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integrated healthcare

with a conscience.

Screening, Brief Intervention, & Referral to Treatment

Fact: The line between alcohol and drug use and misuse can be blurred by many factors, including varying alcohol tolerance levels, misunderstanding about risky use, and social conventions.

Fact: Counties in northern Arizona have some of the highest rates of death and emergency department visits for alcohol and drug use in the state.

Fact: Research on best practices demonstrates that universal screening of adults by primary care and emergency departments can reduce risky drinking and drug use and identify persons in need of treatment.


Solution: SBIRT

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a comprehensive public health approach for delivering early intervention and treatment services to people with, or at risk of developing, substance use disorders. Healthcare providers using SBIRT ask patients about substance use during routine medical and dental visits, provide brief advice, and then, if appropriate, refer patients who are at risk of substance use problems to treatment.Healthcare practitioners have the important responsibility of looking after their patients' general health and welfare. In this role, they must be vigilant in identifying a host of potential health problems. It is critical, therefore, to focus resources and efforts on expanding the continuum of care health practitioners provide for their patients.

With SBIRT, substance abuse screening is incorporated into mainstream healthcare settings, such as college health clinics, hospitals, trauma centers, and dental clinics, as well as into tribal and military healthcare settings. Practitioners screen patients to assess substance use, then, based on the screening results, provide the appropriate intervention. 

Leading Arizona's SBIRT Program

sbirt graphic

In July 2012, NARBHA began a five-year, $7.575 million SAMHSA grant to implement adult Screening, Brief Intervention and Referral to Treatment (SBIRT) in northern Arizona primary care offices and emergency departments. Through universal screening in medical care settings, SBIRT allows NARBHA to provide outreach and engagement to connect identified individuals with services.

The grant is provided by the Arizona State Governor's Office for Children, Youth and Families (GOYCF) in partnership with Arizona Department of Health Services/ Division of Behavioral Health. It was awarded by the Substance Abuse and Mental Health Services Association (SAMHSA).


More than 13,000 Screened!

As part of the grant, more than 13,000 people have been screened for substance use at Verde Valley Integrated and Primary Care in Cottonwood, as well as at Flagstaff Medical Center and North Country HealthCare in Flagstaff, Show Low and Holbrook. NARBHA is working with other sites to bring individuals and communities benefits like those reflected in the following SAMHSA data:

  • Reduction in alcohol and drug use 6 months after receiving intervention (41 percent of respondents reported abstinence from drugs and/or alcohol at follow-up, compared to just 16 percent at baseline)
  • Improvement in quality-of-life measures, including employment/education status, housing stability, and 30-day past arrest rates (95 percent of respondents reported no arrests in the past 30 days at follow-up, compared to 88 percent at baseline)
  • Reduction in risky behaviors, including fewer unprotected sexual encounters (injection drug use decreased from 3.2 percent at baseline to 1.5 percent at follow-up). 



CDC Vital Signs Learn Vital Information about Alcohol Screeening and Counseling.


For providers


SAMHSA's Introduction to SBIRT &resources


For Consumers

SAMHSA treatment locator and help line

Talk to Teens and Children about Drugs