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Substance Use Screening and Brief Intervention for Youth

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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 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​)

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.

Additional Resources​​​

​American Academy of Pediatrics (AAP)
Mental Health Toolkit
Implementing Mental Health Priorities in Practice Substance Use video
Behavioral Health Intervention with Adolescents – Interactive Educational Simulations
Fetal Alcohol Spectrum Disorders Toolkit

​​Substance Abuse and Mental Health Services Administration (SAMHSA)
Should you talk to someone about a drug, alcohol or mental health problem?Underage Drinking: Myths vs. Facts
Tips for Teens: The Truth about Marijuana
Tips for Teens: The Truth About Club Drugs
Talk. They Hear You. Underage Drinking Prevention Campaign

National Institute on Alcohol Abuse and Alcoholism (NIAAA)Alcohol Screening and Brief Intervention for Youth: A Practitioner's Guide

​Centers for Disease Control and Prevention (CDC)
Alcohol Screening and Brief Intervention Efforts
Planning and Implementing Screening and Brief Intervention for Risky Alcohol Use: A Step-by-Step Guide for Primary Care Practices 
Fact Sheets – Underage Drinking

​Additional information is available from the American Academy of Pediatrics Committee on Substance Use and Prevention. ​

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