Addiction Medicine Updates






Screening, Brief Intervention and Referral to Treatment (SBIRT)

SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons with substance use disorders, as well as those who are at risk of developing these disorders. Primary care centers, hospital emergency rooms, trauma centers, and other community settings provide opportunities for early intervention with at-risk substance users before more severe consequences occur.

SBIRT is broadly recommended by multiple federal agencies, the U.S. Preventive Services Task Force (USPSTF), and all of the primary care physician groups. In fact, the National Commission on Prevention Priorities ranked SBIRT among its top five priorities, ahead of 20 other effective services including colorectal cancer screening, hypertension screening and treatment, and influenza immunization. (Solberg et al 2008)

SBIRT has been implemented in North Carolina in a variety of medical settings including family medicine and internal medicine clinics, pediatric offices, emergency departments, and inpatient hospital units. Other SBIRT projects have included community and school based settings. SBIRT NC, a statewide resource for information, resources, and coordination, is a joint effort of the Governor’s Institute (GI), the NC Division of Mental Health, Development Disabilities, and Substance Abuse Services (DMHDDSAS), SAMHSA/CSAT, the NC Center of Excellence for Integrated Care, and Community Care of North Carolina. The GI’s SBIRT activities are funded by the Centers for Substance Abuse Treatment, under the Substance Abuse and Mental Health Services Administration.

Video Demonstrations

SBIRT NC Overview
Watch a brief demonstration of the SBIRT NC Model.
Marie is a 54 year old female in for a follow up visit related to her hypertension. She also presented 6 months ago with a fractured arm from a fall. Marie’s drinking scores place her in the harmful category of substance use.
Michael is a 30 year old male presenting with the chief complaints of insomnia and “feeling anxious”. Michael’s drinking scores fall into the risky category of substance use.

PowerPoint Slide Modules

Module 1
A brief introduction to SBIRT including prevalence, clinical concepts, method, effectiveness, and barriers.
Module 2
The basics for successful screening in SBIRT.  This module provides guidance on the screening process and how to use the SBIRT NC recommended screening tools (annual screen, AUDIT, and DAST).
Module 3
Guidance for conducting a successful brief intervention using a motivational Interviewing oriented approach and the FRAMES Model.  Resources and case examples are also given.

Clinical Tools

Annual Questionnaire
One question addresses alcohol use. (Checking “1 or more” constitutes a positive screen).One question addresses drug use. (Checking “1 or more” constitutes a positive screen).

Drug Screening Questionnaires
The DAST-10 (Drug Abuse Screen Test) is a 10-item, yes/no self-report instrument that should take less than 8 minutes to complete.

Alcohol Screening Questionnaires
AUDIT (Alcohol Use Disorders Identification Test) is a 10-item questionnaire that screens for hazardous or harmful alcohol consumption.

K6 Screen for Co-occuring Disorders
The Kessler 6 (K6) is a standardized and validated measure of non-specific psychological distress.

The Patient Health Questionnaire
(PHQ-9) is the most common screening tool to identify depression.

Brief Intervention (BI) Pocket Card
This pocket-sized card assists clinicians with performing brief interventions.


Making a Referral

Locate your Local Management Entity-Managed Care Organizations (LME-MCOs) and other Substance Abuse resources in your community below.

For contact information on each LME-MCO, click below:

Call the Alcohol & Drug Council of North Carolina’s 24/7 Referral Line at 1-800-688-4232.

Find additional resources with the SAMHSA Behavioral Health Treatment Services Locator.