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Screening, Brief Intervention, and Referral to Treatment (SBIRT)

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach to screen patients for substance use disorders, provide a brief intervention and referral to service as necessary, and provide follow-up with the patient. It is a model for intervening at all stages of substance use disorders from identifying the needs of the patient to connecting them to treatment. SBIRT consists of three major components:

  • Screening: Healthcare providers use standardized, validated tools to assess patients for risky behaviors associated with substance use disorders
  • Brief Intervention: Healthcare providers engage patients in a short conversation about hazardous substance use, offering advice and answering questions
  • Referral to Treatment: Healthcare providers refer patients to treatment as necessary

Benefits of SBIRT are that this model screens for all types of substance use disorders, can be used in a variety of healthcare settings, and is effective in early identification of substance use disorders, particularly alcohol use.

Examples of Screening, Brief Intervention, and Referral to Treatment

  • The Southwest Montana Community Health Center in Butte, Montana, has provided training in motivational interviewing for all staff and provides SBIRT and cognitive behavioral therapy as part of its substance use disorders screening and treatment program.
  • The West Virginia Screening, Brief Intervention, Referral and Treatment Project (WVSBIRT) is a collaboration between mental health centers, primary care clinics, trauma centers, and school based health clinics. The project was created to train providers on how to use SBIRT to provide early intervention for individuals at risk of substance use disorders. WVSBIRT has developed the project with consideration for Appalachia's unique culture, values, and behaviors.

Considerations for Implementation

SBIRT does not require extensive education or training and can be implemented by a variety of healthcare providers, including nurses, social workers, and health educators. SBIRT can be applied throughout the continuum of care and for a variety of patient populations.

While SBIRT is recommended for alcohol use disorder, there is little evidence on its effectiveness for other substance use disorders. However, early studies suggest promising outcomes for substance use disorders related to marijuana, cocaine, heroin, opioids, and some stimulants.

SBIRT has been adapted to use electronic devices such as computers and mobile devices to deliver screening and a brief intervention known as e-SBI (electronic screening and brief intervention). e-SBI is recommended by The Community Guide and the U.S. Preventive Services Task Force as an effective method for preventing excessive alcohol consumption.

Program Clearinghouse Example

Resources to Learn More

The BIG Initiative
Offers trainings, webinars, technical assistance, and information on SBIRT best practices.
Organization(s): NORC at the University of Chicago, National SBIRT Addiction Technology Transfer Center Network (N SBIRT ATTC)

This app, designed for primary care providers, mental health clinicians, and other healthcare providers, guides the provider through the steps of completing the SBIRT assessment and intervention.
Organization(s): Baylor College of Medicine

SBIRT Toolkit
A toolkit containing clinical resources, billing and reimbursement information, sample collaborative agreements, and patient handouts.
Organization: West Virginia Screening, Brief Intervention, Referral and Treatment Project

Systems-Level Implementation of Screening, Brief Intervention, and Referral to Treatment
A comprehensive manual providing background information on SBIRT, with information on implementing and sustaining SBIRT. Includes case studies on two SAMHSA SBIRT grantees.
Organization(s): Substance Abuse and Mental Health Services Administration
Date: 2013