Dental School SBIRT Curriculum – Foundational Training for Substance Use Disorders-MODULE 2

MODULE 2_Alcohol Case.

Pdf Summary

This dental school training module presents a case study of Mr. Ernest, a 65-year-old retired journalist who comes for routine dental care but reveals signs of problematic alcohol use. He reports chronic stomach upset, daily use of prescription Zantac, increasing alcohol consumption, nightly whiskey use to help him sleep, weekend binge drinking, blackouts, and drinking to calm anxiety the morning after heavy use. His social history includes divorce, loneliness, retirement, and social isolation, all of which may contribute to his alcohol use. He denies tobacco or drug use and has no major reported medical conditions.<br /><br />The module teaches how dentists can respond using SBIRT: Screening, Brief Intervention, and Referral to Treatment. Universal screening helps determine whether the issue is alcohol alone or part of a broader substance use problem. Suggested screening tools include open-ended questions, SASQ, AUDIT-C, NIDA Quick Screen, and AUDIT-10. The AUDIT helps classify risk level and guide intervention.<br /><br />Brief Intervention is based on Motivational Interviewing, which emphasizes a patient-centered, collaborative, nonjudgmental approach that respects autonomy and supports self-efficacy. Core MI skills include open-ended questions, reflections, summaries, and empathy. The four steps of brief intervention are: raise the subject, provide feedback, enhance motivation, and negotiate a plan.<br /><br />The module also reviews risk factors for alcohol use disorder, such as heavy drinking, family history, mental health problems, and stress; relapse triggers, including alcohol cues, stress, and exposure to small amounts of alcohol; and symptoms of alcohol withdrawal, ranging from anxiety and insomnia to seizures and delirium tremens.<br /><br />For treatment, it outlines FDA-approved medications for alcohol use disorder: naltrexone, disulfiram, and acamprosate, plus medications for acute withdrawal such as benzodiazepines and sometimes anticonvulsants. The overall goal is to integrate dental care with screening, counseling, and referral to appropriate treatment resources using a “warm hand-off” approach.

Keywords

dental screening

alcohol use disorder

SBIRT

motivational interviewing

AUDIT-C

brief intervention

referral to treatment

alcohol withdrawal

naltrexone

warm hand-off