SBIRT Steps
SBIRT is an evidence-based, cost-effective public health approach that identifies and provides early intervention to adults and adolescents at risk of developing substance use and other behavioral health disorders. The SBIRT model uses validated screening instruments and interventions that have been proven effective.
Maryland SBIRT encourages the use of SBIRT services during routine medical visits in primary care clinics, community-based settings and hospitals.
Screening
for risky alcohol or drug use includes asking questions of all patients to identify those who may misuse alcohol or drugs, or are at risk for developing a problem. There are a number of validated screening instruments that will identify patients with risky levels of alcohol and substance use. Maryland SBIRT primarily uses AUDIT-C and NIDA Quick Screen for adults and CRAFFT for adolescents. You should decide which tool works best in your setting.
Screening Tools:
Tools commonly used in Maryland are the following:
- AUDIT-C is a three-question alcohol screen that can help identify adult patients who are hazardous drinkers or have active alcohol use disorders.
- CRAFFT Screen is a nine-question clinical assessment tool to screen for substance-related risks in adolescents.
- NIDA Quick Screen guides providers through a series of questions to identify risky substance use in their adult patients.
Brief Intervention
is a short conversation between patient and health care provider about the patient’s screening results, information on safe use and next steps. Brief Interventions are motivation-enhancing discussions focused on increasing insight and awareness of substance use disorders, and decreasing or discontinuing unhealthy alcohol and substance use. The ultimate goal of a brief intervention is to negotiate a plan to change behavior and assist the patient in accessing treatment if needed. About 15 percent of those screened require a brief intervention; those interventions typically take 5 to 15 minutes.
Brief Intervention Tools:
Referral to Treatment
is provided for patients who have moderate- to high-risk alcohol or drug misuse and who wish to receive further assessment and/or treatment – on average, about 5 percent of those screened. There are a range of different treatments that are appropriate for different uses and should be matched to specific behaviors and health issues.