Screening, brief intervention, and referral to treatment (SBIRT) implementation in urban underserved family medicine practices.

This article focuses on the implementation and preliminary outcomes of integrating Screening, Brief Intervention, and Referral to Treatment (SBIRT) into three Primary Care Medical Homes (PCMHs) in North Texas as part of a Substance Abuse and Mental Health Services Administration (SAMHSA) grant project. SBIRT is an evidence-based approach aimed at early identification and intervention for patients with Alcohol Use Disorder (AUD) and Substance Use Disorders (SUD). During the first year, 8,275 patients were screened using standardized tools embedded in the electronic medical record, with 517 screening positive and 62 receiving intensive SBIRT services, including brief interventions and referrals to treatment. The program demonstrated feasibility within fast-paced primary care settings, highlighted the importance of embedded clinicians for patient engagement, and identified challenges such as lower-than-expected positivity rates and workflow integration. Ongoing efforts focus on training, workflow optimization, and expanding the program to additional sites to enhance sustainability and patient outcomes.