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
Policy Statement: Substance Use Screening, Brief Intervention, and Referral to Treatment
Clinical Report: Substance Use Screening, Brief Intervention, and Referral to Treatment
Clinical Report: Binge Drinking
Clinical Report: Promoting Optimal Development: Screening for Behavioral and Emotional Problems
Clinical Report: Families Affected by Parental Substance Use
Clinical Report: Fetal Alcohol Spectrum Disorders
Substance Use Screening and Intervention Implementation Guide
The American Academy of Pediatrics (AAP) has developed the Substance Use Screening and Intervention Implementation 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.
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.
The 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.
Substance Use Screening and Assessment Tools Used with Adolescents*
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