Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a comprehensive public health approach for delivering early intervention and treatment services to people with, or at risk of developing, substance use disorders. Healthcare providers using SBIRT ask patients about substance use during routine medical and dental visits, provide brief advice, and then, if appropriate, refer patients who are at risk of substance use problems to treatment. Release of the Institute of Medicine report Broadening the Base of Treatment for Alcohol Problems1 provided recognition that alcohol and drug abuse occur along a continuum of both level of consumption and consequences. This recognition is illustrated by a treatment pyramid (shown above) that has been developed to depict the role of SBIRT in addressing needs across the continuum of use.