SBIRT: Screening, Brief Intervention & Referral to Treatment

Screening, Brief Intervention and Referral to Treatment (SBIRT) is an evidence-based approach to identify individuals who use alcohol and other drugs (substances) at risky levels. SBIRT has been shown to be valid and reliable in identifying and improving outcomes for people who use substances.  The goal of SBIRT is to prevent or reduce use of substances to prevent related health consequences, disease, accidents and injuries through an early intervention approach.   

SBIRT can be utilized by many types of staff in a variety of settings.  SBIRT uses a universal screening approach and intends to screen all people in a particular group (clinic, school, community center, etc). SBIRT incorporates screening for all types of substance use with brief interventions designed to  guide participants in a conversation to identify goals and values, increase motivation to address problematic substance use, and set goals for improving health.  Individuals who need a higher level of care can be identified and referred to specialty supports and services as needed.

Why use SBIRT? 

• Identify risky or potentially risky patterns of substance use in a population
• Provide evidence-based interventions for people who may otherwise not access care. 
• Connect people to resources, services, and supports
• Prevent disease, accidents, and injuries.
• Improve the health of individuals, families, and communities
• Reduce costly healthcare utilization.
• SBIRT is a billable service

Screening quickly assesses the severity of substance use and identifies the appropriate level of treatment. The following approved screening tools include tools developed for the general population as well as tools that have been developed and validated for specific populations: adolescents, older adults, and pregnant persons.

• Pre-screening Tools
• Full Screening Tools
  • Adult Screening Tools
  • Adolescent Screening
  • Older Adult Screening
  • Pregnant Person Screening

A pre-screen, also known as a brief screen, is defined by SAMHSA as "a rapid, proactive procedure to identify individuals who may have a condition or be at risk for a condition before obvious manifestations occur." It involves short questions relating to alcohol and drug use and can be administered prior to beginning a full screening. Many SBIRT providers ask individuals the pre-screening questions first and then ask the full screening questions if the pre-screen is positive.

Common Pre-screening Tools:

• AUDIT-C - consists of three questions related to drinking frequency and quantity. The higher the score, the more likely alcohol is affecting the individual’s health and safety.  Audit-C questions are a subset of the full 10-question Audit | AUDIT-C in Spanish | Full 10-question Audit in Spanish
   
• DAST 1: The DAST-1 refers to the first question of the DAST-10. It asks: "In the last 12 months, have you used drugs other than those required for medical reasons?" Positive responses should be followed up with the full DAST-10 also available in Spanish.
   
• NIAAA Single Alcohol Screening Question (SASQ): “How many times in the past year have you had (4 for women, or 5 for men) or more drinks in a day?”  Responses of one or more should be followed by full screen.
   
• NIDA Single Question Screening Test for Drug Use: “How many times in the past year have you used an illegal drug or used a prescription medication for non-medical reasons (for example, because of the experience or feeling it caused)?” Responses of one or more should be followed up by full screen.
   
• Substance Use Brief Screen (SUBS): “How many times in the past year have you used a recreational drug or used a prescription medication for non-medical reasons?” Responses of one or more should be followed by full screen.
   

Full screening tools are administered after an individual has screened positive on a pre-screen or may be administered alone. Full screening tools ask a validated series of questions that assess the severity of an individual's substance use. Depending on the tool being used, full screens can be administered as written self-reports, or as part of a verbal interview.

Included are tools developed for the general adult population as well as tools that have been developed and validated for specific populations: adolescents, older adults, and pregnant persons.

Adult Screening Tools

Adolescent Screening Tools

Older Adult Screening Tools

Pregnant Person Screening Tools

In classroom:

• SBIRT Training Providers can be found using the Training Catalog.
  • Those seeking an in-person 4-hour or 12-hour training should contact the trainer nearest them to set up training sessions.

Online:

• SBIRT Training Program offered by University of Missouri Kansas City 
  • 3.5 hours SBIRT for Healthcare Professionals (self-paced course)
  • 0.5 hours SBIRT Putting it All Together (self-paced course)
  • Meets 4 hour SBIRT training requirement for SBIRT Medicaid billing (https://www.health.ny.gov/health_care/medicaid/program/update/2016/2016-04.htm#sbirt)
  • Available free of charge with course registration
  • Approved for OASAS credentialing hours