SBIRT

Question 1

Accidents/Injuries are considered the ___ leading cause of death in the U.S.

Answer 1

4th

Question 2

Potentially preventable deaths from unintentional injuries (increased/decreased) 23% from 2010 to 2014.

Answer 2

increased, largely due to deaths from drug poisoning and falls

Question 3

In the “unintentional injury” category of leading causes of death, are accidents or opioid overdoses more common?

Answer 3

now, opioid overdoses (due to recent opioid epidemic)

Question 4

What is the 3rd leading preventable cause of death in the U.S.?

Answer 4

alcohol use

Question 5

Opioid overdose deaths were ___ times higher in 2016 than 1999.

Answer 5

5

Question 6

What are the top 3 leading causes of PREVENTABLE deaths in the U.S.?

Answer 6

1. Smoking
2. Obesity
3. Alcohol

Question 7

What does SBIRT stand for?

Answer 7

Screening, Brief Intervention, & Referral to Treatment

Question 8

What is the main goal of SBRIT?

Answer 8

to identify and effectively intervene with those who are at moderate or high risk for psychosocial or healthcare problems related to their substance use

Question 9

Are brief interventions more effective for those with more or less severe problems?

Answer 9

less severe

Question 10

True or false: SBIRT is a highly flexible intervention.

Answer 10

True! SBIRT settings are very diverse and include all ages/populations.

Question 11

What is binge drinking for men vs. women?

Answer 11

5 drinks in 2 hrs for men; 4 drinks in 2 hrs for women

Question 12

Which Rx drugs are we mainly concerned with regarding prescription drug misuse?

Answer 12

opioids, benzos, stimulants, sleep aids

Question 13

What are some of the symptoms of opioid intoxication vs. withdrawal?

Answer 13

• intoxication: pinpoint pupils, respiratory depression, confusion, nausea/vomiting, loss of consciousness, respiratory arrest
• withdrawal: diarrhea, sweating, body aches, headaches, runny nose, sneezing, tearing, abdominal cramping

Question 14

Which receptors in the brain do opioids act on, and where are these receptors found?

Answer 14

KOP, DOP, and MOP; found in brain, brainstem, spinal cord, and peripheral neurons

Question 15

What is the NODA quick screen used for?

Answer 15

to pre-screen for problems related to alcohol, tobacco, Rx drugs, and illicit drugs

Question 16

What are brief, validated pre-screening tools?

Answer 16

NIAAA Single-Question Screen, US AUDIT, NIDA Single-Question Screen, TAPS

Question 17

A positive alcohol screen is considered a _____ drinker.

Answer 17

at-risk

Question 18

Which zone do most patients score in on the US AUDIT?

Answer 18

Zone 1: Low Risk
(no further action is needed other than reminding the patient of low-risk drinking limits and affirming them for staying within those limits)

Question 19

What are the 4 zones that US AUDIT scores fall into?

Answer 19

I: Low Risk Use (0-6/7)
II: At-Risk Use (7/8-15)
III: Harmful Use (16-19)
IV: Dependent Use (20+)

Question 20

What is the DAST-10 questionnaire used for?

Answer 20

drug abuse pre-screening

Question 21

What is the scoring for DAST-10?

Answer 21

0: no problems reported
0-2: low level of problems related to drug abuse
3-5: moderate leve
6-8: substantial level

Question 22

What are some key points for screening for alcohol and drug use?

Answer 22

• screen everyone
• screen for both alcohol AND drug use (include Rx drugs and tobacco)
• use a validated tool
• demonstrate nonjudgmental, empathetic verbal and nonverbal behaviors
• explore each substance

Question 23

How long does a typical brief intervention with motivational interviewing take?

Answer 23

5-15 minutes

Question 24

What are the principles of motivational interviewing?

Answer 24

• Roll with resistance
• Express empathy
• Develop discrepancy
• Support self-efficacy

Question 25

What are the key steps in the brief negotiated interview?

Answer 25

1) Build rapport (raise subject while asking for permission, explore pros/cons of use)
2) Provide feedback (ask permission, give info, and elicit reactions)
3) Build readiness to change
4) Negotiate a plan for change (plan for reducing use to low-risk levels OR agreement to follow up w/ specialty treatment services)