Screening, brief intervention and referral to treatment

Background

This evidence-based public health approach delivers early intervention and treatment for individuals at risk of or already having substance use disorders. It uses validated screening tools, assesses substance use risk, shares health promotion advice, and conducts interventions to encourage reduction or referral.

The model originated from an Institute of Medicine recommendation for community-based screening. Unhealthy alcohol and drug use cause 3 million deaths yearly worldwide. SBIRT is most effective for those without a substance use disorder, aiming to reduce harms before a disorder develops.

Three major components

SBIRT has three components. Screening uses standardized tools in healthcare and school-based settings to assess risky substance use. Brief intervention involves a short conversation providing feedback and advice to patients showing risky behaviors.

Referral to treatment connects patients needing additional services to brief therapy or further treatment. The U.S. Preventative Services Task Force recommends screening for alcohol misuse in primary care, paired with brief counseling for risky drinking. Formal screening tools, distinct from simply asking about use, quickly assess severity.

Based on results, tailored feedback can influence behavior. Screening many individuals helps engage those needing treatment. Research since the 1980s led to tools like the Michigan Alcohol Screening Test, CAGE, and Drug Abuse Screening Test.