SBIRT

Question 1

What does SBIRT stand for?

Answer 1

Screening, Brief Intervention, and Referral to Treatment

Question 2

SBIRT definition

Answer 2

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

Question 3

goal of SBIRT

Answer 3

–reduce and prevent related health consequences, disease, accidents, and injuries
–reduces costs and healthcare utilization

Question 4

Screening

Answer 4

assessing the severity of substance use and identifies the appropriate level of treatment in the healthcare setting

Question 5

Brief Intervention

Answer 5

focus on increasing insight and awareness regarding substance use and motivation toward behavioral change

Question 6

Referral to Treatment

Answer 6

providing those identified as needing more extensive treatment with access to specialty care

Question 7

AUDIT

Answer 7

The Alcohol Use Disorder Identification Test

Question 8

additional screening tools for SUD

Answer 8

–AUDIT
–CRAFFT (adolescents)
–CAGE
–CAGE-AID (alcohol and drugs)
–T-ACE

Question 9

T-ACE

Answer 9

Tolerance, Annoyance, Cut down, Eye Opener

Question 10

steps included in Brief Negotiated Interview

Answer 10

(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

Question 11

CRAFFT High score metric

Answer 11

use in past 12 months and CRAFFT score > or equal to 2

Question 12

steps of SBIRT

Answer 12

–raise subject
–provide feedback
–enhance motivation
–negotiate plan

Question 13

Raise the Subject

Answer 13

build rapport and ask permission to discuss alcohol use and complete a screening

Question 14

Explore Pros and Cons

Answer 14

discuss patient’s view of “good things” and “not so good things” about their drinking

Question 15

Elicit-Provide-Elicit

Answer 15

Elicit: ask permission
Provide: give information about issue
Elicit: asking for patient’s thoughts on info you just shared

Question 16

examples of risky drinking

Answer 16

–pregnant
–driving
–taking certain meds
–having certain medical conditions
–in recovery from addiction or if you cannot control drinking

Question 17

positive scores for risky drinking

Answer 17

–more than or equal to 3 for women and over 65
–more than or equal to 4 for men

Question 18

hazardous drinking

Answer 18

pattern that increases risk for adverse consequences

Question 19

harmful drinking

Answer 19

negative consequences have already occurred

Question 20

RANGE

Answer 20

–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

Question 21

principles of motivational interviewing

Answer 21

–express empathy
–developing discrepancy
–avoid argument
–roll with resistance
–support self efficacy

Question 22

OARS

Answer 22

–Open ended questions
–Affirmation
–Reflective Listening
–Summarizing

Question 23

High Risk Alcohol Consumption thresholds

Answer 23

–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

Question 24

effects of alcoholism

Answer 24

–heart disease
–liver disease
–amnesia
–sexual problems
–death
–accident
–police arrest
–quarrel
–homelessness

Question 25

outpatient counseling

Answer 25

–individual or group treatment provided weekly or at other intervals
–may include motivational and cognitive behavioral methods

Question 26

acute treatment services (medical detox)

Answer 26

–for patients requiring medical intervention to manage withdrawal from alcohol/drugs
–length of stay ~ 4-7 days followed by transition to outpatient counseling

Question 27

clinical stabilization services

Answer 27

–medical detox is complete and no medical supervision is required
–intense residential counseling of 7-10 days