According to the chapter, what are the key components of Screening, Brief Intervention, and Referral to Treatment (SBIRT) as a public health approach to managing substance abuse?

SBIRT stands for screening, brief intervention, and referral to treatment. Screening uses validated tools to identify patients at risk for substance-related harm. Brief intervention is a short, practical conversation, often using motivational interviewing, to encourage cutting back. Referral to treatment is used when patients need more intensive help, such as those at risk for withdrawal or with daily illicit drug use.

The chapter describes SBIRT as a public health approach recommended by SAMHSA for primary care offices, emergency departments, and trauma centers. The first key component is screening, which should rely on validated and reliable instruments, such as the AUDIT-C for alcohol and a single-question drug screen, to identify patients whose substance use places them at risk for negative consequences. The second component is brief intervention, a quick intervention delivered in the clinical setting that gives practical, meaningful advice to reduce risky substance use; effective delivery often incorporates motivational interviewing techniques. The third component is referral to treatment for patients who need more than brief advice, including those at risk for alcohol withdrawal or who use illicit drugs daily, connecting them to substance use specialists or treatment services. The chapter's case example also illustrates implementation features such as embedding validated screening tools in electronic health records, using clinical decision support, and providing toolkits stratified by risk level to support clinicians.