When clients appear to be struggling with substance use issues, behavioral health professionals often use a tool called Screening, Brief Intervention & Referral to Treatment (SBIRT) to help identify, reduce, and prevent problematic substance use, abuse, and dependence.
What Is SBIRT? And how can behavioral health professionals use this screening tool to help people who are at risk for substance use disorders?
Screening, Brief Intervention & Referral to Treatment (SBIRT) is a comprehensive, evidence-based public health practice for early intervention.
The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends this approach when primary care centers, emergency rooms, trauma centers, and other clinicians work with people with identified substance use disorders or with those who are at risk of developing these disorders.
SBIRT identifies, reduces, and prevents problematic substance use, abuse, and dependence by helping providers to identify problematic substance use. It assesses the risks for physical and emotional health problems, disease, injuries, poor job performance, and family and social problems. The goal of this public health approach is to help decrease the impact of substance use issues and identify the person’s willingness to address them.
The SBIRT includes three main components.
Many behavioral health professionals are involved in recovery-oriented systems of care, which involve a holistic, long-term, coordinated approach to treatment.
Addressing potential substance abuse disorders is important because of the human toll of substance abuse in our society. Substance misuse has a ripple effect on families, workplaces, communities, and health care systems.
Problems connected with substance use disorder include:
Screening does not diagnose, but it does help to determine the severity and risk of a person’s substance use. If we don’t ask, we don’t know.
The SBIRT is a chance to assess how much substance use is interfering with a person’s daily functioning and relationships. It provides valid, self-reported information that can be used for feedback. Importantly, it also gives clients a chance to reflect on their own substance use, setting the stage for the next steps. SBIRT utilizes one of the following valid screening tools.
One of the most common screening tools is called CAGE-AID. It includes just four simple questions.
The letters AID stand for “adapted to include drug use.”
Two or more yes answers on the CAGE-AID is considered clinically significant.
A person’s answers to the screening questions will determine the next steps. In almost 70% of cases, people will be identified as abstainers or low-risk drinkers. That’s an opportunity for the clinician to reinforce the positive screen and perhaps provide information about the hazards of increased substance use.
Approximately 25% of people will screen as risky drinkers (or substance users). That’s when it’s helpful to provide clients with information about the risks of substance use and help them to strategize ways to decrease consumption.
In approximately 5% of people, the screening will show alcohol dependence. Clinicians should set up a clear process for follow-up or refer them to an appropriate treatment program.
Any level of substance use is risky for adolescents. However, SBIRT is a harm reduction model and not an abstinence model.
For clinicians seeking to learn more about using SBIRT and Motivational Interviewing to address the use of drugs and alcohol, CWC’s SBIRT training offers an opportunity to explore SBIRT and incorporate the model into their practice.
It is also important to understand the ways that alcohol, nicotine, opioids, and other substances affect people’s brains and development.
These harm reduction and treatment-focused approaches can help identify and treat substance use issues before they cause further harm to our families and communities.