Promote Screening and Brief Interventions

Screenings and brief interventions (SBI) address risky alcohol use long before it leads to health, financial, social, employment or family problems. Research shows that a brief, non-judgmental intervention by a health care professional can have a positive, long term impact on risky alcohol use.

SBI involves two separate skills that, used together, can reduce risky alcohol use and prevent some individuals from processing to dependence.

Not everyone who is screened will need a brief intervention, and not everyone who needs a brief intervention will require treatment. In fact, the goal of screening and brief intervention is to reduce risky alcohol use before people need treatment.

Screening involves asking questions about patterns of alcohol use. Screening every patient is important because the goal is to identify people at risk for dependence as well as those who are already alcohol dependent.

A brief intervention is a conversation between a professional and patient designed to reduce alcohol use. This conversation presents an opportunity to discuss the health consequences of risky alcohol use and agree on strategies to reduce the patient's drinking.

To assist providers in conducting SBI:

• Many screening tools are available, some for specific populations
• Guides help providers work through the steps of a brief intervention conversation
• Organizations and practices can train staff, and communities can train groups of health care providers using a variety of curricula 

SBI techniques can be used for drug use as well as risky alcohol use.

Significant Barrier

An alcohol and drug provision included in the Uniform Accident and Sickness Policy Provision Law (UPPL) gives health insurers the legal right to deny claims for the care of any injury sustained by an insured person who was intoxicated or under the influence of drugs at the time of the injury.

Health care professionals are often reluctant to ask patients about alcohol use because if they detect alcohol use, the patient's health care is in danger of not being reimbursed by their insurance company.

SBI advocates, like the American Society for Addiction Medicine, have been working to get the alcohol and drug provisions of the UPPL laws repealed. Because UPPL is part of insurance law, it is regulated by each state and must be repealed one state at a time.

Ensuring Solutions has created an Alcohol Exclusion Law Resource Kit, which provides tools and information for advocates and other working to repeal alcohol exclusions.