SBIRT Approach to Substance Abuse

Shandel Douglas

Post Master PMHNP, Herzing University

NU672-7D: Counseling and Psychotherapy

Dr. Vardah Seraphin

July 31, 2022

SBIRT Approach to Substance Abuse

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The purpose of SBIRT is to provide early intervention and treatment for persons or those

at risk of substance abuse. It is a screening tool used in healthcare. Three elements comprise its

brief assessment: screening, a brief intervention, and a referral to therapy. SBIRT results in

short-term improvements in people’s health; long-term implications on population health have

not yet been shown, but simulation models imply that the advantages could be significant.

Patient description

J.R. is a 25-year-old single Caucasian male referred to the clinic by court order. The

patient is unemployed and has lived with friends but would change locations frequently due to

deteriorated relationships with friends and family due to addiction. As a result, his family no

longer welcomes him. The patient stated that he does stay at the shelter but at times still finds a

“place to crash” when he doesn’t want to abide by the strict time restraint. The patient has been

using marijuana since the age of 15. It is no longer “my drug of choice,” a friend introduced him

to heroin at 18 during his first year of college. The patient indicated that his family was aware of

his struggle with addiction. Financially, he had been receiving support from grandparents,

motivated by the need to keep him out of jail and trouble.

Screening Tool to Use and Justification

The instrument that will be used for this patient is the addiction severity index (ASI). ASI

assesses the severity of issues related to substance abuse. The index evaluates several variables,

such as the existence or absence of mental health issues, familial or social difficulties, legal

issues, the frequency of substance usage, employment situation, and medical ailments. Since it

allows for creating an otherwise comprehensive treatment plan that addresses issues connected to

the six main categories outlined above, ASI has been chosen as the best evaluation instrument

for the patient in the case mentioned above. Similarly, the ASI index has been selected as the

perfect instrument since it enables the creation of treatment plans designed to meet each patient’s

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particular or unique needs (Tun, Vicknasingam & Singh, 2021). Thus, its benefits include

matching patients to treatments, evaluating various treatment options, and forecasting treatment

results (Fu, Yuan & Sun et al., 2021).

Issues to Discuss

The ASI questionnaire will be used, and it will also be scored. Regarding the patient’s

health, inquiries will include how many days they have encountered substance addiction

problems in the previous month and whether or not they frequently take any prescription

medications for a physical ailment. The patient’s degree of education, the length of his longest

full-time job, if any, and the number of people who depend on him for basic requirements like

food and shelter is all essential considerations regarding employment and support status. Funds

spent on drugs in the past month, and how many times has he received treatment for alcohol or

drug abuse throughout his life? The following questions will ask how many days in the past

month were spent receiving treatment for alcohol or drug issues in an outpatient setting. They

will also discuss how often he has been arrested and charged with driving while intoxicated,

vandalism, or shoplifting. The following questions about his legal situation will concern whether

he is currently facing any charges, sentencing, or trials.

Motivation for change

Assessments of his familial or social ties will cover things like if he’s ever experienced

abuse, how many close friends he has, and whether he lives with someone who uses illegal

drugs. Last but not least, the section on psychiatric status will concentrate on the number of

times he may have received treatment for emotional or psychological issues and whether he has

previously suffered severe stress or anxiety (related to alcohol or drug use directly). A “yes”

results in a score of 1, whereas a “no” results in a score of 0. A high score indicates a greater

need for therapy. The severity ratings will also denote any extreme problems, significant,

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moderate, little, and no problems. Specific tactics are used to encourage the patient to change.

For instance, reiterating the harmful effects of drug addiction will push the patient’s view of

reality.

Additionally, any actions of making excuses won’t be rewarded. Reducing enabling

behaviors, such as letting his grandparents pay for his costs because they don’t want him to steal,

will also lessen the patient’s comfort level with drug usage. The goal will be to make the patient

accountable and in charge of his life.

Resources for Referral

Some resources for drug and alcohol rehab treatment centers exist in New Jersey, and the

patient will be worth referring to them for further services. They include Blake Recovery Center

(a nonprofit organization), Narcotics Anonymous meetings, Alcoholics Anonymous meetings,

and the N.J. Substance Abuse & Mental Health Program. Also, the patient will need to be linked

to N.J.’s Addiction Helpline to ensure timely interventions in case emergency services or general

consultations are needed while progressing during addiction recovery.

Conclusion

The SBIRT model focuses primarily on how severe drug and substance dependence is. It

also noted that various treatment intensities are available. The goal of brief intervention is to

create motivation for behavioral change and insights and understanding about substance use.

Referral to treatment enables patients who require therapy to employ a more involved one and

obtain medical attention. Drug and substance abusers can benefit from 15 to 30 minutes of

counseling during a brief intervention. A brief intervention is crucial because it helps patients

comprehend drug usage and its harmful implications. The users are urged to submit to a drug

screening. The test is intended to serve as a quick and self-report screening tool. It aids medical

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professionals in understanding the amount of drug or substance abuse. Additionally, it aids

individuals in accepting more extensive therapy to lessen their addiction.

References

Babor, T. F., Del Boca, F., & Bray, J. W. (2017). Screening, Brief Intervention and Referral to

Treatment: implications of SAMHSA’s SBIRT initiative for substance abuse policy and

practice. Addiction, 112, 110–117. https://doi.org/10.1111/add.13675

Campêlo, S. R., Barbosa, M. A., Dias, D. R., Caixeta, C. C., Leles, C. R., & Porto, C. C. (2017).

Association between severity of illicit drug dependence and quality of life in a

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sychosocial care center in BRAZIL: cross-sectional study. Health and Quality of Life

Outcomes, 15(1). https://doi.org/10.1186/s12955-017-0795-5

Fu, R., Yuan, C., Sun, W., Wang, W., Zhang, L., Zhai, J., Guan, Q., Wu, X., Long, J., Zhao, M.,

& Du, J. (2021). Effectiveness of E-SBIRT intervention in community healthcare

institution in China: study proposal for a randomised controlled trial. General

Psychiatry, 34(5), e100486. https://doi.org/10.1136/gpsych-2021-100486

Mitchell, S. G., Gryczynski, J., O’Grady, K. E., & Schwartz, R. P. (2013). SBIRT for adolescent

drug and alcohol use: Current status and future directions. Journal of Substance Abuse

Treatment, 44(5), 463–472. https://doi.org/10.1016/j.jsat.2012.11.005

Tun, S., Vicknasingam, B., & Singh, D. (2021). Factors affecting addiction severity index (ASI)

among clients enrolled in methadone maintenance treatment (MMT) program in 18(1),

84. https://doi.org/10.1186/s12954-021-00523- 2

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