Background: Trauma is the leading cause of years of potential life lost in the United States. Alcohol and drug use is a significant contributing factor. In 2017, a Level II community trauma center was achieving less than 80% screening rate compliance utilizing blood alcohol level as a screening method for trauma patients. The purpose of this article is to evaluate the implementation of a screening, brief intervention, and a referral-to-treatment service program. Methods: In 2018, the trauma program adopted structured interviews as a screening method for trauma patients. The injury prevention coordinator conducted structured interviews as a screening method for trauma patients who met inclusion criteria. High-risk patients were referred to the social worker, who conducted a brief evaluation with subsequent referral to treatment. Results: One year after the implementation of a structured interview approach, 1,021 trauma patients met inclusion criteria for this retrospective evaluation. From 2017 to 2018, the program observed an 86% statistically significant increase in screening using the structured interview SBIRT program (p < .0001) compared with the prior alcohol-level screening approach. Conclusions: On the basis of these data, a structured interview screening method demonstrated a significant improvement in screening compliance rates.