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ABSTRACT
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a model program in the medical context, but it may be missing a large portion of the population with low access to healthcare services. Young adults have the lowest rates of insurance, low healthcare service utilization, and high rates of substance use. Theory driven Screening and Brief Intervention (SBI) conducted in high-risk drinking environments may reduce rates of alcohol related problems. The theoretical basis and implementation requirements for SBI in high-risk drinking settings are presented herein. This SBI has components of the original SBIRT program, including tailored advice, patron-driven commitment and goal setting, and encouragement.
Keywords: SBI, Prevention, Intervention, Bar, Risky Drinking Environment
Young adults have the highest rates of substance use of any age group. Over sixty percent of 18 - 24 year olds report using alcohol (Mulye, Park, Nelson, Adams, Irwin, & Brindis, 2009). As such, young adults also experience an increased burden from alcohol-related problems causing an estimated 1,825 deaths, 696,000 assaults, and 97,000 rapes among 18 - 24 year olds each year (Hingson et al, 2009).
On a population level, alcohol use contributes to a greater number of alcohol-related problems than alcohol abuse. The majority of chronic alcohol-related problems (liver disease, etc.) result from alcohol abuse or dependency while the majority of acute alcohol-related problems (DUI, trauma, injury, etc.) occur after excessive consumption by persons who do not meet dependence criteria (Woerle, Roeber, & Landen, 2007). Therefore, targeting light and moderate alcohol users for interventions is necessary to address the breadth of acute alcohol-related problems.
One approach for preventing acute and chronic alcohol related problems is through screening programs. Screening, Brief Intervention, and Referral to Treatment (SBIRT) programs include negotiation of reduced alcohol use and referral to treatment for individuals meeting guidelines for dependence. SBIRT is endorsed as a model program by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the World Health Organization (WHO). SBIRT interventions are comprehensive, brief, and consist of universal screening. SBIRT interventions also measure at least one targeted behavior, have a strong research component, and occur in a healthcare setting (Bien, Miller, & Tonigan, 1993; Kahan, Wilson, & Becker, 1995; Wilk, Jensen, & Havinghurst, 1997).
Young adults, who drink at the heaviest levels,...