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Systems-Level Implementation of Screening, Brief Intervention and Referral to Treatment

Chapter 1 - Introduction

1. Many individuals may never meet the criteria for substance abuse or dependence, but they may still place themselves and others at risk for harm because of excessive substance use.

A. True

B. False

2. SBIRT is a comprehensive, integrated public health model designed to provide which of the following?

A. Universal screening

B. Secondary prevention

C. Early intervention

D. All of the above

3. The SAMHSA SBIRT model only screens patients with certain identified disorders or when the patient is actively seeking an intervention or treatment for his or her problems.

A. True

B. False

4. All of the following are characteristics reflected by a research-based comprehensive behavioral health SBIRT model supported by SAMHSA, except:

A. It is brief.

B. The screening is universal.

C. The services occur in an SUD treatment setting.

D. It is comprehensive.

5. As a comprehensive or model approach, SBIRT has been demonstrated to be effective only for risky alcohol use.

A. True

B. False

6. Most of the SBIRT research addresses which of the following?

A. Screening and BI components

B. Efficacy of the RT components

C. Cost effectiveness of the RT components

D. All of the above

7. The SAMHSA SBIRT Initiative provides grants and support through all of the following avenues, except:

A. Colleges and universities

B. Private funders

C. Medical residency programs

D. State cooperative agreements

8. Overall, the C1 evaluation team found that SBIRT is not sustainable.

A. True

B. False

9. Which of the following is used to describe drinking so much within about 2 hours that the level of blood alcohol concentration increases to 0.08 g/dL?

A. Binge drinking

B. Excessive alcohol use

C. Harmful drinking

D. Hazardous drinking

Chapter 2 - SBIRT Overview

10. All of the following are true with regard to screening, except:

A. Screening is a process of identifying patients with possible substance misuse or abuse problems.

B. Screening is used to determine the appropriate course of future action for individuals.

C. Screening identifies what kind of problem a person has and how serious a problem it is.

D. Screening determines whether a problem exists or whether further assessment is needed.

11. Which of the following is a commonly used screen for the implementation of SBIRT for alcohol and drug use?

A. Alcohol Use Disorders Identification Test

B. The Cut Down, Annoyed, Guilty, Eye-Opener

C. The National Institute on Drug Abuse Drug Use Screening Tool

D. All of the above

12. Recent studies have found a single question related to alcohol or drug use to be effective in detecting alcohol use or drug use among primary care patients.

A. True

B. False

13. Which of the following is appropriate for patients identified through screening to be at moderate risk for substance use problems?

A. Brief intervention

B. Brief treatment

C. Referral to treatment

D. None of the above

14. Primary care providers cite concerns about angering or insulting patients by bringing up sensitive issues such as alcohol and drug use as a reason not to execute either BI or BT.

A. True

B. False

15. Prescreening / screening tools accurately and quickly identify individuals with problematic conditions in as little time as __________ minutes.

A. 1 - 2

B. 2 - 4

C. 5 - 10

D. 10 - 20

16. Prescreening is a core component of SBIRT.

A. True

B. False

17. Substance abuse has been associated with higher levels of all of the following medical conditions, except for:

A. Cardiovascular disease

B. Respiratory failure

C. Infectious diseases

D. Hepatic disorders

18. The evidence supporting the effectiveness of BI suggests that even short conversations with a healthcare professional such as a nurse, physician assistant, or physician, can reduce a patient’s substance use.

A. True

B. False

19. One study by Svikis and Jones found that screening pregnant women for which lifestyle attribute was a useful way to identify women who were at risk for alcohol and drug use?

A. Sedentary activity level

B. Over-the-counter medication use

C. Smoking

D. All of the above

20. The conduct of SBIRT for alcohol use disorders has already been found to be effective in all of the following healthcare settings for diverse patient populations, except for:

A. Emergency departments

B. Primary care

C. Schools and colleges

D. Employee assistance programs

21. A study by Saitz et al. found that BIs with hospital patients were sufficient for linking medical inpatients who had alcohol dependence with appropriate treatment and that BI had a significant effect on patients’ level of alcohol consumption.

A. True

B. False

22. Some studies have found even telephone interventions to be efficacious.

A. True

B. False

23. SBIs have been linked with reductions in the use of which of the following?

A. Amphetamine-type stimulants

B. Cocaine

C. Heroin

D. All of the above

24. Among persons recommended for BT or RT, patients not only reported reduction in criminal behavior, but also reported significant improvements in which of the following?

A. General health

B. Mental health

C. Employment and housing status

D. All of the above

25. The C1 evaluation team found that SBIRT’s impact on opioid use showed a statistically significant decrease with which group?




D. All of the above

26. The comprehensive SBIRT model has been demonstrated to be effective for which of the following?

A. Risky alcohol use

B. Depression

C. Trauma

D. All of the above

27. Research has shown that mental disorders and cigarette smoking are frequently co-occurring conditions.

A. True

B. False

28. USPSTF supports depression screening for adults even if effective treatment and followup are not available.

A. True

B. False

29. The National Comorbidity Survey Replication found which disorder to have the highest percentage of lifetime prevalence of all the mental disorders in the United States?

A. Depression

B. Anxiety disorders

C. Psychological trauma

D. None of the above

30. A study done by Walker et al. found that 61% of women reported that they believed that is was inappropriate for their primary care physician to ask about previous victimization.

A. True

B. False

Chapter 3 - SBIRT Implementation

31. The MORC scale helps an organization do all of the following, except:

A. Understand its operations

B. Focus on its weaknesses when implementing strategies

C. Tailor strategies to different settings

D. Guide the implementation process

32. Cost-benefit analyses suggest that some functions may be performed as equally well, and at lower costs, by midlevel or support staff as by senior staff.

A. True

B. False

33. Which of the following is not a substance abuse treatment professional?

A. In-house generalist

B. In-house specialist

C. Contracted specialist

D. All of the above are substance abuse treatment professionals

34. All SBIRT staff training should include role-playing and supervised practice.

A. True

B. False

35. The first step in developing a screening protocol is to decide which of the following?

A. The frequency of each person’s screening

B. What will be screened for

C. Who will be screened

D. How patients will be screened

36. Short, simple screens cannot identify hazardous use or dependence as accurately as longer, more complex screening tools, but can be done at a lower cost.

A. True

B. False

37. Research suggests that BI or BT alone will not suffice for people who are severely dependent on alcohol or drugs or who have co-occurring disorders.

A. True

B. False

Chapter 4 - Implementation and Sustainability Issues

38. The Uniform Accident and Sickness Policy Provision Law allows insurance companies to deny payments to individuals injured while under the influence of alcohol.

A. True

B. False

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