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Screening, brief intervention and referral to treatment

Helping at-risk substance and alcohol users


Why are alcohol and substance use screenings and intervention so important? Substance misuse and abuse often result in poor health outcomes and substantial costs. It can lead to increased illness, hospitalizations, motor vehicle injuries and premature deaths. One study estimates substance use cost society $193 billion in 2011.1 Over 21 million Americans have a substance use disorder. But only 1 in 10 gets the treatment they need.2


Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidenced-based practice. It helps identify, reduce and prevent problematic use, abuse and dependence on alcohol and drugs.3,4


SBIRT is ideal for primary care settings. It enables health care staff to screen and assist people who may not be seeking help, but whose drinking or drug use may complicate their health, work or family. SBIRT aims to prevent the unhealthy consequences of alcohol and drug use. It can help those who:


  • May not have reached the diagnostic level of a substance use disorder, or
  • Have the disease of addiction to enter and stay with treatment

The practice helps to reduce:

  • Health care costs5
  • Severity of drug and alcohol use
  • Risk of trauma (distressing events that may have long lasting, harmful effect on a person’s physical and emotional health and wellbeing)
  • The percentage of at-risk patients who go without specialized substance use treatment6

SBIRT aims to help primary care physicians, health care and mental health professionals. It offers:


  • A protocol on how to screen for at-risk substance use and alcohol use among patients
  • Reimbursement for screening and brief intervention


Screening practice and reimbursement information (PDF)


Learn more about SBIRT


1National Drug Intelligence Center (2011) The Economic Impact of Illicit Drug Use on American Society. Washington D.C.: United States Department of Justice.
2U.S. Department of Health and Human Services (2016) Facing addiction in America (PDF).

3Bien, T. H., Miller, W. R., & Tonigan, J. S. (1993). Brief intervention for alcohol problems: A review. Addiction, 88, 315–335.

4Madras BK, Compton WM, Avula D et al. Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: Comparison at intake and six months later. Drug and Alcohol Dependence 2009; 280-295.

5Quanbeck A, Lang K, Enami K, & Brown RL. (2010). A cost-benefit analysis of Wisconsin's screening, brief intervention, and referral to treatment program: adding the employer's perspective. State Medical Society of Wisconsin, Feb; 109(1):9-14.

6Gentilello, L.M., Ebel, B.E., Wickizer, T.M., Salkever, D.S. & Rivara, F.P. (2005). Alcohol intervention for trauma patients treated in emergency department and hospitals: a cost benefit analysis. Annals of Surgery, 241 (4), 541-550.

Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.

This information is provided for informational purposes only and is not intended to direct treatment decisions or offer medical advice. Aetna does not provide health care services and cannot guarantee any results or outcomes. All patient care and related decisions are the sole responsibility of the treating provider.

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