Not One More | NWPA
recovery, opioids, opioid dependence, addiction

SBIRT

SCREENING, BRIEF INTERVENTION, REFERRAL TO TREATMENT

This is the new SBIRT Worklist. SBIRT stands for Screening, Brief Intervention, and Referral to Treatment. This is the Screening Portion, with note sections for the Brief Intervention and Referral to Treatment Sections.

Prescreening | Alcohol
Alcohol Prescreen
A1
Do you sometimes drink beer, wine or other alcoholic beverages?
A2
How many times in the past year have you had five (5) or more drinks in a day?
On average, how many days a week do you have an alcoholic drink?
On a typical drinking day, how many drinks do you have?
Drinks Per Week (Healthy Males to age 65)
Calculate Drinks Per Week using answers from previous questions. If Drinks Per Week is 13 or less prescreening is NEGATIVE. If Drinks Per Week is 14 or greater prescreening is POSITIVE and CAGE-AID screening and Brief Intervention should be performed.
Drinks Per Week (Healthy Females and Healthy Males over age 65)
Calculate Drinks Per Week using answers from previous questions. If Drinks Per Week is 6 or less prescreening is NEGATIVE. If Drinks Per Week is 7 or greater prescreening is POSITIVE and CAGE-AID screening and Brief Intervention should be performed.
Prescreening | Drugs
Drug Prescreen
D1
How many times in the past year have you used an illegal drug or used a perscription medication for non-medical reasons.
If SBIRT Prescreen is NEGATIVE
Proceed to positive reinforcement of healthy Drug and Alcohol habits. Please note that SBIRT Screening Status is NEGATIVE below.
If SBIRT Prescreening is POSITIVE
Proceed to CAGE-AID Screening, and perform Brief Intervention, regardless of CAGE-AID score.
CAGE-AID Screening
CAGE-AID Screening This is performed if the patient is POSITIVE for either the Alcohol or Drug Prescreen.
C
Have you ever felt that you ought to CUT DOWN on your drinking or drug use?
A
Have people ANNOYED you by criticizing your drinking or drug use?
G
Have you ever felt bad or GUILTY about your drinking or drug use?
E
Have you ever had a drink or used drugs first things in the morning to steady your nerves or get rid of a hangover? (EYEOPENER)
CAGE-AID Score
Score the previous four (4) questions.
CAGE-AID Score
Tally the YES answers for the previous four (4) questions. Each YES response equals one (1).
SBIRT Screening Status
Results of the SBIRT Screening
SBIRT Screening Status
Did the patient screen POSITIVE or NEGATIVE on the SBIRT screening? POSITIVE indicates potential substance use disorder.
Brief Intervention
Brief Intervention
Brief Intervention
Did Brief Intervention occur with the patient?
Any notes about Brief Intervention?
Referral to Treatment
Referral to Treatment
Referral to Treatment
Did the patient get referred to treatment?
Any notes about Referral to Treatment?