to the negative
consequences of misuse
-improve linkages between general community health care and specialized substance
abuse providers to facilitate access to care when needed
Why is Alcohol mostly focused on in SBIRT? - answer-hystorically, SBIRT was
developed and tested with people at risk for heavy/problem drinking
Where is SBIRT being used? - answer-primary care
-community health centers
-trauma centers
, -hospital emergency rooms
-and many more places
The components of SBIRT - answer1. screening is rapid, proactive procedure to ID
people who may have or may be at risk for having an alcohol/drug problem
2. brief intervention focuses on increasing client awareness of his/her own substance
use and motivation to change
3. referral to treatment provides clients who require more extensive treatment with
access to specialty care
Who gets screened? - answer-done with EVERYONE (universal)
-no single "right way" to screen
does screening indicate whether someone is at risk or a diagnosis for a given condition?
- answer-tells if someone is at RISK for a given condition
Screening basics - answer1. introduce the screen
2. be specific in your questions
3. make sure you are speaking the same language as the patient
4. convey non-judgmental attitude throughout screen no matter what the answers are
General Screening Guidelines - answer-items should be asked in a matter-of-fact way
-if self-administered, embed items into a broader client survey
-most important: use items that are reliable and valid! (select instrument/items best
suited to your client mix)
Commonly used screeners - answer-AUDIT (alcohol)
-CAGE (alcohol and drugs)
-DAST (drugs)
-CRAFFT (alcohol and drugs)
-T-ACE/TWEAK (alcohol)
AUDIT - answer-developed by WORLD HEALTH ORG (1982)
-excellent for identifying early signs of hazardous drinking and mild dependence
-time frame: past 12 months
-92% effective in detecting hazardous/harmful drinking
-reliable/valid across all ethnic and gender groups
CAGE - answer-Cut down on drinking
-Annoyed by people criticizing your drinking
-Guilty about drinking
-Eye opener about drinking (like hungover)
DAST - answera bunch of yes or no questions asking about drug use in the past 12
months
