This page is part of a larger SBIRT training activity provided by Clinical Tools, Inc. Our SBIRT activities provide clinical skills training for substance use problems to primary care providers, counselors, and students alike.
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If you do not have an account: This page is part of a larger SBIRTTraining activity provided by Clinical Tools, Inc. SBIRTTraining provides clinical skills training for healthcare providers in screening, brief intervention, and referral to treatment for substance use problems. Please refer to the homepage to sign-up and begin the activity!

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  1. Log In
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New Patient

The following case will be used throughout this module to illustrate and give you a chance to apply the concepts learned:

Patient: Mrs. Elise Capello

Age: 35 years old

Scenario: Ms. Capello has returned for blood pressure monitoring. She had missed an appointment to follow-up on a brief intervention for an alcohol use problem. The goal at that time was to reduce alcohol use to healthy limits. But in this office visit, we'll discover that, not only has she not reduced her alcohol use, she has instead increased her drinking and started misusing sedatives as well.


Follow-up is important, whether you manage a substance use problem through brief interventions or make a referral. Follow-up on both brief interventions and referrals is an important part of SBIRT (CASA, 2012; Madras et al., 2009; Fiore et al., 2008; USPSTF, 2008). Mrs. Capello had a brief intervention for her drinking over a year ago, but no follow-up. She now returns with a more severe problem with alcohol.


Referral to other treatment facilities may be the best course of treatment for some patients. More information is needed to determine if Mrs. Capello needs a referral.

Coordinated and comprehensive approaches to substance use disorder treatment are imperative when managing patients with substance use disorders. Multiple health-care providers or treatments, such as mental health counselors, social workers, self-help groups, and addiction treatment facilities may be involved.

View ReferencesHide References
Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008. Available at: Accessed on: 2013-09-26.
Madras BK, Compton WM, Avula D, et al. Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites. Drug Alcohol Depend. 2009; 99: 280-295. Available at: Accessed on: 2011-03-24.
The National Center on Addiction and Substance Abuse at Columbia University (CASA). An SBIRT Implementation and Process Change Manual for Practitioners. CASA. 2012. Available at: Accessed on: 2014-09-30.
U.S. Preventive Services Task Force (USPSTF). Screening for illicit drug use. U.S. Preventive Services Task Force. 2008. Available at: Accessed on: 2014-09-30.