Alcohol Screening and Brief Intervention (SBI)

What to know

Alcohol screening and brief intervention (SBI) is effective at reducing excessive drinking. Although effective, alcohol SBI is underutilized. CDC is working to make alcohol SBI a routine part of health care in primary care settings.

Healthcare professional asking a patient questions and writing on a clipboard

What it is

Alcohol SBI is a preventive service, like blood pressure or cholesterol screening. It can occur as part of a patient's wellness visit. Clinicians can use SBI to identify adults who drink excessively and offer behavioral counseling to those who need it.

Alcohol SBI involves

  • Brief screening questions, which are validated to identify patients' drinking patterns, and
  • A short conversation with patients who are drinking excessively, as well as referral to treatment when appropriate.

Why it's important

Excessive alcohol use* is common

Binge drinking.* Over 90% of U.S. adults who drink excessively report binge drinking.1 Additionally, among all adults in the U.S., 17% report binge drinking.2

Heavy drinking.* In 2022, about 6% of the adult population reported heavy drinking.2

Pregnant women.* During 2018–2020, nearly 1 in 7 (14%) pregnant women in the United States reported drinking alcohol in the past 30 days. About 1 in 20 (5%) reported binge drinking in the same time period.3

People younger than 21 years of age.* Alcohol is the most common drug that young people use in the United States. In 2023, 22% of high school students reported drinking alcohol during the past month.4

*Excessive alcohol use includes:

  • Binge drinking--4 or more drinks for women, or 5 or more drinks for men during an occasion
  • Heavy drinking--8 or more drinks for women, or 15 or more drinks for men during a week
  • Any alcohol use by people younger than 21
  • Any alcohol use during pregnancy

Excessive alcohol use leads to widespread harm

Alcohol and pregnancy. Drinking any amount of alcohol during pregnancy can cause a range of physical, behavioral, and learning problems in the baby, called fetal alcohol spectrum disorders (FASDs).5 Additionally, drinking during pregnancy is a risk factor for other poor pregnancy outcomes, such as miscarriage and stillbirth.6

Health and social harm. Excessive alcohol use contributes to a range of negative health and social consequences, including motor vehicle crashes and intimate partner violence. It can also result in serious medical conditions, such as high blood pressure, digestive problems, liver disease, and various cancers.

Deadly. During 2020–2021, excessive alcohol use was responsible for about 178,000 deaths each year and a total of about 4 million years of potential life lost each year.

Effective clinical interventions are available

Alcohol SBI works. More than 30 years of research has shown that alcohol SBI is effective at preventing excessive alcohol use. Based on this evidence, the U.S. Preventive Services Task Force,7 as well as many other organizations, have recommended that clinicians implement alcohol SBI for all their adult patients in primary healthcare settings.

The Community Preventive Services Task Force recommends the use of alcohol electronic SBI (eSBI).8

  • e-SBI means using electronic devices, such as computers or mobile devices, to identify if someone drinks excessively.
  • It also includes a brief intervention to help those who drink too much to learn ways to cut back.
  • e-SBI can be done in many settings, including workplaces, universities, or healthcare settings.

Alcohol SBI is underutilized

Although 81% of adults in 13 US states and Washington, DC, reported being asked by their healthcare provider about alcohol use, only about 38% reported being asked about binge drinking during a routine checkup in the last 2 years (2017 data). Among adults who reported being asked about their alcohol use at a checkup in the past 2 years and reported current binge drinking, 80% (or 4 of 5 people) were not counseled to reduce their drinking.9

As it relates to pregnancy, data from 2017 and 2019 showed that about 80% of pregnant women were asked about alcohol use during their most recent healthcare visit. Only 16% who self-reported drinking within the past 30 days were advised by their healthcare provider to quit or reduce their use. These findings highlight missed opportunities for healthcare providers to integrate alcohol screening and brief intervention (SBI) in practice, utilize strategies to address recognized barriers (for example, improving reimbursement for alcohol SBI), and help reduce alcohol use during pregnancy.10

Print
Content Source:
National Center on Birth Defects and Developmental Disabilities
  1. Esser MB, Hedden SL, Kanny D, Brewer RD, Gfroerer JC, Naimi TS. Prevalence of alcohol dependence among US adult drinkers, 2009-2011. Prev Chronic Dis. 2014;11:140329.
  2. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System. Accessed February 29, 2024. https://www.cdc.gov/brfss
  3. Gosdin LK, Deputy NP, Kim SY, Dang EP, Denny CH. Alcohol consumption and binge drinking during pregnancy among adults aged 18–49 years – United States, 2018–2020. MMWR Morbidity and Mortality Weekly Report 2022;71(1): 10-13.
  4. Centers for Disease Control and Prevention. 2023 Youth Risk Behavior Survey Data. Accessed December 5, 2024. https://www.cdc.gov/yrbs/index.html
  5. Riley EP, McGee CL. Fetal alcohol spectrum disorders: An overview with emphasis on changes in brain and behavior. Exp Biol Med (Maywood). 2005;230:357–365.
  6. Bailey BA, Sokol RJ. Prenatal alcohol exposure and miscarriage, stillbirth, preterm delivery, and sudden infant death syndrome. Alcohol Res Health. 2011;34(1):86–91.
  7. US Preventive Services Task Force, Curry SJ, Krist AH, Owens DK, Barry MJ, Caughey AB, Davidson KW, Doubeni CA, Epling JW Jr, Kemper AR, Kubik M, Landefeld CS, Mangione CM, Silverstein M, Simon MA, Tseng CW, Wong JB. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US Preventive Services Task Force recommendation statement. JAMA. 2018;320(18):1899-1909.
  8. Tansil KA, Esser MB, Sandhu P, et al. Alcohol electronic screening and brief intervention: A Community Guide systematic review. Am J Prev Med. 2016;51(5):801–11.
  9. McKnight-Eily LR, Okoro CA, Turay K, Acero C, Hungerford D. Screening for Alcohol Use and Brief Counseling of Adults — 13 States and the District of Columbia, 2017. MMWR Morb Mortal Wkly Rep 2020;69:265–270. DOI: http://dx.doi.org/10.15585/mmwr.mm6910a3.
  10. Luong J, Board A, Gosdin L, et al. Alcohol Use, Screening, and Brief Intervention Among Pregnant Persons — 24 U.S. Jurisdictions, 2017 and 2019. MMWR Morb Mortal Wkly Rep 2023;72:55–62. DOI: http://dx.doi.org/10.15585/mmwr.mm7203a2.