The first component of the SBIRT process is screening, which provides a quick and simple method of identifying patients who use substances at at-risk levels, as well as those who are already experiencing substance use-related issues. The typical screening process involves the use of a brief one-three question prescreen, such as the National Institute on Alcohol Abuse and Alcoholism’s (NIAAA) 3 Question Screen or the National Institute on Drug Abuse’s (NIDA) quick screen. If a person screens positive on one of these screening instruments, they would then be given a longer alcohol or drug use screening such as the AUDIT or the ASSIST. The screens usually assess patient self-reported information about substance use, and any health care professional can easily score the results.
CIHS compiled the below resources, include screening examples, that could be used to implement SBIRT, as well as manuals and guidelines on how to utilize some of the screenings.
The World Health Organization’s Alcohol Use Disorders Identification Test (AUDIT) Manual guides AUDIT use in primary care.
The World Health Organization’s Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) guides ASSIST use in primary care.
Adolescent Screening, Brief Intervention, and Referral to Treatment for Alcohol and Other Drug Use: Using the CRAFFT Screening Tool provides adolescent primary care providers the resources needed to efficiently incorporate CRAFFT, brief advice, and referrals for further evaluation and treatment for alcohol and other drug use into routine adolescent visits.
NIDA’s Screening for Drug Use in General Medical Settings Resource Guide provides clinicians serving adult populations in general medical settings with the screening tools and procedures necessary to conduct screening, brief intervention, and/or treatment referral for patients who may have or may be at risk of developing a substance use disorder.
AlcoholScreening.org, a free service of Join Together, helps individuals self-assess their own alcohol consumption patterns to determine if their drinking may be harmful to their health or increasing their risk for future harm. Through education and referral, the site urges individuals whose drinking is harmful or hazardous to take positive action, and informs all adults who drink alcohol about guidelines and caveats for healthier drinking.
The CAGE Questionnaire, developed by Bowles Center for Alcohol Studies Founding Director Dr. John Ewing, is an assessment instrument used by primary caregivers to identify people with alcohol-related problems.
The CRAFFT Screening Interview is a behavioral health screening tool designed for children under the age of 21. Recommended by the American Academy of Pediatrics' Committee on Substance Abuse for use with adolescents, the screening tool consists of a series of six questions intended to identify adolescents who may have simultaneous risky alcohol and other drug use disorders. It is a short, effective tool meant to assess whether a longer conversation about the context of use, frequency, and other risks and consequences of alcohol and other drug use is warranted.
NIAAA 3 Question Screen is a three-question screen developed by NIAAA to assess problem alcohol use.
ASSIST obtains information from patients about lifetime use of substances, as well as current substances use associated problems over the last 3 months. It can identify a range of problems associated with substance use, including acute intoxication, regular use, dependent or ‘high risk’ use, and injecting behavior.
AUDIT is a simple method of screening for excessive drinking and brief assessment. It can help identify excessive drinking as the cause of a presenting illness. It also provides a framework for intervention to help drinkers reduce or cease alcohol consumption and thereby avoid the harmful consequences of their drinking.
Michigan Alcoholism Screening Test (MAST) is a quick and accurate screen designed to assess problems with alcohol use.
The Drug Abuse Screening Test (DAST) has served as a successful screening instrument for abuse of drugs and alcohol since its development in 1982. DAST is a 28-item self-report scale that consists of items that parallel those of the Michigan Alcoholism Screening Test (MAST).
The Wisconsin Initiative to Promote Healthy Lifestyles’ (WIPHL) Sample Behavioral Health Screen assesses a patients’ drug and alcohol use, as well as screens for depression and exposure to domestic violence.
Global Assessment of Individual Needs Short Screen (GAIN-SS) was created by Chestnut Behavioral Health to screening a general population and quickly and accurately identifies clients who may have one or more behavioral health disorders.
The Patient Health Questionnaire (PQ-9) is the nine-item depression scale of the Patient Health Questionnaire. The PHQ-9 is a powerful tool for assisting primary care clinicians in diagnosing depression as well as selecting and monitoring treatment.