SBI with Adolescents

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Introduction

Although substance use sometimes seems like a normal part of adolescence, even occasional use can be harmful. Over two thirds of emergency department visits by 12-17 year olds involved the use of alcohol, drugs, or the misuse of prescription drugs.1 In addition, there are long-term consequences: one in four Americans who begin using alcohol or drugs before age 18, will develop a diagnosable substance use disorder in adulthood.2

So, how can you help prevent and reduce substance use among adolescents?

Research shows that screening and brief intervention is a promising protocol for preventing and reducing substance use The American Academy of Pediatrics has recommended SBI as part of routine clinical practice.3 Many states have initiatives for screening and brief intervention, and some even offer reimbursement through Medicaid and private insurance. The process consists of a Screening to assess the person’s level of risk and a Brief Intervention to negotiate a behavior change plan. The majority of brief interventions will be with teens who screen as moderate risk, where the focus will be either on abstinence or on harm reduction, which minimizes the negative consequences of substance use. To be as effective as possible, these conversations should be conducted in a private space.

Confidentiality laws vary, but almost everywhere the adolescent’s right to a confidential conversation is protected by law, which means you will need to ask parents to leave the room. You can find more about confidentiality and parental involvement in the Resources section. Every adolescent should have the opportunity to discuss substance use with a professional. These conversations could happen in any health-related setting: primary care offices, integrated care facilities, clinics, hospitals, emergency rooms, juvenile justice settings, and schools.

1 Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (April 2010). The OAS Report: A Day in the Life of American Adolescents: Substance Use Facts Update. Rockville, MD

2 The National Center on Addiction and Substance Abuse at Columbia University. (June 2011) Adolescent Substance Use: America’s #1 Public Health Problem. New York, NY

3 American Academy of Pediatrics. (November 2011) “Substance Use Screening, Brief Intervention and Referral to Treatment for Pediatricians,” Pediatrics.

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