Download Brief Screening, Intervention, and Referral for Alcohol and Opiate

Brief Screening, Intervention, and Referral
for Alcohol and Opiate Disorders
An Effective Three-Step Process
Brief Screening
AUDIT-C FOR ALCOHOL
1. How often do you have a drink
containing alcohol?
2. How many drinks containing alcohol do
you have on a typical day of drinking?
3. How often do you have five or more
drinks on one occasion?
0
Never
1 or 2
1
2
3
4
Score
Monthly 2-3 times 2-3 times
4 or more
or less per month per week times per week
3 or 4
5 or 6
7 to 9
10 +
Less than
Daily or
Monthly Weekly
monthly
almost daily
A standard drink in the US is any drink that contains
about 14 grams of pure alcohol. One drink equals:
AUDIT-C Score (add items 1-3)
12 oz. beer, 5 oz. wine, or 1.5 oz. liquor.
Never
Recommended Level and Focus of Brief Intervention Based on Screening Results
z
NEGATIVE SCREEN < 4 for men/ 3 for women - Inform client that they are at low risk. Congratulate
clients at low risk and encourage them to remain that way. Simple advice can be offered.
z
POSITIVE SCREEN > 4 for men/ 3 for women - Inform client that they screen positive for hazardous
alcohol use and are at risk for health and other problems. Either provide a brief intervention and/or
continue by giving the patient a copy of: "Alcohol: It May Be Legal, But It Can Hurt Your Health," which
contains the full AUDIT and referral sources.
DAST PRE-SCREENER FOR OPIATES
1. In the past 12 months, have you used drugs other than those required for medical reasons?
Yes | No
A YES response to the DAST pre-screener indicates a POSITIVE drug prescreen – either provide a brief
intervention and/or continue by giving the patient a copy of: "Opiates: When Pain Medications Become A
Problem," which contains the full DAST and referral sources.
Brief Treatment Intervention – “FLO” and “SEW”
Feedback
Listen and Elicit
Options (Goal Setting)
Summarize patient’s statements in favor of change
Emphasize their strengths
What agreement was reached
Reimbursement
Use of the codes below requires documentation in the clinical record. Services provided under these
codes are separate and distinct from all other Evaluation & Management (E/M) services performed during
the same clinical session (i.e., date of service).
Screening & Brief Intervention 15 to 30 minutes
Screening & Brief Intervention > 30 minutes
Commercial
CPT 99408
CPT 99409
Medicare
G0396
G0397
Medicaid
H0049
H0050
Online Resource for Screening and Brief Intervention: http://sbirt.samhsa.gov/about.htm
Prepared by a collaboration of National Behavioral Consortium, George Washington University, and Reckitt Benckiser Pharmaceuticals