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Running head: SBIRT

SBIRT
Salena Barnes
Georgia College and State University

Running head: SBIRT

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SBIRT

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a comprehensive and


integrated approach to early detection, intervention, and treatment services through universal
screening for individuals with substance use disorders and those at risk (Substance Abuse and
Mental Health Services Administration, 2014). SBIRT is used in a variety of settings including
primary care centers, community health centers, emergency departments, and trauma centers in
an attempt to modify behaviors and prevent more severe consequences for at-risk users. The
screening tool assesses the severity of abuse and identifies and establishes an appropriate level of
treatment. The brief intervertion assists the user recognizing the issues associated with their
substance use and aids in motivating them towards a change in their behavior. Lastly, a referral
for specialty care is identified and recommended for those with more extensive substance use
issues (Substance Abuse and Mental Health Services Administration, 2014). Use of this
screening tool is an important part of primary care and essential for nurse practioners to becomre
proficient at utilizing.
A randomized, controlled trial of SBIRT for drinking among at-risk and dependent
drinkers was conducted in an emergency department (ED) in Sosnowiec, Poland (Cherpitel,
Moskalewicz, Swiatkiewicz, Ye, & Bond, 2010). All participants were 18 years and older, not
currently being treated for alcohol related problems, and signed informed consent to be randomly
placed in a group using a two-stage process. Over a 23-week period, from 4:00 pm to midnight,
data were collected. Exactly 446 patients were recruited into the study (90% of those who
screened positive) and randomized to three conditions following a two-stage process: screened
only (n= 147), assessed (n= 152), and received intervention (n= 147). Subjects in the assessment
(85%) and intervention (83%) conditions were blindly reassessed at 3 months by phone

Running head: SBIRT

interview. Those in the assessment and intervention groups were contacted by an interviewer
(blind to group assignment) via telephone and reassessed at 3 months (Cherpitel et al., 2010).
Participants randomized to the intervention condition received a brief motivational
intervention by a nurse (trained in SBIRT, using the Brief Negotiated Interview) (Cherpitel et al.,
2010). The intervention took about 15-20 minutes to complete and combined the principles of
motivational interviewing and readiness to change with specific action, builds on self-efficacy,
and uses the patient's existing strengths and resources to enable and maintain positive behavior
change. Subjects randomized to the assessment group received were assessed based on the
following: estimated BAC, reason for the ED visit, readiness for and stage of change, risk
taking/impulsivity and sensation-seeking dispositions, and other factors (Cherpitel et al., 2010).
Results indicate that both assessment and intervention conditions showed significant
decreases in at-risk drinking, average drinking days per week, drinks per drinking day, maximum
drinks per occasion, and negative consequences of drinking (Cherpitel et al., 2010). No
differences were noted between the two conditions at the 3-month follow-up. However, some
positive outcome were found in the subgroup analysis of the intervention and secondary
measures (Cherpitel et al., 2010).
The results of this study suggest the importance of utilizing SBIRT in all settings as the
opportunity arises. Therefore, as a nurse practioner, it is imperative to be skilled when using this
screening tool with all patients in order to identify those at-risk or in need of specialized
treatment. SBIRT provides clinicians with the opportunity to identify, reduce and prevent
problematic use, abuse, as well as dependance on alcohol and illicit drugs.

References

Running head: SBIRT

Cherpitel, C. J., Moskalewicz, J., Swiatkiewicz, G., Ye, Y., & Bond, J. (2010). Screening, brief
intervention, and referral to treatment (SBIRT) in a polish emergency department: Threemonth outcomes of a randomized, controlled clinical trial. Journal of Studies on Alcohol
and Drugs, 70(6), 982-990.
Substance Abuse and Mental Health Services Administration, S. (2014). About screening, brief
intervention, and referral to treatment (SBIRT). from http://www.samhsa.gov/sbirt/about