Screening, Brief Intervention, and Referral to Treatment (SBIRT)

What is SBIRT?

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a comprehensive integrated public health approach to the delivery of early intervention and treatment services for people with substance use disorders as well as those who are at risk for developing those disorders.

It consists of three major components:

ScreeningAssess the patient for risky substance use behaviors using a standardized screening measure (typically the AUDIT, ASSIST, or DAST).

Brief Intervention: Engage a patient showing signs of risky use in a short conversation about their use, using motivational techniques to provide feedback and enhance motivation for change.

Referral to Treatment: For those identified as possibly dependent on a substance or needing additional services, offer information on how to access treatment.

SBIRT is designed for use by providers who don’t specialize in SUD treatment and can be offered in any public health, medical, or related setting, including emergency departments, primary care physicians’ offices, community clinics, and even schools/universities. 

Is SBIRT Effective?

Addiction journalA recent study (Babor, Del Boca & Bray, 2017) of over one million people who were screened for drug and alcohol use disorders over a 5-year period evaluated the effectiveness of SBIRT in a variety of medical and community settings.

The study, funded by SAMHSA, found SBIRT to be an innovative and effective way to integrate the management of substance use disorders into primary care and general medicine. Substantial numbers of patients received recommendations for intervention or treatment, with greater intervention intensity associated with larger decreases in substance use.

Patients receiving SBIRT demonstrated significant reductions in substance use, with some caveats that raise questions about the best ways to implement SBIRT as a public health program. It was also associated with improvements in treatment system equity (the provision of care to patients varying in economic status, race/ethnicity, and setting) and efficiency, and found to be cost-effective, too.

Find more research on SBIRT in PubMed, the database for the U.S. National Library of Medicine.

Babor TF, Del Boca F, Bray JW. Screening, Brief Intervention and Referral to Treatment: Implications of SAMHSA’s SBIRT initiative for substance abuse policy and practice. Addiction 2017;112(Suppl. 2): 110-117.

Looking for SBIRT Training or Technical Assistance?

Group of studentsThe Northwest ATTC offers a range of SBIRT training and technical assistance (TA) services to health care organizations. The SBIRT services described below may be offered individually or as part of a training/TA package.

If you are interested in SBIRT training or technical assistance please contact us at

Orientation to SBIRT

This presentation, which can be delivered in either 30- or 60-minute format, offers healthcare providers and/or management:

  • a quick review of the 3 basic components of SBIRT (Screening, Brief Intervention, and Referral to Treatment)
  • rationale and evidence for delivering SBIRT in healthcare settings,
  • video demonstration of SBIRT within the clinic workflow,
  • a general introduction to the four steps of the brief intervention, and
  • discussion of key implementation steps.

This presentation is appropriate for clinic leadership staff who may be considering full implementation of SBIRT or as a general staff introduction to SBIRT.

SBIRT Basic Training

doctorsThis 4-hour basic SBIRT training is designed to provide potential SBIRT providers and billers (primary care, emergency department, and behavioral health) with an overview of the background and rationale for SBIRT, along with the details for providing screening, brief interventions, and referral to treatment. The training consists of four modules:

  • SBIRT Overview & Rationale – reviews SBIRT’s key components, evidence base, goals, and the target population for services
  • Screening – reviews the pre-screen questions, full screens (AUDIT/DAST), screening protocols, clinic workflow examples, and matching interventions to the three levels of risk
  • Delivering a Brief Intervention – presents the four-step Brief Negotiated Interview model and provides participants with demonstrations and opportunities to engage in role-play.
  • Referral to Treatment & SBIRT Billing – reviews the key steps for making an effective referral for individuals at high risk of having a substance use disorder. SBIRT billing requirements are discussed along with important steps for implementation.
  • Meets the 4-hour training requirement for certification from the WA State Health Care Authority to submit billing for SBIRT and provide or supervise individuals providing SBIRT services. 


SBIRT for Medical Assistants

Medical assistants (MAs) often play a key role in delivering the screening components of SBIRT. This training provides them with an overview of the SBIRT process and rationale. The primary focus is on helping MAs develop the necessary skills to effectively deliver the pre-screens and full screens to patients. This training can be customized for the clinic setting and ranges from 30-60 minutes.

SBIRT Technical Assistance for Implementation

Training is just one component of implementing the SBIRT process. The NWATTC provides intensive technical assistance (TA) to clinics, emergency departments, and mental health organizations to assist them in developing SBIRT implementation. The TA provides a model for building staff buy-in of the SBIRT process, developing an effective clinic flow, integrating SBIRT into the clinic’s EMR system, training the key personnel to deliver their respective parts of the SBIRT process, and tracking data to measure the success of implementation.  

If you are interested in SBIRT training or technical assistance please contact us at


Additional SBIRT Resources

Online Training

  • healtheknowledge logoScreening, Brief Intervention, and Referral to Treatment in Washington State
    Developed by the previous Northwest ATTC, the Washington State Dept. of Health, and the UW’s Alcohol & Drug Abuse Institute, this free, 6-module online training on the HealtheKnowledge site introduces learners to SBIRT and takes them through all 3 of its components. Meets the 4-hour training requirement for certification from the WA State Health Care Authority to submit billing for SBIRT and provide or supervise individuals providing SBIRT services. CME/CEU may be available from some licensing/credentialing entities (includes a certificate of completion).

    o    Find more SBIRT trainings on the HealtheKnowledge site
  • Substance Use in Adults and Adolescents: Screening, Brief Intervention and Referral to Treatment (SBIRT) 
    Funded by SAMHSA, this 2 hour online training addresses the basic principles of SBIRT, including how to code and receive reimbursement for SBIRT delivery. It is intended for primary care physicians, pediatricians, psychiatrists, emergency physicians, dentists, chiropractors, social workers, nurses, nurse practitioners, and physician assistants. 1.75 AMA PRA Category 1 credits available (as well as contact hours for other providers).

Other Resources

  • SBIRT: Screening, Brief Intervention, and Referral to Treatment 
    SAMHSA-HRSA Center for Integrated Health Solutions’ SBIRT page links to a wide range of resources related to SBIRT, including training and implementation materials, webinars, apps for implementation support, literature reviews, and more.
  • SBIRT Toolkit 
    This Institute for Research, Education, & Training in Addictions (IRETA) toolkit is designed for practitioners and organizations who are using (or considering the use of) SBIRT in a variety of settings. Includes brochures for clients, and resources to assist with implementation and delivery of SBIRT to adults and adolescents.
  • ATTC National Center on Screening, Brief Intervention & Referral to Treatment 
    Though this center is no longer receiving funding, the website continues to offer a number of useful resources, including the National Registry of SBIRT Trainers, webinars, training-of-trainers curricula, case studies, and more.
  • Find all ATTC-developed resources on SBIRT 
    Includes brochures, web sites, online courses, curricula, videos, and more.
  • SBIRT Oregon 
    This site from Oregon Health & Science University (OHSU) offers clinical tools for implementing SBIRT, along with several video demonstrations of Brief Interventions. It also provides copies of the DAST and AUDIT screening tools in multiple languages.
    This University of Missouri-Kansas City site includes demonstrations of brief interventions and offers clinical tools for delivering SBIRT services.