The effectiveness of screening, brief intervention, and referral (SBIRT) has been documented in hundreds of published and peer-reviewed articles. It can be used for both alcohol and drug issues, and many patients are known to have been using both before the emergency department (ED) visit. The teachable moment created by an injury and treatment in an ED can be a wakeup call for patients to change their risky drinking or drugging behavior and seek help. Help may be through Alcoholics/Narcotics Anonymous, outpatient treatment, inpatient treatment, or decreasing or stopping drinking and or drugging. This document includes screening tools, a three-step process for SBIRT and a brief intervention handout for patient at discharge.