WHAT IS BI, BT AND RT?

  • Brief intervention (BI) - Is provided when a screening indicates moderate risk. Brief intervention utilizes motivational interviewing techniques focused on raising patients’ awareness of substance use and its consequences and motivating them toward positive behavioral change.
  • Brief therapy (BT) - Continues motivational discussion for persons needing more than a brief intervention. Brief therapy is more comprehensive and includes further assessment, education, problem solving, coping mechanisms, and building a supportive social environment.
  • Referral to treatment (RT) - Provides a referral to specialty care for persons deemed to be at high risk.

Read more about BI, BT and RT here


SCREENING PROCESS & COMMUNICATION TECHNIQUES

Planning and Implementing Screening and Brief Intervention for Risky Alcohol Use is designed to help an individual or small planning team adapt alcohol SBI to the unique operational realities of their primary care practice. It takes them through each of the steps required to plan, implement, and continually improve this preventive service as a routine element of standard practice. Rather than prescribing what the alcohol SBI services should look like, the Guide will help you and your colleagues create the best plan for your unique situation.

How Do You Start a Conversation About Your Patient's Drug Use? provides a step by step guide on how to engage your patients in a discussion about their drug use.

Talking to Patients About Sensitive Issues explores communication techniques that decrease patient and physician anxiety and increase the accuracy and specificity of patient reporting about sensitive topics, such as substance abuse and partner violence.

The Four Motivational Interviewing Processes to use with Patients

  • Engaging - The process by which both parties establish a helpful connection and a working relationship
  • Focusing - The process by which you develop and maintain a specific direction in the conversation about change
  • Evoking - Having the person voice arguments for change – people talk themselves into changing
  • Planning – When people’s motivation reaches a threshold of readiness, the balance tips and they begin thinking and talking more about when and how to change and less about whether or why to change

Examples of Reflective Listening

Examples of Effective Motivational Interviewing

Examples of Ineffective Motivational Interviewing

Roadblocks to Communication, outlines Thomas Gordon's 12 roadblocks to communication and factors that affect effective listening

Words and Behaviors Associated with Stages of Change

Simple Fact Sheet about GPRA Data Collection

Social and Cultural Aspects of Alcohol


Marylandsbirt.org provides information about the SBIRT service, tools that providers can use to help patients assess and address alcohol and drug use, and links to other resources about alcohol and drug use disorders.

Institute for Research, Education and Training in Addictions (IRETA) SBIRT Toolkit is designed for practitioners and organizations who are using (or considering using) Screening, Brief Intervention & Referral to Treatment in a variety of settings.

Pocket Guide to Addiction Assessment and Treatment 

The Language of Recovery

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GUIDELINES FOR LOW RISK DRINKING

Guidelines for Men:                                                                   Guidelines for Women:
No more than 4 drinks in a single day                                       No more than 2 drinks in a single day
No more than 14 drinks per week                                              No more than 7 drinks per week

Standard Drink Chart


VIDEOS

Patient Testimonial

SBIRT Brief Intervention

SBIRT Overview

The Effective Physician: Motivational Interviewing Demonstration

The Ineffective Physician: Non-Motivational Approach




































SPECIAL POPULATIONS & CO-OCCURING DISORDERS

Special populations are groups who face particular risks from drinking alcohol based on personal characteristics such as age or gender. Special populations also include certain ethnic and racial minorities who can experience more negative consequences of illness generally, and who may share certain drinking patterns.

Read more from the National Institute on Alcohol Abuse and Alcoholism.

Behavioral Health Treatment Locator is an on-line source of information for persons seeking treatment facilities in the United States or U.S. Territories for substance abuse/addiction and/or mental health problems.

Drugs are a Local Phenomenon for LGBTQ Populations:  Implications for SBIRT - This free webinar examines the ways that drugs are experienced as local phenomena in the LGBTQ community, reviews methods for working with LGBTQ populations within a minority-stress model, and discusses the implications for SBIRT. These models and approaches will be presented within a general health disparities framework.

Substance Abuse Treatment Addressing the Specific Needs of Women - A resource that assists treatment providers in offering treatment to adult women with substance use disorders. Reviews gender-specific research and best practices, such as common patterns of initiation of substance use among women and specific treatment issues and strategies.

Opioid Overdose Prevention Toolkit - Free toolkit from SAMHSA that equips health care providers, communities and local governments with material to develop practices and policies to help prevent opioid-related overdoses and deaths. Updated in 2016.

Native Americans and Alcohol Use - A University of Arizona study found that Native Americans are more likely to abstain from alcohol than whites, and heavy drinking and binge drinking rates are about the same for both groups

SAMHSA pocket guide for Medication Assisted Treatment for Opioids - a new pocket guide for health professionals, Medication-Assisted Treatment of Opioid Use Disorder.
 
AIDS.gov discusses how alcohol and other drug use can play a significant role in the spread of HIV.

Real Kids are Curious About Alcohol - arms adults with facts, tools, and advice for talking with children about underage drinking and alcohol prevention. 

Medication for the Treatment of Alcohol Use Disorder: Pocket Guide provides guidance for the use of medication-assisted treatment for alcoholism and alcohol abuse in clinical practice.

Midbrain functional connectivity and ventral striatal dopamine D2-type receptors: Link to impulsivity in methamphetamine users

Marijuana Use and Pregnancy

Trends in Marijuana Use Among Pregnant Women, 2002 - 2014 

Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015

Heavy Teen Drinking Linked to Reduced Brain Volume

Prescription Pain Killers:  The Latest Threat to Child Welfare 

Alcohol’s Effects on Immunity—Increasing the Risks for Infection and Injury

Counseling Parents and Teens About Marijuana Use in the Era of Legalization of Marijuana

A Public Health Response to Opioid Use in Pregnancy

Ultra-Low-Dose Buprenorphine as a Time-Limited Treatment for Severe Suicidal Ideation: A Randomized Controlled Trial

National Safety Council - Drugs at Work:  What's it Costing Your Company?

Should Patients With Substance Use Disorders Be Prescribed Benzodiazepines?

How Drug Use Changes the Brain - and Makes Druyg Use All Too Common 

Treating Women Who are Pregnant and Parentung for Opioid Use Disorder

The Association of Prenatal Cocaine Exposure, Externalizing Behavior and Adolescent Substance Use

Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome

Predictive Validity of Outpatient Follow-up After Detoxification as a Quality Measure

Fentanyl:  A Briefing Guide for First Responders

Cumulative effects of early adolescent depression on cannabis and alcohol use disorder

Opioid Use and Opioid Use Disorder in Pregnancy

What I Tell Parents Looking to Get Their Child into Treatment

Substance Use Among Transgender Students in California Public Middle and High Schools

Addiction-ary

WEBINARS AND TRAINING

ASAM - Treatment of Opioid Use Disorder Course - Includes Waiver Qualifying Requirements
ASAM offers this eight-hour course in a blended format of half online and half live. The first four hours of the course is online and requires completion before attending the second four hours, which is offered live in person or by live webinar. The live portion of the course builds off the content delivered in the online portion.

SBIRT: A Brief Clinical Training for Adolescent Providers - 
This webinar provides clinical training on delivering the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model in adolescent settings. 

All About SBIRT for Teens - This webinar will review each of the SBIRT components in terms of resources, implementation and evidence of effectiveness.

Reducing Teen Substance Misuse: What Really Works This free webinar highlights ten indicators of the types of policy strategies that can help curb substance misuse by tweens, teens, and young adults, and provides scores for all 50 states and the District of Columbia based on these indicators.

Integrating Screening and Brief Intervention for Alcohol and Other Drugs in Behavioral Health Settings Serving College Students - This free webinar will focus on the application of cutting-edge research on integrating and applying the evidence-based practice of screening and brief intervention (SBI) for alcohol and other drugs within primary health and mental health care settings serving college student populations. 

A New Adolescent SBIRT Toolkit for Educators - Dr. Tracy McPherson of NORC at the University of Chicago will review the newly-released Adolescent SBIRT Instructor's Toolkit for Social Work, Nursing, and Other Educators. 


Motivational Interviewing CME activity
“Talking with Patients About Health Risk Behaviors” From the National Institute on Drug Abuse (NIH)

SBIRT for Health & Behavioral Health Professionals
 
- This self-paced online 4 hour course is open to the public. Created by the University of Missouri--Kansas City, this course explains the value and use of SBIRT for both medical providers and behavioral health professionals. 

The Prevalence of Prescription Opioid Misuse: Doctor Shopping, Co-ingestion, and Exposure - This FREE self-paced online course, sponsored by NIDA Notes & IRETA (National Institute on Drug Abuse and Institute for Research, Education & Training in Addictions), covers important topics in prescription opioid misuse. The three sections will introduce you to prescription opioids, the link between multiple doctors and opportunities for misuse, and the prevalence of high-risk use among adolescents (including mixing pills with other drugs).  

Matrix Intensive Outpatient Treatment for People with Stimulant Use Disorders: Counselor's Family Education Manual w/CD from SAMHSA.This is a free Comprehensive kit that provides substance abuse treatment professionals with a year-long intensive outpatient treatment model for clients with dependence on stimulant drugs such as methamphetamine and cocaine. Includes family education sessions and handouts. 

MAT Waiver Eligibility Training - Training is available for those interested in seeking their waiver to prescribe buprenorphine in the treatment of opioid addiction.

Qualify for Nurse Practitioners (NPs) and Physician Assistants (PAs) Waiver - Physician Assistants and Nurse Practitioners can now take the eight hour DATA-waiver course for treatment of opioid use disorder 

Recommendations to Consider Before Prescribing Opioids for Chronic Pain