Introduction: In Mexico the consumption of tobacco and alcohol represents a public health problem. Models of screening, brief intervention and referral to treatment (SBIRT) have shown efficacy in reducing such consumption, so they are used in different scenarios. One of its most important characteristics is the proximity of professionals to situations and problems about consumption. Despite extensive experience in the development of these models, they have been poorly adapted for use by medical and health personnel at the first level of care.

Objective: To describe barriers and opportunities encountered during the implementation of a pilot project of screening, brief counseling and referral to treatment aimed at medical and related personnel of the first level of health care.

Method: Two focus groups were conducted in a randomized sample of 15 certified health professionals out of a total of 64, who developed practical experience performing interventions with the population of their health facility.

Results: Various communication barriers, personal and organizational, were found; however, opportunities emerging from the implementation of this model were also identified.

Discussion and conclusions: The use of brief interventions at the first level of care has advantages for those who apply and receive them, such as the increase in the productivity of the screening and brief counseling actions reported in the Health Information System, as well as the opportunity to provide the user with a personalized intervention focused specifically on the problems of the local population.