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Clinical Tools, Inc. is accredited by the ACCME to provide continuing medical education for physicians.

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CME/CE Activity Details (learn more)

Professional Practice GapAs many as 20% of primary care patients have substance use problems and primary care physicians could have a significant impact on their problems through providing screening, brief interventions, and referral to treatment (SBIRT) (Mersy, 2003). Unfortunately, PCPs screen less than half of their patients for tobacco use and less than a third for alcohol use (Seale et al 2010, Roche & Freeman 2004). The rate of screening for illicit drug use is also inadequate; about a third of primary care physicians and psychiatrists surveyed in one study did not screen routinely for illicit drug use (Friedmann, et al., 2001). Brief intervention in primary care is effective and cost-efficient approach to reduce patients' alcohol use (AAFP 2010; Seale 2010; Madras 2009). There is growing evidence that brief intervention for illicit drug use may also lead to positive patient outcomes (Compton 2009, Volkow 2010). And evidence also supports the effectiveness of interventions by medical providers for tobacco (USPSTF, 2008). However, brief interventions happen even less often than screening; for example counseling for problem drinking without dependence was reported by only 13% of patients in the 1998 Healthcare for Communities survey (D'Amico, 2005). Appropriate follow-up is also happening less often than is optimal. For example, only a little less than 50% of problem drinkers in this study reported receiving follow-up. There is also a practice gap in referral to treatment. Less than one-third of PCPs make a referral after identifying a substance abuse problem (CASA, 2000). Primary care physicians need to understand the different types of specialty treatment so that they can make appropriate referrals for their substance abuse patients (SAMHSA, 2008).


American Academy of Family Physicians (AAFP). Brief Alcohol Screening and Intervention in Family Medicine. 2010. Available at: http://www.aafp.org/online/en/home/clinical/publichealth/alcohol.html

Compton P. Urine toxicology screening: a case study. Emerging Solutions in Pain. 2009.

D'Amico EJ, Paddock SM, Burnam A, Kung FY. Identification of and guidance for problem drinking by general medical providers: results from a national survey. Med Care. 2005; 43(3):229-236.

Friedmann PD, McCullough D, Saitz R. Screening and Intervention for Illicit Drug Abuse. A National Survey of Primary Care Physicians and Psychiatrists. Arch Intern Med. 2001;161(2):248-251.

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: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760304/ Accessed on: 2011-03-24.

Mersy DJ. Recognition of alcohol and substance abuse. American Family Physician. 2003; 67: 1529-1532.

Roche AM, Freeman T. Brief interventions: good in theory but weak in practice. Drug and Alcohol Review. 2004; 23: 11-18.

The National Center on Addiction and Substance Abuse (CASA). Missed Opportunity: National Survey of Primary Care Physicians and Patients on Substance Abuse. 2000. Columbia University. Available at: http://www.casacolumbia.org/download.aspx?path=/UploadedFiles/kksvjhvx.pdf

Seale JP, Shellenberger S, Velzsquez MM, Boltri JM, Okosun I, Guyinn M, Vinson D, Cornelius M, Johnson JA. Impact of vital signs screening and clinician prompting on alcohol and tobacco screening and intervention rates: a pre-post intervention comparison. BMC Fam Pract. 2010; 11:18.

Substance Abuse and Mental Health Services Administration (SAMHSA). A Guide to Substance Abuse Services for Primary Care Clinicians: Concise Desk Reference. 2008. Treatment Improvement Protocol (TIP) Series #24.

U.S. Preventive Services Task Force Grade Definitions After May 2007. May 2008. http://www.uspreventiveservicestaskforce.org/uspstf/gradespost.htm

Goal/Expected Learner Outcome The learner will be able to accurately screen for and identify hazardous substance use, direct patients with substance use problems to an appropriate level of care, and create and implement a brief intervention and education tailored to patients with substance use problems.
Participation and Technical Requirements

Activity Credit: Obtaining credit for participation in this activity requires that you complete the pre-assessments, work through the modules (including all in-module interactive activities), complete the post-assessments with a 70% score on the post-test, and then request credit. At the end of the activity, you will be instructed on how to print out a certificate for your records. Time Requirement: Keep track of the amount of time it takes you to complete this activity. You will be required to spend a set amount of time in order to claim credit. You should claim credit only for the time actually spent in the activity. Technical Requirements: To participate in this activity, you will need a computer, an Internet connection, and a Web browser. This activity requires Chrome, Firefox, and IE7 or higher.

Target Audience: Physicians and primary care providers
Dates: 1-1-14 to 12-31-15


To complete the activity:

  • plan to spend at least an hour
  • complete the pre-assessments
  • complete all modules and in-module activities
  • complete post assessments with a 70% score on post test
  • print completion certificate

Module Description

Basics of SBIRT in Primary Care (for providers in Oklahoma): This module utilizes an emphasis on alcohol to briefly introduce substance use screening tools and guidelines, as well as several opportunities for learners to practice their screening skills. Additionally, learners will be introduced to basic motivational interviewing techniques for primary care, techniques that have been used effectively to motivate people with alcohol and other substance abuse problems to change their behavior.

What Will the Learner Gain?

  • Select and use screening and assessment tools
  • Perform brief interventions
  • Refer patients to the appropriate treatment
  • Follow-up and reassess patients after SBIRT
  • Integrate SBIRT skills via interactive case scenarios
  • (Hospitals) Comply with Joint Commission Substance Abuse and Tobacco Treatment Measures


  • All internet-based, available 24/7
  • Includes Motivational Interviewing Skills
  • Interactive cases

Funding Information for the Basics of SBIRT in Primary Care (for providers in Oklahoma) Activity:

This activity was adapted from a activity initially developed with funding from the National Institute on Drug Abuse (NIDA) - contract #HHSN271200900036C - at the National Institutes of Health. The activity contents are solely the responsibility of the authors and do not necessarily represent the official views of NIDA. Ongoing development and maintenance is funded by the training fee and Clinical Tools, Inc.

Author & Reviewer Information

As an ACCME accredited provider of continuing medical education, Clinical Tools, Inc. complies with the Standards for Commercial Support issued by the ACCME and requires disclosure of and resolution of any conflicts of interest for those in control of content.

  • Clinical Tools, Inc (Company)
  • Karen Rossie, PhD, DDS (Research Scientist, Clinical Tools, Inc.)
  • Reviewer: Dane Libart, MSW
Clinical Tools, Dr. Rossie, and Mr. Libart have disclosed no relevant financial relationships.

Accreditation Statement

AMA PRA Category 1 Credit™, DCBN credits available

  • Credit Statement for AMA PRA Category 1 Credit(s)™: Clinical Tools, Inc. designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • Release Date 1-1-14. Expiration Date 12-31-15.
  • Estimated time: 1.5 hours
  • Designation Statement:This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) by Clinical Tools, Inc. Clinical Tools, Inc. is accredited by the ACCME to provide continuing medical education for physicians.

Educational Objectives

After completing this activity, participants will be able to:

  • Employ motivational interviewing techniques to develop rapport with the patient
  • Interpret appropriate screening tools and intervention techniques for hazardous substance use problems based on patient history and characteristics
  • Implement a brief intervention that is tailored to the patient and the severity of the substance use problem
  • Triage patients to the appropriate level of care within your practice
  • Provide the patient with education and resources needed