- People who use alcohol and other drugs can benefit from universal screenings.
- Screening is the first step for prevention and serves as a powerful education tool.
- Research proves that screening within a healthcare setting can motivate people to make changes in substance use.
- The benefit of SBIRT extends beyond people who use alcohol or other drugs--–to the person’s family and employer, to law enforcement and to the healthcare industry.
- Current treatment resources address only dependent users, for whom treatment is more expensive.
- For every $100 spent on substance use problems in Colorado, only $0.06 is spent on treatment or prevention. This is less than two percent of the average spent on abuse problems in other states.
The HealthTeamWorks Alcohol and Substance Use Guideline details the SBIRT process outlined below.
Prescreen: Universal prescreening for alcohol and other drug use is incorporated into the routine in healthcare settings and identifies people with risky substance use.
Screen: For those with a positive prescreen, further screening identifies the appropriate level of intervention required. Screening can be through interview and self-report using validated screening tools such as the AUDIT, DAST, ASSIST for adults and CRAFFT for adolescents.
Brief Intervention: Provided when a screening indicates moderate risk. A BI utilizes Motivational Interviewing techniques focused on raising a person’s awareness of his or her substance use and its consequences, and motivating the toward positive behavioral change. Successful BI encompasses support of the client’s empowerment to make changes. A typical BI takes 5-15 minutes to conduct. Approximately 15.9% of those screened require Brief Intervention.*
Brief Interventions work in two ways: (1) to educate people at low risk about moderate drinking limits, and health risks if limits are exceeded; and (2) to encourage those at risk of health and other consequences to think differently about their use and make changes to improve their health.
Brief Therapy: After a screening result of moderate to high risk (approximately 3.2% of those screened*), a referral to Brief Therapy is recommended. Much like Brief Intervention, this involves motivational discussion and client empowerment. Brief Therapy is more comprehensive and includes assessment, education, problem solving, coping mechanisms and building a supportive social environment, all centered around client goals. Typical Brief Therapy consists of four to six sessions with each session treated as if it could be the last. Brief Therapy encourages a shift in thinking for therapists, engaging clients in the development and implementation of their therapy. Clients are viewed as the experts on their own lives and are encouraged to identify their goals, while the therapist helps them achieve those goals by looking at solutions that innately build on clients’ skills.
Referral to Treatment: Following a screening result of high risk (around 3.7% of those screened*), a referral to treatment is provided. This is a proactive process that facilitates access to specialty care for those requiring more extensive assessment than the healthcare provider offers.
SBIRT process flow chart