SBIRT Implementation: What drives success?

Routine screening, brief intervention, referral to treatment (SBIRT) for substance use is an important healthcare practice to encourage behavior change. Unhealthy alcohol use contributes to a number of health concerns including heart disease, cancer, injury and other illnesses, and is often not addressed in the context of a routine health visit. To encourage adoption of this practice in healthcare settings, the National Center for Chronic Disease Prevention and Health Promotion released its January Vital Signs with a call to action to healthcare professionals to screen all adult patients for alcohol use as part of their usual services. With commonly reported barriers including limited time, training and reimbursement and the stigma attached to substance use disorders, the question is how will SBIRT survive the competing demands in healthcare?

Building system level support for SBIRT is an important step for successful integration. Buy in is necessary from leaders in healthcare, associations, behavioral health treatment providers, payers, business leaders and purchasers, and others to support integration. Additionally, opportunities exist to support SBIRT integration as a critical strategy to improve patient care. Examples include the creation of health homes, implementation of healthcare reform, the final passing of the Parity rule, and the recognition of SBIRT as an effective strategy to prevent unhealthy substance use and improve health by the CDC, the American Congress of Obstetricians and Gynecologists, the Joint Commission, and the United States Preventive Services Task Force. Capitalizing on these opportunities will contribute to the success of SBIRT integration.