SBIRT information

What is SBIRT?

Screening, Brief Intervention and Referral to Treatment (SBIRT) is a comprehensive, integrated, public
health approach for early identification and intervention with patients whose patterns of alcohol and/or
drug use put their health at risk.

SBIRT components are:

  • Universal, annual Screening (S) identifies unhealthy use. 75-85% of patients will screen negative. For those who screen positive, further assessment is needed to determine level of risk.
  • Brief Intervention (BI) provides feedback about unhealthy substance use. It also focuses on education, increasing patient insight and awareness about risks related to unhealthy substance use, and enhances motivation toward healthy behavioral change.
  • Referral to Treatment (RT) helps facilitate access to addiction assessment and treatment. A referral is usually indicated for only about 5% of people screened.

Research shows SBIRT to be most effective with patients with unhealthy alcohol or drug use who do not have a substance use disorder.

Breakdown of how many people require screening, referral and treatment

Why is SBIRT important?

Unhealthy alcohol and other drug use are among the most common causes of preventable morbidity and mortality. Despite their frequent presentation in healthcare settings, unhealthy alcohol and other drug use often go unrecognized. While there is substantial research on the effectiveness of SBIRT on alcohol use, there is less research on the impact of SBIRT on other drug use.

Unhealthy substance use can complicate existing chronic conditions like diabetes, hypertension, cardiovascular diseases or mental health disorders and interact with prescribed medications.

Research has shown that large numbers of people whose patterns of use put them at-risk of developing alcohol or drug problems can be identified through screening (Babor, Substance Abuse 2007).

SBIRT has been found to:

  • Decrease the frequency and severity of drug and alcohol use 
  • Decrease emergency department visits and hospital days
  • Demonstrate net-cost savings

The U.S. Preventive Services Task Force (USPSTF) recommends screening and behavioral counseling interventions to reduce alcohol misuse by adults, including pregnant women, in primary care settings. The National Quality Forum (NQF) endorses outpatient annual alcohol screening and recommends a systematic approach be used to identify drug use. The Joint Commission currently has optional quality standards that require unhealthy substance use identification and management in inpatient settings.

What is unhealthy alcohol or drug use?

Chart of range of riskSubstance use (alcohol and drug) occurs on a continuum from no or low risk use to substance use disorders. Effective interventions are available for people at all points on that continuum. In most cases, unhealthy substance use issues can, and should, be addressed in general healthcare settings.

Unhealthy substance use is an all-encompassing term that includes the full spectrum of unhealthy use from:

  • Risky use (i.e., consumption of amounts that increase the likelihood of health consequences)
  • Substance use disorders (i.e., abuse and dependence)

Some people should not drink at all.