People with mental health and substance abuse problems remain untreated for a variety of reasons. A major reason is being undiagnosed. But early identification through routine screenings within primary and other healthcare settings can lead to early intervention. Screening and brief intervention in primary care can promote significant reductions in alcohol and substance use. Additionally, other physical health, emotional, and interpersonal problems associated with substance abuse can also be addressed once identified.
There are hundreds of screening instruments available to aid clinicians and others in identifying patients with alcohol and substance abuse problems. Indian Health Service recommends the following tools for alcohol screening:
- Alcohol Use Disorders Identification Test (AUDIT)
- Alcohol Use Disorders Identification Test - C (AUDIT-C)
- CRAFFT (for children and youth under 21 years old)
- CAGE (a four-item assessment test)
Various screening tools are available on the Substance Abuse and Mental Health Services Administration (SAMHSA) – Health Resources and Services Administration (HRSA) Center for Integrated Health Solutions screening tools webpage.
The National Institute of Health's National Institute on Drug Abuse (NIDA) lists tools and links to these tools designed to be used with adults and youth on their Evidence-Based Screening Tools for Adults and Adolescents page.
Screening, Brief Intervention, and Referral to Treatment
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice used to identify, reduce, and prevent problematic alcohol and illicit drug use, abuse, and dependence. SBIRT is intended to meet the public health goal of reducing the harms and societal costs associated with risky use by reducing diseases, accidents, and injuries. SBIRT screens for all levels of substance use, not just dependency. Each unique part of the SBIRT process provides individualized information and assistance tailored to meet the patient’s needs.
SBIRT consists of 3 major components:
- Screening — a healthcare professional in any healthcare setting assesses a patient for risky substance use behaviors using standardized screening tools.
- Brief Intervention — a healthcare professional talks with a patient showing risky substance use behaviors in a brief conversation, providing feedback and recommendations.
- Referral to Treatment — a healthcare professional provides a referral to brief therapy or additional treatment to patients whose screens indicate the need for additional services.
Additional information can be found on the Substance Abuse and Mental Health Services Administration (SAMHSA)–Health Resources and Services Administration (HRSA) Center for Integrated Health Solutions SBIRT webpage.
SBIRT training and other resources can be located on the SAMHSA–HRSA Center for Integrated Health Solutions' SBIRT Training and Other Resources webpage .
Reimbursement for SBIRT
Reimbursement for SBIRT is available through commercial insurance, Medicare, and Medicaid. SAMHSA provides information about reimbursement for SBIRT on Coding for Screening and Brief Intervention Reimbursement.