1. Adoption Barriers

2. Percent of adults who report EVER discussing alcohol use with a health professional:
?? of U.S. adults overall
“We’ve just spent a great deal of time reviewing the rationale and evidence in support of SBIRT. Based on all of this, what would you guess is the percent of U.S. adults who report ever discussing alcohol use with a health professional?”

3. Percent of adults who report EVER discussing alcohol use with a health professional:
16% of U.S. adults overall
“Unfortunately, the figure is quite small with only 1 in 6 U.S. adults reporting having ever discussed alcohol use with a health professional.”

4. 35% of those who binge drink ≥ 10 times in the past month
Percent of adults who report EVER discussing alcohol use with a health professional:
16% of U.S. adults overall
17% of current drinkers
25% of binge drinkers
35% of those who binge drink ≥ 10 times in the past month

5. Most adult patients (68-98%) with moderate or severe alcohol use disorders are not detected by physicians.
(Friedmann et al., 2000; Yersin et al., 1995; Wilson et al., 2002)

6. Perceived barriers to addressing alcohol use with clients
(CASA, 2000)

7. Questions health care professionals may ask when contemplating SBIRT:
Do I really have to do this thing?
How much hassle is involved?
Will it annoy my Clients?
Well…
“Research on provider attitudes and perceived barriers suggest that there are several specific barriers to adoption.”

8. Perceived barriers to addressing alcohol use with Patients
Time constraints
Belief that Patients lie
Uncertainty about treatment
Fear of questioning Patient’s integrity
Fear of frightening/angering Patient
Personally uncomfortable with subject
May encourage Patient to see other MD
Belief that insurance doesn’t reimburse PCP time
Perceived barriers to addressing alcohol use with Patients
(CASA, 2000)

9. Client Perceptions
How would you guess Clients feel about receiving SBIRT?

10. Survey on Patient Attitudes
Patients are open to discussing their substance use to help their health professional
(Miller et al., 2006)
Survey on Patient Attitudes
Agree/Strongly Agree
“If my doctor asked me how much I drink, I would give an honest answer.”
92%
“If my drinking is affecting my health, my doctor should advise me to cut down on alcohol.”
96%
“As part of my medical care, my doctor should feel free to ask me how much alcohol I drink.”
93%
Disagree/Strongly Disagree
“I would be annoyed if my doctor asked me how much alcohol I drink.”
86%
“I would be embarrassed if my doctor asked me how much alcohol I drink.”
78%
“Miller addressed this question with a survey of 159 primary care patients and found that, overall, patients were supportive of SBIRT. Most agreed or strongly agreed that doctors should feel free to ask about alcohol use as part of patient’s medical care.”
Miller, P. M., et al. (2006). Alcohol & Alcoholism.
Adapted from The Oregon SBIRT Primary Care Residency Initiative training curriculum (