Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice used in healthcare settings to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs.

SBIRT: A Model for Addiction Prevention in Healthcare

SBIRT1 stands for Screening, Brief Intervention, and Referral to Treatment. The model encourages mental health and substance abuse screenings as a routine preventive service in healthcare.

SBIRT can identify and help people who:

  • Do not yet have problems with substance abuse, but are likely to develop them
  • Are demonstrating high-risk behaviors but do not believe they need treatment
  • Are medically diagnosed with the disease of addiction and need clinical assistance in obtaining treatment
  • Have a family member with an addiction, and are otherwise forced to depend on the justice system as their primary gateway to getting help for their loved one

The four steps to SBIRT are designed for use in medical settings such as clinics, hospital wards, emergency rooms, and other health care sites.

Step 1: Screening

Healthcare providers initiate an evidence-based questionnaire to identify a patient’s placement on a spectrum of substance abuse use, ranging from risky, to problematic, to the disease of addiction. The screening yields a numerical score reflecting the severity of abuse and guides the level of intervention. In some cases, screening alone can raise awareness, reduce use, and have preventive effects.

Step 2: Brief Intervention

People displaying mild symptoms receive a 15–30-minute intervention. They’re given their screening score, discuss their risks and motivations, and establish goals and strategies to reduce use. The brief intervention is shown to significantly reduce substance use.

Step 3: Brief Treatment

People who score in the moderate-to-severe range of the substance abuse spectrum are given brief treatment through several counseling sessions—a less costly alternative to formal substance abuse treatment centers.

Step 4: Referral to Treatment

People diagnosed with the disease of addiction, or with complicated psychiatric symptoms, are referred to specialty treatment right away.

Is SBIRT effective?

Very. The National Commission on Prevention Priorities ranked the top 25 prevention measures for highest impact, based on if the service were to be delivered to all people in the largest population of those affected. Screening and Brief Intervention for alcohol ranked in the second highest category (earning a score of 9 out of 10), after only childhood immunizations, smoking cessation counseling, and daily aspirin use to prevent cardiovascular disease.

The potential for addiction prevention in healthcare cannot be underestimated.

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1. Madras, Bertha K. 2009. Mental Health Screening and Substance Abuse Screening Should Be Expressly Included as a Routine Preventive Service in Health Care.