SBIRT Core Training Activity: Screening, Brief Interventions, and Referral to Treatment

This activity is NY OASAS approved for Medicaid reimbursement training

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4 hrs. Covers all SBIRT skills + Opportunity to practice skills via simulated cases.

CME/CE Activity Information

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:

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: 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:

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.

Goal/Expected Learner OutcomeThe learner will be able to appropriately screen for and identify substance abuse, plan and implement a tailored brief intervention, and will apply the SBI approach to substance abuse problems by individualizing these clinical skills to different patients. The learner will be able to improve care management and referral skills for patients with relatively more severe substance use problems and improve follow-up and brief treatment skills for patients with substance use problems. The learner will apply all SBIRT clinical skills learned in several simulated cases with a variety of 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.

This activity is designed to change competence, performance, and patient outcome.


  1. SBIRT: Brief and Effective Screening for Hazardous Substance Use: How brief and effective screening for substance use problems can improve patient outcomes.
  2. SBIRT: Brief Interventions for Substance Use Disorders: Brief interventions when another treatment is the focus.
  3. SBIRT: Referral to Treatment and Follow-up Care: Options for specialty treatment, planning and arranging substance use disorder treatment referral.
  4. SBIRT: In Practice!: Three interactive cases give a chance to practice skills and clinical decision making presented in first three modules.


To complete the activity:

  • Complete the pre-assessments
  • Complete all modules and in-module activities
  • Complete post assessments with a 70% score on post test
  • Print completion certificate


  • All internet-based, available 24/7
  • Interactive modules

Accreditation Statement

  • Credit Statement for AMA PRA Category 1 Credit(s)™: Clinical Tools, Inc. designates this enduring material for a maximum of 4 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
    Release: 4/15/14 / Expiration: 4-14-16 / Estimated time: 4 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.
  • NY OASAS, AAFP, NBCC, DCBN, FBM, FAPA ce credits available
  • Clinical Tools, Inc. is an NBCC-Approved Continuing Education Provider (ACEP) and may offer NBCC-approved clock hours for events that meet NBCC requirements. The ACEP is solely responsible for all aspects of the activity.
  • A letter of completion is available for non-physicians

Target Audience

Primary care providers and counselors


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 MS (Research Scientist, Clinical Tools, Inc.)
  • Steve Applegate, MEd MEd (President, Applegate Consulting)
  • Reviewers: Ted Diedrich, MSc (SBIRT activity Coordinator; PhD Student, Denver Health and Hospital Authority), Timothy John McGrath, MD (Family Physician, Private Practice)
Clinical Tools, Dr. Rossie, Mr. Applegate, Mr. Diedrich, and Dr. McGrath have disclosed no relevant financial relationships.


  • Rate for 4 hr activity: $50 per individual;
  • Group Rates Available!
    Group Rates
    Cost Structure
    Core Activity:
    4 hours/NY OASAS qualified activity (all SBIRT skills)
    Up to 4 people $50 per person

    5 to 15 people $45 per person

    16+ people $40 per person

    Custom Group Portal Web Page $500/group + user fees

    A custom webpage allows additional data collection (user entered, for example, practice name) and reporting of data. Minimum of $500 for 5 data items and monthly reporting. Recommended for very large groups who wish additional information and oversight of activity usage. Per user fees still apply.

    Please contact us if you have questions

Initial development of this activity was supported by a contract from the National Institute on Drug Abuse (#HHSN271200800038C).

Educational Objectives:

After completing this activity, participants will be able to:
  • Select and utilize tobacco, alcohol, and drug use screening tools with patients.
  • Perform brief interventions for tobacco and substance use problems with patients.
  • Refer patients to the appropriate type of substance abuse treatment center and/or specialist.
  • Follow-up with and reassess patients who receive treatment for substance abuse or tobacco use.
  • Apply the SBIRT approach to substance use problems at a comprehensive and integrated level by individualizing screening, brief interventions, and referral for different patients.
  • (Hospitals) Comply with Joint Commission Substance Abuse and Tobacco Treatment Measures.
Clinical Tools, Inc. is accredited by the ACCME to provide continuing medical education for physicians.