SBIRT Rationale


SBIRT is an integrated public health intervention that provides universal screening for substance use, detects risky or hazardous substance use that may lead to abuse or dependence, and offers early intervention and timely referral and treatment for people who have substance use disorders. Often substance use interventions happen after an individual is diagnosed as having a severe substance use disorder. SBIRT widens the focus from individuals with severe substance use disorders to include individuals who may be at risk of negative social and health consequences as a result of their substance use.


Providing SBIRT in a healthcare setting can:


  • Decrease the number of alcohol related emergency department visits and repeat hospitalizations
  • Reduce physical, emotional, legal, financial, family, and professional consequences of substance use
  • Improve service coordination for persons with substance use disorders
  • Decrease the number of alcohol related injuries and deaths


Who Endorses SBIRT?


The White House Office of National Drug Control Policy, 2012 National Drug Control Strategy


"Screening, Brief Intervention, and Referral to Treatment services continue to reach more Americans in the health care system, and more patients in health centers across the Nation were provided access to substance disorder treatment services."



Affordable Care Act


After September 10, 2010, new health insurance plans were required to cover alcohol misuse screening and counseling for adults. SBIRT is a Medicaid billable service in Washington State as of January 1, 2014.



United States Preventive Services Task Force


"The USPSTF recommends that clinicians screen adults aged 18 years or older for alcohol misuse and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse."



Centers for Medicare and Medicaid Services (CMS)


From the Decision Memo for Screening and Behavioral Counseling Interventions in Primary Care: CMS has determined there is adequate evidence to conclude that adult screening and behavioral counseling to reduce alcohol misuse in primary care settings is reasonable and necessary for the prevention or early detection of illness or disability. CMS will cover annual alcohol screening and, for those that screen positive, up to four brief, face-to-face interventions per year for Medicare beneficiaries.