Screening, brief intervention, and referral to treatment in medical and integrated care settings.

Abstract

H ealth care reform efforts in the United States have led to unprecedented changes and opportunities for the way that substance use is addressed in health care settings. These efforts include the integration of care for substance use and behavioral health with traditional medical care. Screening, brief intervention, and referral to treatment (SBIRT) is a model that can be used in health care settings as part of integration efforts to identify and begin to address risky substance use (Sacks et al., 2016). SBIRT seizes the opportunity to address substance use among patients as part of routine, usual medical care. Uptake of substance use screening and brief intervention (BI) is recommended by a number of organizations in the United States (e.g., Substance Abuse and Mental Health Services Administration; SAMHSA). This chapter first provides an overview of SBIRT research in primary care, emergency department (ED), and other practice settings. Second, the chapter reviews clinical considerations, practical tips, and research on implementing SBIRT. Finally, we project the future of SBIRT in medical and integrated care settings, including innovations to the model, use of technology, and areas where more research is needed.