Screening and brief intervention (SBI) has begun to emerge as a critical
strategy for targeting this large but often overlooked population of individuals
who exceed low risk guidelines. The primary goal of screening and brief
intervention efforts is not to identify alcohol- or drug-dependent individuals for
referral to treatment. Rather, these approaches are intended to meet the public
health goal of reducing the harms and societal costs associated with risky
drinking.
A significant advantage for those working to create a positive impact on this
problem is the potential to make significant gains by virtue of the large, easily
identifiable, and accessible group of risky drinkers. Small positive changes
spread over a large group will manifest themselves in the lives of the subjects,
their families and all those around them - an encouraging multiplier effect.
SBI efforts hinge on finding opportunities in general medical, public health
and other systems to identify and address individuals who may benefit from
education and guidance about their substance use. These educational efforts are
directly aimed at helping risky drinkers change their behavior.
Screening involves the use of specific, evidence-based questionnaires in
verbal, written or electronic formats that are designed to detect risky alcohol
and/or drug use. The questions asked in formal screening are intended to
measure quantity and frequency of substance use over defined periods, as well
as the occurrence of its adverse consequences. These screenings are designed to
be quick, often lasting only five to 15 minutes.
A brief intervention generally consists of a nonconfrontational encounter
between a health professional and a patient that is designed to help improve
chances that the patient will reduce risky alcohol consumption or discontinue
harmful drug use. A brief intervention goes beyond the sharing of simple
advice. It uses evidence-based approaches to give the patient tools for changing
his beliefs about substance use and coping with everyday situations that
exacerbate his risk for harmful use.
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