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This change guide is designed to assist primary care clinicians and leaders to integrate care for patients with unhealthy alcohol and/or other drug use into routine medical care. As behavioral health care is increasingly integrated into medical settings, especially primary care, the focus is often on depression and anxiety. Care for alcohol and/or other drugs is often omitted or minimized, likely reflecting: stigma, lack of workforce training/education, and the traditional separation of care for alcohol and other drugs from traditional health care (e.g., primary care, emergency care, and behavioral health, etc.). This guide expands on and updates the widely recognized model of Screening, Brief Intervention, and Referral to Treatment (SBIRT).

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