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An even briefer screening tool has only 2 questions: “In the past year, how often have you drank 5 or more drinks per day?” “Have you used prescription drugs for non-medical purposes or illegal drugs within the last year?” Brief Intervention: Brief negotiated interview Build rapport, ask permission to discuss substance use and goals Open ended questions, non-judgmental Give feedback and share concern if patient gives permission Identify the problem and your concern, and tie it to ED presentation Use the “Readiness Ruler” to assess stage of change On a scale of 1-10, how ready are you to make a change today