Screening, Brief Intervention and Referral to Treatment (SBIRT) - alcohol abuse

Most people drink some alcohol in their lifetime. In 2013, 87% of adults reported drinking alcohol at some point in their life, 71% drank in the past year and 56% drank in the past month (Substance Abuse and Mental Health Services Administration, 2013).

In addition, 25% of adults reported binge drinking in the past month and 7% reported heavy drinking in the past month. The economic, social and health burden of alcohol-related problems are well known, with 17.6 million adults meeting criteria for a past-year alcohol-use disorder in 2004 (Grant et al, 2007) and alcohol misuse costing the US $223.5 billion (Centers for Disease Control and Prevention, 2006).

However, few individuals receive treatment for their alcohol problems, despite the availability of interventions that are cost-effective and improve relevant clinical outcomes (Dawson et al, 2005; Zarkin et al, 2010). Brief interventions for alcohol use present an opportunity to identify alcohol problems, offer brief advice and encourage individuals to cut down on their drinking in various medical settings (Babor et al, 2007).

To address the full spectrum of alcohol use problems (including heavy alcohol use, severe problems etc.) Screening, Brief Intervention and Referral to Treatment (SBIRT) programmes focus on referring individuals to treatment. Whilst reviews and meta-analyses have demonstrated the effectiveness of brief alcohol interventions in reducing alcohol use (Kaner et al, 2009; Whitlock et al, 2004), few have examined the ability of SBRIT programmes to improve the use of alcohol-related treatment. In one review, the efficacy of SBIRT in adolescent drinkers was unable to identify any randomised controlled trials (RCTs) that assessed referral to treatment (Mitchell et al, 2013). Similarly, reviews of SBI have not provided sufficient data to inform the referral to treatment part process in SBIRT. In general, reviews have not provided adequate evidence to determine whether brief alcohol interventions increase subsequent treatment use.

The present study aimed to evaluate the extent to which RCTs of brief alcohol interventions are effective in referring individuals to alcohol treatment services.