SBIRT Flashcards
What does SBIRT stand for?
Screening, Brief Intervention, and Referral to Treatment
SBIRT definition
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
goal of SBIRT
–reduce and prevent related health consequences, disease, accidents, and injuries
–reduces costs and healthcare utilization
Screening
assessing the severity of substance use and identifies the appropriate level of treatment in the healthcare setting
Brief Intervention
focus on increasing insight and awareness regarding substance use and motivation toward behavioral change
Referral to Treatment
providing those identified as needing more extensive treatment with access to specialty care
AUDIT
The Alcohol Use Disorder Identification Test
additional screening tools for SUD
–AUDIT
–CRAFFT (adolescents)
–CAGE
–CAGE-AID (alcohol and drugs)
–T-ACE
T-ACE
Tolerance, Annoyance, Cut down, Eye Opener
steps included in Brief Negotiated Interview
(1) build rapport and ask permission to discuss alcohol use and to do the screening
(2) patient discusses pros and cons and nurse summaries
(3) nurse provides information and patient gives feedback: Elicit, Provide, Elicit
(4) discuss and interpret the score from the screening tools (AUDIT/CRAFFT)
(5) determine the patient’s motivation to change using readiness, confidence, and importance rulers
(6) negotiate an action plan
CRAFFT High score metric
use in past 12 months and CRAFFT score > or equal to 2
steps of SBIRT
–raise subject
–provide feedback
–enhance motivation
–negotiate plan
Raise the Subject
build rapport and ask permission to discuss alcohol use and complete a screening
Explore Pros and Cons
discuss patient’s view of “good things” and “not so good things” about their drinking
Elicit-Provide-Elicit
Elicit: ask permission
Provide: give information about issue
Elicit: asking for patient’s thoughts on info you just shared
examples of risky drinking
–pregnant
–driving
–taking certain meds
–having certain medical conditions
–in recovery from addiction or if you cannot control drinking
positive scores for risky drinking
–more than or equal to 3 for women and over 65
–more than or equal to 4 for men
hazardous drinking
pattern that increases risk for adverse consequences
harmful drinking
negative consequences have already occurred
RANGE
–Range: audit scores can range from 0-40
–Ask: what do you think your score was?
–Normals: people at low risk from use of alcohol score from 0-15
–Give Score
–Elicit Reaction
principles of motivational interviewing
–express empathy
–developing discrepancy
–avoid argument
–roll with resistance
–support self efficacy
OARS
–Open ended questions
–Affirmation
–Reflective Listening
–Summarizing
High Risk Alcohol Consumption thresholds
–men (healthy): > 4 drinks on any day or > 14 drinks per week
–women (healthy and non pregnant): >3 drinks on any day or >7 drinks per week
effects of alcoholism
–heart disease
–liver disease
–amnesia
–sexual problems
–death
–accident
–police arrest
–quarrel
–homelessness
outpatient counseling
–individual or group treatment provided weekly or at other intervals
–may include motivational and cognitive behavioral methods
acute treatment services (medical detox)
–for patients requiring medical intervention to manage withdrawal from alcohol/drugs
–length of stay ~ 4-7 days followed by transition to outpatient counseling
clinical stabilization services
–medical detox is complete and no medical supervision is required
–intense residential counseling of 7-10 days
