When we learn that our patients are using substances, we naturally want to help patients understand and change their substance use in order to reduce our patients risks and improve their health.


Those changes may involve stopping use altogether, that is, becoming abstinent, or target smaller changes that are more readily adoptable by our patients, such as moderation or other harm reduction.

Brief interventions are a first step we can take to help patients initiate change in their substance use behaviors.

A good place to start with a brief intervention is to understand the patient’s stage of change: have they thought about changing? Where are they in relation to changing?

With a particular stage of change in mind, we can then use FRAMES to help build a change plan with patient.

Throughout the process, motivational interviewing, or MI, can help us understand, connect with, and foster change among our patients.

MI flowchart