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West J Emerg Med. 2017 Oct;18(6):1143-1152. doi: 10.5811/westjem.2017.7.34373. Epub 2017 Sep 21.

Effectiveness of SBIRT for Alcohol Use Disorders in the Emergency Department: A Systematic Review.

Author information

North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York.
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.
Harborview Medical Center, University of Washington Medical Center, Department of Emergency Medicine, Seattle, Washington.
American College of Emergency Physicians, Dallas, Texas.
Cedars-Sinai Medical Center, Department of Emergency Medicine, Los Angeles, California.
UCLA David Geffen School of Medicine, Emergency Medicine Center, Los Angeles, California.
Indiana University School of Medicine, Department of Emergency Medicine, Indianapolis, Indiana.
Cullman Regional Medical Center, Department of Emergency Medicine, Cullman, Alabama.
Parkland Memorial Hospital, Department of Emergency Medicine, Dallas, Texas.
Lincoln Medical and Mental Health Center, Department of Emergency Medicine, Bronx, New York.
Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts.



Alcohol use disorders (AUD) place a significant burden on individuals and society. The emergency department (ED) offers a unique opportunity to address AUD with brief screening tools and early intervention. We undertook a systematic review of the effectiveness of ED brief interventions for patients identified through screening who are at risk for AUD, and the effectiveness of these interventions at reducing alcohol intake and preventing alcohol-related injuries.


We conducted systematic electronic database searches to include randomized controlled trials of AUD screening, brief intervention, referral, and treatment (SBIRT), from January 1966 to April 2016. Two authors graded and abstracted data from each included paper.


We found 35 articles that had direct relevance to the ED with enrolled patients ranging from 12 to 70 years of age. Multiple alcohol screening tools were used to identify patients at risk for AUD. Brief intervention (BI) and brief motivational intervention (BMI) strategies were compared to a control intervention or usual care. Thirteen studies enrolling a total of 5,261 participants reported significant differences between control and intervention groups in their main alcohol-outcome criteria of number of drink days and number of units per drink day. Sixteen studies showed a reduction of alcohol consumption in both the control and intervention groups; of those, seven studies did not identify a significant intervention effect for the main outcome criteria, but nine observed some significant differences between BI and control conditions for specific subgroups (i.e., adolescents and adolescents with prior history of drinking and driving; women 22 years old or younger; low or moderate drinkers); or secondary outcome criteria (e.g. reduction in driving while intoxicated).


Moderate-quality evidence of targeted use of BI/BMI in the ED showed a small reduction in alcohol use in low or moderate drinkers, a reduction in the negative consequences of use (such as injury), and a decline in ED repeat visits for adults and children 12 years of age and older. BI delivered in the ED appears to have a short-term effect in reducing at-risk drinking.

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Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

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