SBIRT Approach to Substance Abuse
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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