Screening, Brief Intervention, and Referral to Treatment: Evaluation of a National Implementation
Evidence has been lacking to support routine screening, brief intervention, and referral to treat-ment (SBIRT) for illicit drug use in medical practice. The authors of this study sought to evaluate the impact of the Center for Substance Abuse Treatment’s 2003 implementation of large-scale SBIRT initiatives in 6 states. Settings were diverse and included trauma centers, emergency departments, primary and specialty care sites, and hospitals. All patients (N=459,599) were screened for substance use, 23% of whom screened positive for risky or problematic alcohol or drug use in the prior 30 days. Of these, 52% reported using alcohol, and 55% reported using illicit drugs (categories were not mutually exclusive). Based on the severity of their disorder, 70% of patients who screened positive were recommended for brief intervention (BI), 14% were recommended for brief treatment (BT), and 16% received a referral to specialty treatment (RT). Protocols for each treatment varied across sites. Ten percent of patients who screened positive were randomly selected for reassessment 6 months later.
- Self-reported rates of heavy alcohol use and illicit drug use had decreased by 39% and 68%, respectively.
- Self-reported rates of overall and mental health, employment, housing status, and criminality among persons receiving BT or RT improved significantly.