SBIRT Basics


Ask about alcohol and drug use using validated screening questions.  For patients who have unhealthy substance use, assess for severity and consequences.  MASBIRT TTA recommends two approaches to screening:

Standard Approach (usually used when instruments are incorporated into the EMR)

  • Ask: AUDIT-C & Single-item drug screen
  • Assess: AUDIT and DAST-10

Quick Approach (usually used when relying on memory)

  • Ask: Single-item alcohol & drug screens
  • Assess: CAGE-AID 

Alternative Approach (usually used when instruments are self administered on paper)

  • Ask: Single-item alcohol & drug screens
  • Assess: AUDIT and DAST-10

The goal of screening is to determine which patients require further interaction around unhealthy substance use.  The use of validated questions makes screening more standardized, removes judgment, and helps the service to feel like part of routine care.

Brief Intervention

Brief Intervention is a short conversation that explores the patient's motivation to change.  The goal is to elicit change talk from the patient and build motivation to take action.

The basic components to Brief Intervention include:

  • Ask pros and cons of substance use
  • Provide feedback
  • Establish a goal
  • Summarize the interaction

See the BNI-ART, Institute Algorithm for more information.

Referral to Treatment

If a patient is interested in exploring substance abuse treatment options, refer to the Massachusetts Substance Abuse Information and Education Helpline at or call 800-327-5050.  The Helpline provides free and confidential information and referrals for alcohol and other drug abuse problems and related concerns.