Screening, Brief Intervention, and Referral to Treatment (SBIRT)
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach for intervening at all stages of substance use disorder (SUD), 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 SUD
- Brief Intervention: Healthcare providers engage patients in a short conversation about harmful substance use, offering advice and answering questions
- Referral to Treatment: Healthcare providers refer patients to treatment as necessary
SBIRT offers many benefits to providers. The model screens for multiple types of SUD, can be used in a variety of healthcare settings, and is effective in early identification of SUD, particularly alcohol use disorder.
Examples of Rural Screening, Brief Intervention, and Referral to Treatment
- The Southwest Montana Community Health Center in Butte, Montana provides SBIRT and cognitive behavioral therapy as part of its SUD 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. It 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.
SBIRT is recommended for alcohol use disorder. There is little evidence on its effectiveness for other substance use disorders. However, early studies suggest that SBIRT has promising outcomes for people with SUDs involving marijuana, cocaine, heroin, opioids, and some stimulants.
SBIRT has been adapted for use with electronic devices such as computers and mobile devices for an intervention called e-SBI (electronic screening and brief intervention), which 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
Guides primary care providers, mental health clinicians, and other healthcare providers through the steps of completing the SBIRT assessment and intervention.
Organization(s): Baylor College of Medicine
Provides clinical resources, billing and reimbursement information, sample collaborative agreements, and patient handouts.
Organization: West Virginia Screening, Brief Intervention, Referral and Treatment Project
Screening, Brief Intervention, and Referral to Treatment
Provides information about using SBIRT and other resources. Includes information on coding for reimbursement and identifies SAMHSA funded grantees.
Organization(s): Substance Abuse and Mental Health Services Administration (SAMHSA)
Systems-Level Implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT)
Discusses the principal components of screening, brief intervention, and referral to treatment (SBIRT) programs for people living with or at risk for SUD. Offers information on the implementation, challenges, barriers, cost, and sustainability of SBIRT services, and includes two SAMHSA grantee case studies.
Organization(s): Substance Abuse and Mental Health Services Administration