Editorial: The evidence and practice-gap of screening and brief interventions for substance misuse

Screening and brief intervention (SBI) is a low-intensity, time-limited psychosocial treatment for substance misuse. The therapeutic principle is grounded on the social cognitive theory encompassing different combinations of personalized feedback, styles of motivational interviewing (MI), decisional balance, advice, identifying and managing high-risk situations, and providing a personalized menu of options to reduce or stop substance use (1). SBI could be limited to brief structured advice or extended as an MI-based intervention with more than one session and can be as little as 5 min (2). Heather, one of the architects of SBI, has termed it a “family of interventions” (3). The essence of SBI lies in its flexibility- different delivery settings, delivery by a wide range of professionals or through mobile or internet, and effectiveness across age groups. Modeling studies show alcohol BI is cost-effective in terms of the quality-adjusted life year gains and provides modest cost savings to the healthcare system (4, 5). Although during the first couple of decades, SBI was tested for problem alcohol use, in the last two decades, it has been tested for drug misuse and problem behaviors (6). The brevity, flexibility, and cross-cutting application have made SBI scalable, even in resource-limited settings. Therefore, SBI could become a public health tool to reduce the substantial disability attributed to substance use (7). SBI, in conjunction with other population-level measures for alcohol use, can help realize the global non-communicable disease target of a 10% reduction in harmful alcohol use. Despite being a promising intervention, SBI has several evidence and implementation gaps that must be addressed.