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. It identifies and helps individuals who are drinking more than the recommended amounts.

Alcohol SBI involves

  • Validated screening questions, which only take a few minutes to complete, that identify patients' drinking patterns, and
  • A short conversation with patients who are drinking more than the recommended amounts, as well as referral to treatment when appropriate.

Why it's important

Excessive alcohol use* is common

Binge drinking.* More than 37 million American adults binge drink.1

Heavy drinking.* In 2018, about 7% of the adult population reported heavy drinking.2

Pregnant people.* During 2018–2020, nearly 1 in 7 (14%) pregnant people 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.* In 2017, 60.4% of high school students reported having ever drank alcohol.4

*Excessive alcohol use includes binge drinking (5 or more drinks for men and 4 or more drinks for women within a 2-hour time period), heavy drinking (more than 14 drinks a week for men and more than 7 a week for women), and any alcohol consumption by pregnant people or people younger than 21 years of age.

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. Over time, it can result in serious medical conditions, such as high blood pressure, digestive problems, liver disease, and various cancers.

Costly and fatal. During 2015–2019, excessive alcohol use was responsible for more than 140,000 deaths and 3.6 million years of potential life lost each year, on average.

Effective clinical interventions are available

Alcohol SBI works. More than 30 years of research has shown that alcohol SBI is effective at reducing excessive alcohol use. Based on this evidence, the U.S. Preventive Services Task Force,7 as well as many other organizations, have recommended that alcohol SBI be implemented for all adults being seen in primary healthcare settings.

In 2012, the Community Preventive Services Task Force recommended the use of alcohol electronic SBI (eSBI).8

Alcohol SBI is underutilized

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Alcohol screening and brief intervention can help prevent or reduce alcohol exposure during pregnancy. 80% of pregnant people were asked about recent alcohol use at their last healthcare visit. Only 16% who reported current drinking were advised to quit or reduce their alcohol use. We can do more to address barriers to implementing alcohol screening and brief intervention during pregnancy.
Alcohol screening and brief intervention (counseling) during pregnancy

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 persons) were not counseled to reduce their drinking.9

As it relates to pregnancy, data from 2017 and 2019 showed that about 80% of pregnant people 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

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Content Source:
National Center on Birth Defects and Developmental Disabilities
  1. Stahre M, Roeber J, Kanny D, Brewer RD, Zhang X. Contribution of excessive alcohol consumption to deaths and years of potential life lost in the United States. Prev Chronic Dis. 2014;11:E109.
  2. Centers for Disease Control and Prevention. "Data and Maps" Alcohol and Public Health, CDC. https://www.cdc.gov/alcohol/data-stats.htm, March 27, 2018.
  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. Youth Risk Behavior Surveillance – United States, 2017 Morb Mortal Wkly Rep Surveil Summ 2018; 67 (No. SS: 1-479).
  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.