About SBIRT
SBIRT is a comprehensive, integrated, public health approach to delivering early intervention for individuals with risky alcohol & drug use. SBIRT provides a timely referral to more intensive substance use treatment for those with substance use disorders. Primary care centers, ERs, trauma centers, and community health settings provide opportunities for early intervention with at-risk substance users before more severe consequences occur.” (SAMSHA, 2011)
What Are We Doing?
Performing Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use in every pregnant and non-pregnant person of reproductive age.
Why are we doing SBIRT?
Drug-related deaths contribute to pregnancy associated deaths, with substance use being a preventable causal or correlating factor in maternal mortality. SBIRT for substance use needs to be done as part of your duty as a medical professional. It is the standard of care.
Where are we supposed to do this?
In all settings where a pregnant person or non-pregnant person of reproductive age seeks services.
Who can do this?
A wide variety of health care staff can perform SBIRT, including physicians, nurses, nurse practitioners, physician assistants, licensed midwives, and licensed clinical social workers.
When are we supposed to do this?
All Physicians, Advanced Practitioners and Nurses: When a pregnant or non-pregnant person of reproductive age is being seen for the first time (first contact). – or – When you first recognize a pregnancy. Additionally, on an annual basis, if you are providing continuous care for a pregnant or non-pregnant person of reproductive age.
How do I do this?
The Adopt SBIRT team at CASAT/UNR serves Nevada with expertise and key resources to assist organizations to promote, prepare, adopt, and implement SBIRT. Please complete the Online Training Readiness Form (see link above) to get started today
Websites
Adopt SBIRT
Adopt SBIRT serves Nevada with expertise and key resources to assist organizations to promote, prepare, adopt, and implement SBIRT.
Screening, Brief Intervention, and Referral to Treatment (SBIRT)
This website from SAMHSA provides information on Screening, Brief Intervention, and Referral to Treatment, which it describes as “an approach to the delivery of early intervention and treatment to people with substance use disorders and those at risk of developing these disorders.”
Tools & Resources
Adopt SBIRT
teachSBIRT Curriculum Infusion Packet (CIP)
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is designed to provide universal screening, secondary prevention (detecting risky or hazardous substance use before the onset of abuse or dependence), and early intervention and treatment within health care settings for people who have problematic or hazardous alcohol problems. Nevada’s Train, Educate, Adopt & Collaborate for Healthcare SBIRT (teachSBIRT) Curriculum Infusion Packet (CIP) is designed to provide resources for faculty in helping profession academic programs (e.g., Social Work, Counseling, Psychology and Behavioral Health) to present SBIRT to students.
The Conversation Guide for Delivering a Trauma-Informed Brief Intervention
The link between childhood trauma and substance use disorders is well-documented in the literature. This resource acknowledges that link and is intended to help healthcare providers deliver a brief intervention for substance use using a trauma-informed care approach. Whether you are well-versed in the Screening, Brief Intervention, and Referral to Treatment (SBIRT) process, or just looking for an effective way to address substance use concerns with your patients, this guide provides practical examples to facilitate that conversation. The left column provides scripts and concrete strategies to move through the brief intervention process, while the right column provides considerations to ensure trauma-informed care principles are integrated into the delivery.
Screening Tools
There are a number of screening tools available that can be self-administered via pen and paper, computer and tablet, or conducted by an interviewer. Each screening tool has pros and cons and a program should decide which screening tool is best for their agency based on population served with consideration to which substances are being used as well as state/regional billable terms for utilization of specific screening forms. Adopt SBIRT offers training and technical assistance on the use of screening assessments.
Perinatal Health Media Toolkit
To help with patient substance misuse and dependency screening and referral, two Perinatal Health Reference Guides have been developed and are available for Medical professionals to aid in this effort. To raise awareness of these resources and the use of Screening, Brief Intervention and Referral to Treatment (SBIRT), we have launched the Media Toolkit: #PerinatalHealthSBIRT
Publications
TAP 33: Systems-Level Implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT)
This guide describes core elements of screening, brief intervention, and referral to treatment (SBIRT) programs for people living with or at risk for substance use disorders. It provides information on implementing SBIRT services and covering challenges, barriers, cost, and sustainability.
Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide
“Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide” is designed to help health care professionals quickly identify youth at risk for alcohol-related problems. NIAAA developed the Guide and Pocket Guide in collaboration with a team of underage drinking researchers and clinical specialists and practicing health care professionals.
Reference Guide for Labor and Delivery Complicated By Substance Use
(Revised April 2021) Substance misuse, dependency, and substance use disorders (SUDs), including opioid use disorder (OUD), are prevalent among Nevada adult populations, including among individuals of reproductive age. Subsequently, OUD also occurs during pregnancy at an alarming rate with far reaching effects on both the parent and infant. SUD is a primary chronic disease similar to diabetes and hypertension, not a moral failure or character weakness, and should be treated as such by the medical professionals who care for pregnant patients and their infants. Currently, pregnant patients with SUD who present to Labor & Delivery (L&D) units, may receive significant variation in services. These differences include identification and treatment of SUD, identification and treatment for the infant(s), reproductive planning, and care coordination. Practice variance without the use of common generally accepted expert guidelines may potentially lead to parental and/or neonatal complications before, during, and/or after delivery. This reference guide aims to address some of these variances and provide a resource with best practices, guidelines, and protocols for medical professionals involved in the care of pregnant patients with OUD who are admitted to L&D units for delivery and their infants up until discharge.
Reference Guide for Reproductive Health Complicated by Substance Use
(Revised April 2021) Substance misuse, dependency, and substance use disorders (SUDs), including opioid use disorders (OUDs) are common among Nevada adult populations. These issues are also occurring during pregnancy at an alarming rate with far reaching effects on both mother and infant. To date, the single best strategy we have to identify and help those that want assistance is adding screening and referral to treatment, known as Screening, Brief Intervention and Referral to Treatment (SBIRT), into the clinical setting. Medical professionals are often the first line to aid in this effort. Note that this document uses the term “medical professional” to be inclusive of doctors and advanced practitioners. The intention for this guide is to provide basic directives for successfully implementing Screening, Brief Intervention and Referral to Treatment (SBIRT), into the clinical setting. SBIRT, specifically how to apply it to pregnant and non-pregnant persons of reproductive age populations.
Medication-Assisted Treatment (MAT) Services for Opioid Dependence Billing Instructions Guide
The Division of Health Care Financing and Policy has taken action to address the opioid crisis by updating Nevada Medicaid policy and opening Medication-Assisted Treatment (MAT)-related evaluation and management (E/M) codes for billing by Nevada Medicaid providers effective with dates of service on or after January 1, 2020. In addition to MAT related E/M codes, Nevada Medicaid opened Screening, Brief Intervention, Referral to Treatment (SBIRT) codes to assist providers in performing screening services to recipients at risk or struggling with Substance Use Disorder (SUD).
Posters & Infographics
Webinars & Online Learning
Overview: The purpose of this series is to provide healthcare professionals the opportunity to learn how to care for themselves and their patients during challenging times. Each session is intended to address Nevada specific CME requirements related to ethics, SBIRT, and suicide prevention.
This session topic is part of a three-part series offered in collaboration with the University of Nevada Reno School of Medicine and Nevada State Opioid Response Grant Adopt SBIRT Project. To view all session topics in this series, please click on TriplePlay! On-Demand CME Program Series: Ethics. SBIRT. Suicide Prevention.
The SBIRT for Health Professionals ECHO provides community health professionals with the training and support they need to manage substance use issues within health settings specializing in treating pregnant and non-pregnant persons of reproductive age populations using an SBIRT model. This program will include an expert specialist team and interdisciplinary clinicians and other health professionals in local Nevada communities. The series will include six weekly tele-ECHO clinics that include a didactic presentation, combined with patient case presentations and mentoring.
The Screening and Brief Intervention (SBI) for Alcohol and Opioid/Substance Use Professionals course is designed as a comprehensive evidence-based approach for facilitating conversations between patients/clients and healthcare providers in medical and community health settings regarding alcohol and opioid/substance use. The course includes a didactic component on the topics of: Substance use among adults, adolescents, and pregnant persons; Substance use and mental health; categories of substance use; SBI cost effectiveness, Screening tools; Brief Intervention; Core motivational interviewing skills; and Referral to treatment. In addition, demonstrations on how to use SBI with patients/clients for both alcohol and opioid/substance use are provided.
This brief virtual presentation will provide a guide through several Screening, Brief Intervention and Referral to Treatment (SBIRT) training and technical assistance options that are available to medical professionals licensed to practice in the state of Nevada (including physicians, nurses, nurse practitioners, physician assistants, licensed midwives and licensed clinical social workers) to learn about strategies to implement SBIRT within your healthcare or OBGYN setting.