This is an encounter for a new patient to a primary care practice where all patients are screened for drug and alcohol use. The patient is going to complete a DAST-10 Questionnaire which asks a series of questions about drug use but does not include alcohol or tobacco. The patient has been using heroin. In the past was on opiates for pain management but those were stopped about a year ago. Since then the patient has been buying opiates or buprenorphine off the street and eventually switched to heroin as it was cheaper. Has had injection drug use. Recently had an overdose scare but didn’t go to the hospital. Hides use from family and friends. Working full time. The provider will use a technique called SBIRT which stands for Screening Brief Intervention Referral to Treatment to assess patient’s possible drug abuse and help patient get treatment if needed. When obtaining a substance use history need to assess for Age of First Use, Amount per use, Frequency of Use, Duration of Use, Method of Use and When Last Used Substances. Finally the provider will use Motivational Interviewing techniques to illicit how ready the patient is to make a change and consider treatment.

The scene begins after the provider has introduced themselves and started the history taking process. The provider will have asked about medical and surgical history and will now approach the social and substance use history.