-small-thumbnail.jpg?v=1731071636)
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a healthcare tool that was developed to help identify and address at-risk individuals with signs of unhealthy drug and alcohol use. It can be implemented in any clinical setting and with any age group to help prevent issues and improve health.
- SBIRT includes screening, brief interventions, and treatment referrals for people with risky drug or alcohol use.
- SBIRT can help prevent harmful substance use behaviors from developing into severe issues and can improve access to treatment for those with more severe substance use issues.
- SBIRT can be an effective tool for people with substance and alcohol use issues, and research into its effectiveness continues to grow.
.jpg?v=1736508127)
What is SBIRT?
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a tool used by clinicians to help identify harmful and risky substance use behaviors and implement brief treatment interventions. [1]
SBIRT can be utilized in any setting, including hospitals, psychiatric care, and community centers, and is administered by trained professionals. It can be used with people of any age, including children, adolescents, and adults, in order to highlight risky behaviors or at-risk individuals. [2]
SBIRT helps people access necessary treatment, including those who require higher-level care. It can identify risky levels of any drug or alcohol use and highlight specific treatment or referral needs. Interventions can then be implemented to help identify goals, increase motivation to reduce and stop substance use, and improve overall health. [3]
SBIRT began being implemented as a public health approach in the 1980s, along with the development of effective screening tests, such as CAGE and DAST. [2] The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that between 2021 and 2023, the SBIRT program was utilized by over 450,000 people. [1]
Benefits of SBIRT: Why use it?
SBIRT can benefit individuals by: [1][2][3]
- Helping to identify risky substance use behaviors
- Implementing evidence-based treatments
- Improving access to care and appropriate referrals
- Improving overall health
- Reducing the need for more intensive interventions to address severe substance use issues
SBIRT and its impact on substance use prevention
Utilizing SBIRT programs can help prevent people with at-risk substance use behaviors from developing severe substance use issues. They can help identify people who are at high risk and provide early intervention strategies and referrals to reduce alcohol and substance use before it worsens, improving awareness and understanding of the potential harms of substance use and the available support and treatment options. [3][4]
Since the development of SBIRT, substantial research has been conducted that indicates the effectiveness of SBIRT in reducing alcohol and tobacco use. [2] Its impact on other substance use continues to be investigated, and current research is limited. However, growing research indicates that SBIRT can help reduce drug use and improve abstinence maintenance. [2][3]
The components of SBIRT
SBIRT includes screening, brief interventions, and referral to services.
Screening
First, the individual is screened to determine whether a drug or alcohol use issue is present and to what degree. Different types of screening tools can be used, depending on the age of the individual and the type of substance used. Specific screening tools can be used for adolescents, older adults, or pregnant women.
This process might involve pre-screening, aiming to ascertain whether a full screen is necessary. Pre-screening is very brief, typically including a short version of commonly used screening tools, such as the AUDIT-C or DAST-1. The question(s) asked at this stage inquire about the occurrence of any drug or alcohol use within the last 12 months. [5]
If this initial pre-screen is positive, a full screen should be administered using a screening tool that asks more in-depth questions to gather more details about drug or alcohol use, such as: [4]
- AUDIT: The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item questionnaire developed by the World Health Organization (WHO) to identify risky alcohol use.
- DAST-10: The Drug Abuse Screening Test (DAST) is a 28-item test, with a shorter 10-item version, the DAST-10, that helps identify risky drug use behaviors not including alcohol use.
Screening tools specific to adolescents include: [2][5]
- CRAFFT: The CRAFFT (Car, Relax, Alone, Friends, Forget, Trouble) is a drug and alcohol use screening tool for people aged 12-21, and it is recommended by the American Academy of Pediatrics.
- NIAAA Alcohol Screening for Youth: The National Institute of Alcohol Abuse and Alcoholism (NIAAA) Alcohol Screening for Youth is a two-item test designed to identify risky alcohol use in people aged 9-18.
Brief interventions
Following screening, if risky drug or alcohol use behaviors have been identified, brief interventions can be implemented by the primary care provider or other clinical professional who is in contact with the individual. This might include motivational interviewing or behavioral counseling. [3]
These interventions can educate about and increase awareness of the harms and consequences of risky substance use, provide advice about stopping use, and give motivation or encouragement to change addictive behaviors. Clinicians can provide a brief session to teach coping mechanisms and information about altering harmful behaviors. [2][4]
Referrals
People who have been identified as having moderate or severe substance use issues or co-occurring mental health issues will be referred to appropriate services to receive more intensive treatments. This might include specialized service providers, such as rehabilitation facilities, detoxification support, or mental health care.
These referrals can help individuals access care they may not otherwise have access to, facilitating the implementation of appropriate intervention. [1]
Challenges and limitations of SBIRT
Some of the challenges and limitations of SBIRT can include: [2][3][4]
- It may be less effective in certain populations, such as those who are homeless.
- Evidence for its use in reducing risky drug use is limited, although research is increasing.
- It is difficult to provide numerous brief interventions for people screened for multiple conditions due to resource limitations.
- Staff members require suitable training to implement effective screenings and interventions.
