{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T22:30:12Z","timestamp":1791757812402,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2017,1,10]],"date-time":"2017-01-10T00:00:00Z","timestamp":1484006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["P60-AA003510-39"],"award-info":[{"award-number":["P60-AA003510-39"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>This paper describes the major findings and public health implications of a cross\u2010site evaluation of a national Screening, Brief Intervention and Referral to Treatment (SBIRT) demonstration program funded by the US Substance Abuse and Mental Health Services Administration (SAMHSA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eleven multi\u2010site programs in two cohorts of SAMHSA grant recipients were each funded for 5\u00a0years to promote the adoption and sustained implementation of SBIRT. The SBIRT cross\u2010site evaluation used a multi\u2010method evaluation design to provide comprehensive information on the processes, outcomes and costs of SBIRT as implemented in a variety of medical and community settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>SBIRT programs in the two evaluated SAMHSA cohorts screened more than 1\u00a0million patients\/clients. SBIRT implementation was facilitated by committed leadership and the use of substance use specialists, rather than medical generalists, to deliver services. Although the quasi\u2010experimental nature of the outcome evaluation does not permit causal inferences, pre\u2013post differences were clinically meaningful and statistically significant for almost every measure of substance use. Greater intervention intensity was associated with larger decreases in substance use. Both brief intervention and brief treatment were associated with positive outcomes, but brief intervention was more cost\u2010effective for most substances. Sixty\u2010nine (67%) of the original performance sites adapted and redesigned SBIRT service delivery after initial grant funding ended. Four factors influenced SBIRT sustainability: presence of program champions, availability of funding, systemic change and effective management of SBIRT provider challenges.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The US Substance Abuse and Mental Health Services Administration's Screening, Brief Intervention and Referral to Treatment (SBIRT) demonstration program was adapted successfully to the needs of early identification efforts for hazardous use of alcohol and illicit drugs. SBIRT is an innovative way to integrate the management of substance use disorders into primary care and general medicine. Screening, Brief Intervention and Referral to Treatment implementation was associated with improvements in treatment system equity, efficiency and economy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.13675","type":"journal-article","created":{"date-parts":[[2017,1,13]],"date-time":"2017-01-13T10:06:31Z","timestamp":1484301991000},"page":"110-117","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":210,"title":["Screening, Brief Intervention and Referral to Treatment: implications of SAMHSA's SBIRT initiative for substance abuse policy and practice"],"prefix":"10.1111","volume":"112","author":[{"given":"Thomas F.","family":"Babor","sequence":"first","affiliation":[{"name":"University of Connecticut School of Medicine  Farmington CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Del Boca","sequence":"additional","affiliation":[{"name":"University of Connecticut School of Medicine  Farmington CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy W.","family":"Bray","sequence":"additional","affiliation":[{"name":"University of North Carolina at Greensboro  Greensboro NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,1,10]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Publishing Addiction Science: A Guide for the Perplexed","author":"Babor T. 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