What is SBIRT? | How do I know SBIRT is effective? | How are other health care providers implementing SBIRT? |  Trainings? | Tools? | Resources for Parents?

 What is SBIRT?

SBIRT Factsheet – A comprehensive public health approach for delivering early intervention and treatment services to people with, or at risk of developing, substance use disorders.

SBIRT One Pager Toolkit – The NH Youth SBIRT Initiative  toolkit of one-pagers describing each component of SBIRT.

What is SBIRT? What is it for? How does it work? And with what populations? presented by Dr. Ken Winters, Ph.D., Professor, Dept. of Psychiatry, University of Minnesota Medical School

SBIRT for Pediatricians – As a component of comprehensive pediatric care, adolescents should receive appropriate guidance regarding substance use during routine clinical care. This resource addresses practitioner challenges posed by the spectrum of pediatric substance use and presents an algorithm-based approach to augment the pediatrician’s confidence and abilities related to substance use screening, brief intervention, and referral to treatment in the primary care setting.

An Overview of the Unique Elements of Adolescent Substance Misuse and the Principles of Treatment – Principles of Adolescent Substance Use Disorder Treatment, focuses exclusively on the unique realities of adolescent substance use—which includes abuse of illicit and prescription drugs, alcohol, and tobacco—and the special treatment needs for people aged 12 to 17. This guide, published by the National Institute on Drug Abuse (NIDA),  includes an overview of elements of addiction specifically for adolescents, principles of treatment, frequently asked questions, treatment centers, and several different evidence based approaches to treatment.

Updated policy statement and guidance from American Academy of Pediatrics (AAP) – In a pair of reports, the AAP has reaffirmed its recommendation to incorporate universal screening, brief intervention, and referral to treatment (SBIRT) practices for adolescent substance use into routine health care.  A revised policy statement has been simplified from a 2011 statement, and a new clinical report contains updated guidance, including screening tools and intervention procedures. (AAP News, 6/20)

 How do I know SBIRT is effective?

A Provider Call to Action – Learn more on why multiple sectors in the state of Wisconsin are advocating for this effective strategy.

Practice SBIRT-Understanding the Magnitude of the Problem – A review of literature for the 12- to 17-year-old population regarding alcohol and drug use, adolescent brain maturation, specific adolescent risk considerations, and results of a national survey regarding the frequency and methodology of providing SBIRT for this population.

Integrating Screening, Brief Intervention, and Referral to Treatment (SBIRT) into Clinical Practice Settings: A Brief Review – A study of SBIRT’s development and summary findings regarding the utilization of SBIRT across settings. The Review includes medical settings, emergency departments, primary care, employee assistance and special consideration of studies of SBIRT with children and adolescents.

Binge Drinking – A Clinical Report published by the American Academy of Pediatrics in September 2015 highlighting Screening and Brief Intervention as universal preventive intervention that should be adopted by pediatricians.

SBIRT for Adolescents – A two and a half hour video presentation by Dr. Sharon Levy on the adolescent brain and why SBIRT is an effective strategy for this target population.

SAMHSA National Survey – Substance Abuse and Mental Health Services Administration’s (SAMHSA) latest (2015) National Survey on Drug Use and Health (NSDUH) report shows less underage drinking and smoking, but overall substance use and mental illness levels remain constant. The report shows that there continues to be a significant treatment gap for mental and substance use disorders.

How are other health care providers implementing SBIRT?

A Quick Start Guide to Behavioral Health Integration for Safety-Net Primary Care Providers – A SAMHSA infographic on decision-making and assessment of an organization’s readiness for behavioral health integration.

Assessing Substance Use in Primary Care – A publication by SAMHSA-HRSA Center for Integrated Health Solutions designed to help providers learn how interdisciplinary teams can build capacity to address substance use in primary care settings.

The Power of Best Practices – Launching SBIRT in a Community Health Center – A publication to cultivate an appreciation for the opportunities and challenges that community health centers face in adopting the practice known as SBIRT (Screening, Brief Intervention and Referral to Treatment).

Integrating Substance Use Treatment Into Adolescent Health Care – Substance use (SU) problems are common among adolescents, a serious health risk for them and a major public health problem, but are inadequately addressed in most pediatric health care settings. Primary care offers an excellent context for SU assessment and treatment for adolescents and their families, offering better access and a less stigmatized environment for receiving treatment than specialty programs. This document examines the literature on the integration of substance use treatment with adolescent health care, focusing on 2 areas: Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Emergency Departments and Primary Care, and School- and College-Based Health Centers.

Integrating SBIRT into Clinical Practice Settings – Screening, brief intervention, and referral to treatment (SBIRT) is a public health approach to the delivery of early intervention and treatment services for individuals at risk of developing substance use disorders (SUDs) and those who have already developed these disorders. SBIRT can be flexibly applied; therefore, it can be delivered in many clinical care settings. SBIRT has been adapted for use in hospital emergency settings, primary care centers, office- and clinic-based practices, and other community settings, providing opportunities for early intervention with at-risk substance users before more severe consequences occur. In addition, SBIRT interventions can include the provision of brief treatment for those with less severe SUDs and referrals to specialized substance abuse treatment programs for those with more severe SUDs. Screening large numbers of individuals presents an opportunity to engage those who are in need of treatment. However, additional research is needed to determine how best to implement SBIRT.

Paving the Road to Change: Advancing quality interventions for adolescents who use, abuse or are dependent upon alcohol and other drugs – A discussion of the individual and community consequences that stem from untreated adolescent alcohol and other drug use, and what can be done to fix the treatment system for adolescents struggling with substance misuse.

Learning Brief: Lessons From Cross-Site Implementation of SBIRT for Adolescents – The experience in Baltimore, MD, represents an approach that local jurisdictions can learn from and adapt to successfully integrate SBIRT into a continuum of care to address the public health crisis of substance misuse.

What trainings are available?

SBIRT Learning Opportunities available through the Center for Excellence: workshops, technical assistance, additional resources.

IRETA ATTC Trainings – The Institute for Research, Education, and Training in Addictions (IRETA) provides free training programs on the components of SBIRT.

Talking about binge drinking: Guidance for pediatricians – A new clinical report from the American Academy of Pediatrics lays out the case for preventing adolescent binge drinking, then provides clear recommendations for pediatricians. For starters: “it is very important to start talking to children about the dangers of drinking as early as 9 years of age.

SBIRT Core Training – This training center has several online programs that cover the core components of SBIRT, as well as specific strategies, such as Motivational Interviewing.  CME/CE

Introduction to SBIRT for Adolescents by Dr. Sharon Levy, Boston Children’s Hospital  – The purpose of this course is to enhance the knowledge of SBIRT that is necessary so practitioners have the skills to identify and address the needs of young individuals who are using alcohol or other drugs (AOD) in a risky manner. CME/CE

IRETA (Institute for Research, Training, and Education in Addictions): SBIRT for Adolescents – This presentation will 1) review the impact of substance use on the developing brain with particular focus on alcohol and marijuana; 2) review the use of validated screening tools for adolescent substance use and present a brief motivational intervention strategy targeted at reducing substance use by high risk adolescents.

Adolescent and Adult SBIRT Resources and Training – This adolescent and adult SBIRT resource list provides links to self-paced webinars and courses as well as materials to download.

What tools are available?

Moving Upstream: Addressing Youth Substance Use – Learn more about preventing youth substance use by addressing risk factors and enhancing protective factors from the Conrad N. Hilton Foundation.

8 Things Your Primary Care Provider Should Know About Working with People with Substance Use Disorders – IRETA compiled a list of eight considerations primary care providers should consider while caring for patients with substance use disorders.

Screening and Brief Intervention Tool Kit for College and University Campuses – in an effort to reduce impaired driving due to alcohol misuse, the National Highway Traffic Safety Administration published this toolkit for college campuses to implement screening and brief intervention to reduce drinking and subsequent impaired impaired driving behaviors among problem drinkers.

Partnership for Drug Free Kids – the iconic ‘This is Your Brain on Drugs’ ad has been re-imagined to encourage parents to discuss drugs and alcohol with their kids. Tips for starting the discussion can be found on the “Be Ready with Answers” page and the “Parent Toolkit“, which includes a Drug Guide for Parents, a Grandparent’s Guide, Guide on How to Prevent Drug Use at Every Age and Tips for Dads on Talking to your Teens.

Follow-Up Materials: presentation slides from Kerri Coleman (Keystone Hall): NH Statewide Addiction Crisis Line; as well as slides from Christin D’Ovidio (Community Health Institute): QuitWorks

Free SBIRT Toolkit  – IRETA provides tools and resources for practitioners and organizations on general SBIRT topics as well as adolescent-specific materials.

Identifying and Responding to Substance Use Among Adolescents and Young Adults: A Compendium of Resources for Medical Practice – Prepared by The National Center for Physician Training in Addiction Medicine, this compendium is a comprehensive toolkit with resources for practitioners treating adolescents and young adults.  Available resources begin with Screening tools and follow through Referral to Treatment guidance, and also include resources for other important components of care.

SBIRT One-pager Toolkit – The NH Youth SBIRT Initiative  toolkit of one-pagers describing each component of SBIRT.

SBIRT Deep Dive – Working with Youth – presented by Ken Winters, Ph.D., Professor, Dept. of Psychiatry, University of Minnesota Medical School

Brief Intervention Utilizing Motivational Interviewing Techniques – presented by Catherine Ulrich Milliken, MSW, LICSW, MLADC, LCS, ICADC, ICCS, Program Director for The Dartmouth Hitchcock Medical Center Addiction Treatment Program

Resource Guide for Addiction and Mental Health Care Consumers – Developed by UNH and New Futures, the Resource Guide for Addiction and Mental Health Care Consumers: Answering Questions About Addiction and Mental Health Care Coverage, is part of a statewide educational effort to help consumers learn how to access health insurance and use their coverage to pay for necessary treatment. The guide is designed to help individuals and families in the state access addiction and mental health care services.

Understanding Adolescent Inhalant Use – This report provides insights into adolescent use of inhalants; about 684,000 adolescents aged 12-17 used inhalants in the past year in 2015.

 Resources for Parents

Legalizing Marijuana Not Good for Kids: AAP Policy Explained – The American Academy of Pediatrics (AAP) believes that youth should not use marijuana, this article explains why.

Marijuana: What Parents Need to Know – Marijuana is often portrayed as harmless, but it can be an addictive drug, especially for teens, that can cause serious risk and consequences. Parents are a child’s first and best protection against drug abuse. This article provides information from the American Academy of Pediatrics (AAP) about marijuana and how parents can help their child say “No” to drug use.

Teen Safe – This online course and video provides parents resources and strategies around substance misuse to help keep their children safe and healthy.

Drug Free New Hampshire – This website provides a wide range of informative resources and guides for families and teenagers.

Presentations from 3rd Annual NH SBIRT Summit: S•BI•RT Works: Putting Patients at the Center – Integrating Behavioral Health and Primary Care

Opening Remarks: Tym Rourke – New Hampshire Charitable Foundation

Keynote Speaker: Dr. Richard Brown – University of Wisconsin

Stories from Early Adopters: On the Ground Perspectives of SBIRT in Primary Care: Patricia Finn – Concord Hospital; Susan Tanski – Dartmouth Hitchcock; Shawna Delworth – Weeks Medical Center

Sharing the Vision: Transforming NH’s Health Delivery System: James Vara – Governor’s Adviser on Addiction and Behavioral Health

Unique Screening Needs of Special/Vulnerable Populations: Lea Ayers LaFave – Community Health Institute; Daisy Goodman – Dartmouth Hitchcock

Utilizing Community Partners for SBIRT: Meghan Shea – Families in Transition

Getting Started with SBIRT: Martha Bradley and Shasta Jorgensen – Community Health Institute

Financial Implications of Screening and Intervening: Jeanne Ryer – NH Citizens Health Initiative and Steven Korn – Anthem, Inc; Dr. Richard Brown – University of Wisconsin

A Balancing Act: Patient Confidentiality in Integrated Care Settings: Lucy Hodder- UNH; Deborah Reid – Legal Action Center

Medication Assisted Treatment in NH: Implementation of Best Practices: Rekha Sreedhara – Community Health Institute and Dr. Peter Mason – Dartmouth Hitchcock