SBIRT Protocol
Workflow
Universal Screening for Alcohol and Substance Use Misuse/Disorders
MAs ask initial screening questions during Triage
Negative screening - filed and completed
Positive screening - Patient is handed the Audit-C (for alcohol) or the DAST-10 (for drug use)
Triage based on score
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Low Risk: Audit-C score (0-2; women, 0-3; men), DAST-10 score (0-2):
- Provider updates alcohol/drug history
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Moderate Risk: Audit-C score (3-7; women, 4-7; men), DAST-10 score (3-5):
- Provider updates alcohol/drug history
- Provider does Brief Intervention: using the .alcoholdrugintervention dotphrase
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High Risk: Audit-C score (8+), DAST-10 score (6+):
- Provider updates alcohol/drug history
- Provider Refers to REACH clinic (email reach@mountsinai.org or #REACH) and Calls the Patient Navigator for REACH (646-951-1693) for real-time, in person warm handoff. If evening clinic, please just send the email as below If in the evening or on a Saturday, please email REACH as below, and a patient navigator will reach out to the patient.
- Patient Initials
- MRN
- Firm and Room number
- Substance(s) used in the last year
- Interested in buprenorphine
- Patient have untreated hepatitis C
- Name of provider
- Phone number of provider
- Patient Best Phone Number
-use your Mount Sinai email address to send the above!
- If patient is not appropriate for REACH, Provider Refers to SW (using BPA that pops up) and Calls the SW (health homes or triage- see care team in EPIC to assess if HH) for real-time, in person warm handoff.SW does Brief Intervention using the .alcoholdrugintervention dotphrase and if patient amenable - refers to treatments center (some options below)
Important dotphrases
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Intervention
- .alcoholdrugintervention**
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Educational
- .alcoholeducation; .marijuanaeducation; .cocaineeducation; .opioideducation; .otherdrugeducation
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Goals dotphrases
- .alcoholgoalsworksheet; .druggoalsworksheet
Recommended limits for alcohol use
- FOR HEALTHY MEN UP TO AGE 65: No more than 4 drinks in a day AND no more than 14 drinks in a week
- FOR HEALTHY WOMEN, AND MEN OVER AGE 65: No more than 3 drinks in a day AND no more than 7 drinks in a week
Substance Use Disorder Options
IMA SW Triage: Please refer to IMA SW for assistance in identifying resources and making appointments for mental health and substance use. Triage Walk-in hours on Mondays-Fridays 9am-4pm. Have patient register at your primary care firm front desk to see Social Work during walk in hours.
Mount Sinai West Addiction Institute of NY. 429 West 58th Street NY NY 10019, Contact: Mr. Stephen Torre: 212-523-8009 (Alcohol, Tx: Methadone/Suboxone, Stimulants, Sedatives, Cannabis) or Ingrid Pascail, LCSW: 212-523-6166
Mount Sinai Beth Israel OTP. 429 2nd Avenue, NY, NY 10010, Contact: Georgina Spence-Hardy: 212-726-6800 (Opioid Tx: Methadone/Suboxone, Alcohol and benzodiazepine treatment) or main number 212-726-6824
Mount Sinai St. Luke's Treatment Center. 411 W 114th St, New York, 10025 Rm 400. 212-280-0100
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Lower Eastside Service Center, Inc. (LESC)
- Outreach Coordinator: Dennis Murphy @ 917-217-3771
- Opioid Treatment Program (outpatient): Contact: Jaime Holder@ cell 347-723-0859 or @ office 212-343-3584 46 East Broadway, NY, NY 10002 and 62 East Broadway, NY, NY 10002,
- Outpatient Treatment: Contact: Theresa Pension @ 212-343-3522 46 East Broadway, NY, NY 10002, Residential Treatment:Contact: Sabrina Mangual @ office 212-566-7590 or cell 347-538-2632 7 Gouvernuer Slip East, NY, NY 10002;
To explore alternative referral options for this patient one may
visit www.hitesite.org
call or visit 1888-NYC-well (1-888-692-9355) NYCwell.cityofnewyork.us/en/ and provide insurance info and zip code