SBIRT Training: Screening, Brief Intervention, and Referral for Treatment for Substance Use Disorder

Upon completion of this course, participants will be able to:

1. Explain the SBIRT model, the epidemiology and spectrum of unhealthy substance use, and the rationale for universal screening and early intervention in general healthcare settings.

2. Administer validated, age-appropriate screening tools to triage patients across the continuum of low, moderate, and high-risk use.

3. Deliver a structured brief intervention grounded in motivational interviewing to elicit change talk and support behavior change.

4. Coordinate referral to treatment, including medications for opioid and alcohol use disorder and harm-reduction resources, while addressing common barriers to treatment linkage.

5. Integrate ethical, legal, and culturally responsive, stigma-reducing practices into longitudinal, patient-centered care that treats the whole person (body, mind, and social context) and supports each patient's capacity for change.

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based public health approach for identifying and responding to the full spectrum of unhealthy substance use in everyday practice. It is designed for interprofessional clinicians in general healthcare settings, including primary care, emergency departments, pharmacies, and dental practices. These clinicians are often the first, and sometimes the only, point of contact for patients whose substance use would otherwise go undetected. The course follows the model step by step. It covers the rationale for universal screening and the evidence-based, validated screening tools across age groups; the brief intervention, grounded in motivational interviewing; referral to treatment, including medications for opioid and alcohol use disorder and harm-reduction resources; implementation across settings and special populations; and the ethical and legal dimensions of the work, including confidentiality and stigma-reducing, person-first communication. For physicians and physician assistants specifically, the content maps to core clinical responsibilities, including diagnostic assessment, treatment planning, prescribing of medications for opioid and alcohol use disorder by a practitioner with appropriate DEA authority under applicable state law, naloxone co-prescribing, referral and care coordination, and documentation under federal substance use confidentiality rules, in keeping with USPSTF recommendations for screening and brief counseling in routine adult care (US Preventive Services Task Force, 2018, 2020; Substance Abuse and Mental Health Services Administration, n.d.).

Educational Need

Unhealthy substance use is common, costly, and frequently missed in general healthcare settings, where it often presents without an obvious complaint. Drug overdose is the leading cause of death among U.S. adults aged 18 to 44, and a substantial treatment gap persists, with only a minority of people with opioid use disorder receiving the medications that are the most effective tool for preventing overdose death. National bodies recommend routine screening and brief counseling for unhealthy alcohol use and, where treatment can be offered or referred, for unhealthy drug use, yet screening is applied inconsistently, brief intervention is underused, and linkage to treatment, the step where most patients are lost, remains the weakest link in the chain. Generalist and frontline clinicians are positioned to close much of this gap, but many report limited training and confidence in screening, intervening, and connecting patients to care. This activity addresses that need by equipping clinicians with a practical, evidence-based framework they can apply within the routines of everyday practice.