Babor, T. F., McRee, B. G., Kassebaum, P. A., Grimaldi, P. L., Ahmed, K., & Bray, J. (2007). Screening, Brief Intervention, and Referral to Treatment (SBIRT) toward a public health approach to the management of substance abuse. Substance abuse, 28(3), 7-30.
BRIEF NOTE: This article provides an excellent overview of the history of SBIRT over the past 60 years, and the public health rationale behind the SBIRT model.
Beaton, A., Shubkin, C. D., & Chapman, S. (2016). Addressing substance misuse in adolescents: a review of the literature on the screening, brief intervention, and referral to treatment model. Current opinion in pediatrics, 28(2), 258-265.
BRIEF NOTE: This comprehensive review provides an extensive overview of SBIRT’s potential public health benefits and considerations for implementation. Notably, the authors conclude that while the growing field of research has demonstrated the potential benefits of discrete screening and brief intervention approaches, more rigorous research is still needed to generate more knowledge about the overall impact of SBIRT for adolescents and its long-term effects. Nonetheless, the authors conclude by supporting the American Academy of Pediatrics’ recommendation that SBIRT be widely implemented to address the impact of substance use on adolescent health and well-being.
D’Souza-Li, L., & Harris, S. K. (2016). The future of screening, brief intervention and referral to treatment in adolescent primary care: research directions and dissemination challenges. Current opinion in pediatrics, 28(4), 434-440.
BRIEF NOTE: This review discusses next steps that the field needs to take to answer critical questions about SBIRT for adolescents and to highlight promising areas for future development and implementation. In particular, the use of technology, the use of nonphsycian behavioral health providers, and the embedding of screening and decision support tools in electronic systems hold promise to advance the field of primary-care based SBIRT for adolescent patients.
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.
BRIEF NOTE: This review highlights that the evidence base for adolescent SBIRT is not as comprehensive as it is for adults, due largely to the clinical, methodological, and logistical challenges associated with conducting well-controlled randomized trials of SBIRT protocols for adolescent populations. It highlights the need for further research on SBIRT in community-based medical and other service settings where adolescents often receive care, and the importance of measuring outcomes other than those narrowly related to substance use (e.g. patient satisfaction) and referral to treatment.
Ozechowski, T. J., Becker, S. J., & Hogue, A. (2016). SBIRT-A: adapting SBIRT to maximize developmental fit for adolescents in primary care. Journal of substance abuse treatment, 62, 28-37.
BRIEF NOTE: This article presents readers with information about steps that could be taken to adapt existing SBIRT protocols designed to identify and address adult substance use for implementation with adolescent populations. These considerations may be particularly useful in settings where adult SBIRT is already being implemented, and it may be easier to modify existing protocols for adults for use with adolescents instead of creating new SBIRT protocols for adolescents from scratch. While this article focuses on medical settings, the adaptations could be used in other settings (e.g. justice settings) that serve both adult and adolescent populations.
Patnode, C. D., O’Connor, E., Rowland, M., Burda, B. U., Perdue, L. A., & Whitlock, E. P. (2014). Primary Care Behavioral Interventions to Prevent or Reduce Illicit Drug Use and Nonmedical Pharmaceutical Use in Children and Adolescents: A Systematic Evidence Review for the US Preventive Services Task Force Interventions to Prevent or Reduce Drug Use in Children and Adolescents. Annals of internal medicine, 160(9), 612-620.
BRIEF NOTE: This review highlights that the evidence base concerning the benefits of primary-care based interventions to prevent or reduce illicit drug use or the nonmedical use of prescription drugs among youths is limited. However, it is important to note that trials have shown promise particularly for cannabis use, which is notable since cannabis is the most widely used substance other than alcohol among adolescents and young adults. Furthermore, the research evidence on SBIRT for drug use among adults is also limited (see Hingson, R., & Compton, W. M. (2014). Screening and brief intervention and referral to treatment for drug use in primary care: back to the drawing board. Journal of the American Medical Association312(5), 488-489), so the fact that multiple trials have shown benefits of SBIRT for drug-using adolescents is promising.
Sterling, S., Kline-Simon, A. H., Jones, A., Satre, D. D., Parthasarathy, S., & Weisner, C. (2017). Specialty addiction and psychiatry treatment initiation and engagement: Results from an SBIRT randomized trial in pediatrics. Journal of Substance Abuse Treatment. 82, 48-54
BRIEF NOTE: This study is notable in that it sheds light on the difficult question of how to successfully link adolescents who need specialty care with treatment. The study highlights the potential benefits of having embedded behavioral health clinicians (rather than pediatricians) facilitate referrals to specialty care.
Stockings, E., Hall, W. D., Lynskey, M., Morley, K. I., Reavley, N., Strang, J., … & Degenhardt, L. (2016). Prevention, early intervention, harm reduction, and treatment of substance use in young people. The Lancet Psychiatry, 3(3), 280-296.
BRIEF NOTE: This review highlights that evidence concerning the efficacy of brief interventions following screening for adolescents is limited, though it does not conclude that such brief interventions are ineffective either. The review also highlights that for young people drinking at harmful levels, face-to-face interventions that incorporate personalized feedback and utilize motivational interviewing approaches are most effective.
Tanner-Smith, E. E., & Lipsey, M. W. (2015). Brief alcohol interventions for adolescents and young adults: A systematic review and meta-analysis. Journal of substance abuse treatment, 51, 1-18.
BRIEF NOTE: This review highlights the effectiveness of brief alcohol interventions for adolescents and young adults, showing that they are associated with significant reductions in alcohol consumption and alcohol-related problems for adolescents up to one year following interventions. In particular, motivational interviewing, decisional balances, and goal settings are associated with beneficial effects.
Tanner-Smith, E. E., Steinka-Fry, K. T., Hennessy, E. A., Lipsey, M. W., & Winters, K. C. (2015). Can brief alcohol interventions for youth also address concurrent illicit drug use? Results from a meta-analysis. Journal of youth and adolescence, 44(5), 1011-1023.
BRIEF NOTE: This review is notable in showing that brief interventions for a range of substances can be effective with adolescents if appropriately targeted. In particular, it highlights the potential benefits of targeting brief interventions to address both alcohol and other substances.
UCLA Integrated Substance Abuse Programs, SBIRT Brief: Screening