An evaluation of screening, brief intervention, and referral to treatment in emergency departments

Abstract

Alcohol use disorders are major national public health problems that are responsible for impaired health. The emergence of SBIRT (Screening, Brief Intervention, and Referral to Treatment) has potentially revolutionized the strategies used to reach the at-risk population of drinkers, specifically within emergency departments (EDs). Several studies have confirmed the efficacy of SBIRT as a viable ED intervention method. Improved study measures have included keeping appointments for treatment, decreased average alcohol consumption and heavy episodic drinking, reduction in health care costs, and reduction in subsequent DUIs (Driving Under the Influence) and alcohol-related re-injury requiring emergency treatment. However, some studies reveal more mixed and sometimes complete lack of support. This manuscript brings this body of evidence together and introduces potential moderators to study results. These moderators include ethnicity, alcohol severity, type of injury, setting disparities, adherence to clinical trial guidelines, and emphasis on referral to treatment. This paper also analyzes patient motivations and behavior change patterns, their potential effect on study outcomes, and suggestions to improve study designs. SBIRT in EDs has provided a significant yet cost and resource-effective method of curbing alcohol misuse. Results from efficacy studies will hopefully mirror the SBIRT's evolution and resulting improvements to our nation's health.