The acronym SBIRT stands for Screening, Brief Intervention, and Referral to Treatment. This integrated public health framework addresses substance use across a spectrum of severity. SBIRT aims to identify individuals whose alcohol or drug use is risky or problematic and reduce associated negative health and social consequences. By integrating these services into general healthcare, the model catches issues early and offers timely support before a severe substance use disorder develops.
Deconstructing the Acronym
The first component, Screening, is a rapid, universal procedure to assess a person’s substance use severity and associated risks. It is not a diagnostic tool but determines if a patient needs further assistance. Brief Intervention is a short, structured conversation with individuals identified as being at moderate risk for substance-related issues. This session focuses on helping the patient become more aware of their usage patterns and potential for harm. The final component, Referral to Treatment, is reserved for individuals who screen as high-risk or dependent and require specialized, intensive care.
Identifying Risk Through Screening
The screening process typically takes place in general medical settings, such as primary care offices, emergency departments, and community health centers. Standardized, validated tools ensure accuracy and consistency. For example, the Alcohol Use Disorders Identification Test (AUDIT) is a 10-question tool for alcohol risk, while the Drug Abuse Screening Test (DAST) assesses drug use.
The results of these brief screens determine a patient’s risk stratification, placing them into low, moderate, or high-risk categories. Low-risk patients may only receive positive reinforcement for their healthy choices. The classification of risk dictates the appropriate next steps in the SBIRT model, ensuring resources are matched to the patient’s level of need.
Core Elements of Brief Intervention
The Brief Intervention (BI) is for moderate-risk patients who do not meet the criteria for a substance use disorder. This focused, one-on-one session typically lasts between 5 and 15 minutes and is conducted by a trained healthcare professional. The core of the BI uses the principles of Motivational Interviewing (MI), a collaborative, person-centered counseling style.
The provider avoids confrontation and works with the patient to explore ambivalence about changing their substance use behavior. The session aims to increase the patient’s insight into the connection between their substance use and potential health consequences. The goal is to enhance the patient’s internal motivation and collaboratively set small, achievable goals for reducing their use.
Pathways for Referral to Treatment
Referral to Treatment (RT) is for patients who display indicators of high-risk use or dependency. This connects individuals needing a higher level of care with specialized services outside of the general medical setting. A central concept is the “warm handoff,” where the provider actively facilitates the patient’s transition to a treatment specialist.
A warm handoff involves the provider making a direct, in-person or virtual introduction to a behavioral health specialist or treatment facility while the patient is still in the clinic. This active connection reduces barriers and increases the likelihood that the patient will follow through with specialty care. Specialized treatment settings include outpatient programs, intensive outpatient programs, and inpatient rehabilitation facilities.