Brief intervention and referral to treatment-sbirt

Question

Assignment Task:

Presentation: Screening - with Brief Intervention and Referral to Treatment (SBIRT). Need Assignment Help?

Develop a PowerPoint presentation that includes the following criteria:

Slide 1:  Title Page.

Slide 2:  SBIRT overview - Describe the history of SBIRT, the SBIRT process and how it is used in clinical practice settings using US research articles.

Slide 3: Case Presentation - Do not include patient identifying information but include demographics i.e. age, gender, race/ethnicity, chief complaint, social history, family psychiatric history, psychiatric history, and risk factors.

Slide 4:  Screening Tool used - Describe the screening tool, validity (sensitivity and specificity), scoring information, and citation.  Your patient's score and the interpretation of the patient's score are required.

• Must include a picture of the screening tool

Slide 5:  Brief Intervention - How was the Motivational Interviewing process applied and shared your client's score and need for behavioral changes.

Slide 6:  Referral for Treatment - Describe the referral for follow-up treatment plan.  Include the name, address and telephone number of the local large organization.  Be specific with the department where necessary.

Slide 7:  Evaluation of the process - Share the patient's outcome and your evaluation of the SBIRT process.

- Include Four Stages of MI

• Engaging, Focusing, Evoking, Planning
• OARS technique during session, how it was used
• Roadblocks from patient
• And clients stage of change

Slide 8:  References -5 references.  7th Edition APA format.  Include Screening Tool authors.

Submission Instructions:

• The slides are to be clear and concise, and students will lose points for improper grammar, punctuation, and misspelling.
• The narration is to be fluid with clear enunciation and the volume of speech is appropriate, with no pauses or distracting fillers.
• The PowerPoint presentation should be formatted per current APA guidelines and 8-10 slides in length, including the title and references slides. Incorporate a minimum of 5 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. For presentation clarification, students may include the presenter's notes. Only web links will be accepted as references for community resources. Scholarly

Patient Case Summary: Opioid Use Disorder

• Chief Complaint: "I want help to stop using oxycodone and blues."
• Age: 38 years old
• Gender: Male
• Race/Ethnicity: Caucasian, Non-Hispanic

History Summary:

- HPI (History of Present Illness):

T. L. is a 38-year-old Caucasian male presenting for psychiatric evaluation and treatment of opioid use. He reports increasing dependence on prescription painkillers, originally prescribed following a work-related back injury five years ago. Over the past year, he began purchasing opioids illicitly due to tolerance and lack of refills. He describes daily use of oxycodone (approximately 80-100 mg per day) and occasional fentanyl use when he cannot afford or obtain the oxycodone, he will use "blues". Oral only, denies any intravenous drug abuse (IVDA). He reports experiencing withdrawal symptoms such as chills, muscle aches, and insomnia if he goes without opioids for more than 12-16 hours. He has had two prior non-fatal overdoses and states, "I'm scared I won't wake up next time." He reports using to avoid withdrawal rather than for euphoria. He expresses readiness for treatment but is unsure where to begin.

- Social History:

T.L is divorced, has partial custody of his 10-year-old son. He currently lives with his mother and is unemployed due to chronic pain and opioid dependence. He previously worked in construction but has been out of work for three years. He reports financial instability and strained family relationships. He denies current romantic relationships. Tobacco use: 1 pack/day. Alcohol: drinks socially, 1-2 times/month. Denies other illicit drug use aside from opioids.

- Family Psychiatric History:

• Father: history of alcohol use disorder, deceased (cirrhosis, age 58)
• Mother: diagnosed with generalized anxiety disorder
• Paternal uncle: suicide (unknown psychiatric history)

- Psychiatric History:

T.L. reports a history of major depressive disorder, first diagnosed in his late teens. He was previously prescribed sertraline but discontinued due to sexual side effects. He reports current symptoms of depression, including low motivation, poor concentration, and feelings of worthlessness. No prior psychiatric hospitalizations. No history of psychosis or mania. He has had limited engagement with therapy but is open to counseling if paired with addiction treatment.

- Risk Factors:

• History of chronic pain and opioid prescription
• Family history of substance use and psychiatric illness
• Unemployment and psychosocial stressors
• Two prior overdoses
• Poor coping skills and limited support system
• Depression and hopelessness
• Access to illicit opioids

Interventions:

1. Medically-Assisted Withdrawal (Detoxification Phase):

Clonidine 0.1 mg PO TID PRN

• Use: Off-label for opioid withdrawal symptoms (e.g., anxiety, sweating, irritability).
• Monitor: BP and sedation.
• Cost: Generic; ~$5-10 for 30 tablets.

Hydroxyzine 25 mg PO Q6H PRN

• Use: Anxiety, insomnia, nausea.
• Cost: Generic; ~$4-6 for 30 tablets.

Loperamide 2 mg PO PRN (up to 8 mg/day)

• Use: Diarrhea management.
• Cost: OTC; <$10.

Acetaminophen 500 mg Q6H PRN

• Use: Muscle aches and generalized discomfort.
• Cost: OTC; <$5.

Trazodone 50 mg PO QHS PRN for sleep

• Use: Short-term sleep support during detox.
• Cost: ~$6-10 generic.

2. Maintenance Treatment (Post-Detox / Craving Management):

Buprenorphine/naloxone (Suboxone) 8 mg/2 mg SL daily

• Titrate as needed (typical maintenance dose: 8-16 mg/day).
• Use: First-line MAT (medication-assisted treatment) for OUD. Reduces cravings and withdrawal symptoms.
• Split dosing if cravings persist
• Must be at least 12 hours sober, free of opioid use prior to iniating
• Can also help with detox after 12 hour period to help with detox symptoms and duration
• Cost: ~$100-200/month (generic programs and discount cards may reduce cost).

Narcan Nasal- Naloxone (Narcan) 4 mg nasal spray, Dispense: 2 devices

Sig: Spray 1 spray into one nostril upon signs of overdose; may repeat after 2-3 minutes in alternate nostril.

CALL 911 if you have to use Narcan

Screening: First we need to manage detox/ withdrawal symptoms.

4. COWS (Clinical Opiate Withdrawal Scale)

Purpose: Not a screening tool per se, but used to assess opioid withdrawal severity.

Use Case: Guides buprenorphine induction timing.

Format: 11-item clinician-administered scale (e.g., pulse, GI upset, yawning).

Scoring:

• 5-12 = Mild withdrawal
• 13-24 = Moderate
• 25-36 = Moderately severe
• 36 = Severe withdrawal

5. DSM-5 OUD Checklist (Structured Clinical Criteria)

Purpose: Diagnostic screening using DSM-5 criteria.

Content: 11 criteria assessing impaired control, social impairment, risky use, and pharmacologic indicators (tolerance, withdrawal).

Severity:

• 2-3 criteria = Mild OUD
• 4-5 = Moderate
• ≥6 = Severe

6. ORT (Opioid Risk Tool)

• Purpose: Predicts risk of opioid misuse before initiating opioid therapy.
• Format: 5-question patient self-report (e.g., personal/family SUD history, psychological disorders).
• Scoring: Low, moderate, or high risk.
• Limitations: Not used for diagnosis but risk stratification.

7. SOAPP-R (Screener and Opioid Assessment for Patients with Pain - Revised)

• Purpose: Assesses risk of misuse in patients being considered for long-term opioid therapy.
• Format: 24-item self-report.
• Best For: Chronic pain patients, not acute diagnosis of OUD.