June 4, 2020
Substance abuse often starts in adolescence and, if left untreated, can cause acute and chronic health problems as well as impair growth and development because neurodevelopment continues into a person’s 20s, said Dr. Shawanna Ogden, a psychiatry fellow at the College of Community Health Sciences.
The good news, she said, is that research shows adolescents are likely to benefit from substance abuse screening.
Ogden provided the information in her lecture in May as part of the College’s Grand Rounds monthly lecture series. Her talk was titled “Substance Abuse Screening in Adolescents.”
Ogden cited several substance abuse screening tools that are currently used by health-care providers. One is the Screening, Brief Intervention, and Referral to Treatment (SBIRT), used to identify, reduce and prevent problematic use, abuse and dependence on alcohol and illicit drugs. Another are guidelines provided by the U.S. Public Service Task Force that encourage physicians to ask adolescent patients about their tobacco, alcohol and illicit drug use.
The screening tool that has been most widely studied for people ages 12 through 21 is the CRAFT Screening Test, Ogden said. The tool is designed to screen for substance-related risks and problems in adolescents, and CRAFT stands for the key words of the six items in the assessment – car, relax, alone, forget, friends and trouble. The CRAFT Screening Test is recommended by the American Academy of Pediatrics.
The CRAFT test can be administered by physicians, or it can be self-administered by the adolescent patient, Ogden said. “It’s meant to assess if a discussion and/or a brief intervention is warranted,” she said.
Among the questions asked: During the past 12 months, have you a.) had more than a few sips of alcohol; b.) ridden in a car driven by someone using, including yourself; and c.) do you use substances to relax.
Ogden said a score of 0 or 1 on the screening assessment signifies patients are at low risk and physicians should talk to patients about the adverse health effects of substance abuse and advise them to stop using. A higher score translates to higher risk and requires further assessment of the adolescent patient.
Ogden acknowledged there are barriers to screening, including limited time during patient visits, and a lack of knowledge and training about screening tools on the part of physicians.