Substance-Use-Screening

Substance Use Screening and Brief Intervention for Youth

Substance use by adolescents has an enormous impact on their health and well-being. It impairs healthy growth and development, is associated with risky behaviors such as unprotected sex and dangerous driving, and contributes to the development of many other health problems.

Pediatric care providers play a critical, ongoing role in the lives of their adolescent patients and have a unique opportunity to educate them about the dangers of substance use and to influence their behaviors.

Compared to people in other age groups, adolescents are at the highest risk for experiencing health problems related to substance use (Committee on Substance Use and Prevention, American Academy of Pediatrics, 2015). The potential benefits of identifying substance use and intervening to reduce or prevent it are substantial.

AAP Policy

Substance Use Screening, Brief Intervention, and Referral to Treatment, AAP Policy Statement
Substance Use Screening, Brief Intervention, and Referral to Treatment, AAP Clinical Report
Binge Drinking, AAP Clinical Report
Promoting Optimal Development: Screening for Behavioral and Emotional Problems, AAP Clinical Report
Families Affected by Parental Substance Use, AAP Clinical Report
Fetal Alcohol Spectrum Disorders, AAP Clinical Report

Substance Use Screening and Intervention Implementation Guide

The American Academy of Pediatrics (AAP) has developed this guide to help pediatricians incorporate screening, brief intervention, and referral to treatment (SBIRT) for use of alcohol, tobacco, marijuana, and other drugs among adolescent patients. This development of this guide was supported by funds from the Centers for Disease Control and Prevention (Cooperative Agreement Number 5 U38 OT000167-03). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the United States Department of Health and Human Services.

The guide is one component of AAP work as a national partner in the Improving Fetal Alcohol Spectrum Disorders (FASD) Prevention and Practice through National Partnerships project. This Centers for Disease Control and Prevention project aims to increase pediatric clinicians' awareness of fetal alcohol spectrum disorders and help clinicians to identify, treat, and care for infants and children who were prenatally exposed to alcohol.

This development of this guide was supported by funds from the Centers for Disease Control and Prevention (Cooperative Agreement Number 5 U38 OT000167-03). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the United States Department of Health and Human Services

Brief screens

S2BI (Screening to Brief Intervention)

Single frequency-of-use question per substance
Identifies the likelihood of a DSM-5 SUD
Includes tobacco, alcohol, marijuana, and other/illicit drug use
Discriminates among no use, no SUD, moderate SUD, and severe SUD
Electronic medical record compatible
Self- or interviewer-administered

BSTAD (Brief Screener for Tobacco, Alcohol, and Other Drugs)

Identifies problematic tobacco, alcohol, and marijuana use
Built on the NIAAA screening tool with added tobacco and "drug" questions
Electronic medical record compatible
Self- or interviewer-administered

NIAAA Youth Alcohol Screen (Youth Guide)

Two-question alcohol screen
Screens for friends' use and for personal use in children and adolescents aged ≥9 y
Free resource: Alcohol Screening and Brief Intervention for Youth

Brief assessment guides

CRAFFT (Car, Relax, Alone, Friends/Family, Forget, Trouble)

Quickly assesses for problems associated with substance use
Not a diagnostic tool

GAIN (Global Appraisal of Individual Needs)

Assesses for both SUDs and mental health disorders

AUDIT (Alcohol Use Disorders Identification Test)

Assesses for risky drinking
Not a diagnostic tool

* Adapted with permission from American Academy of Pediatrics; Levy S, Bagley S. Substance use: initial approach in primary care. In: Adam HM, Foy JM, eds. Signs and Symptoms in Pediatrics. Elk Grove Village, IL: American Academy of Pediatrics; 2015:887–900. DSM-5, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; NIAAA, National Institute on Alcohol Abuse and Alcoholism.