Brief Youth Substance Use Intervention for Primary Care

Launched by RAND · Feb 13, 2006

Keywords

ClinConnect Summary

Over the past decade, many new programs intended to motivate adolescents to decrease substance use have been developed and evaluated. There has been a recent shift towards brief interventions for youth in school (Brown, 2001; D'Amico and Fromme, 2002) and health care settings, such as emergency rooms and inpatient clinics (Barnett et al., 2001; Colby et al., 1998; Monti et al., 1999). Many youth who use drugs and alcohol are at risk for consequences (Johnston et al., 2003). The primary care setting presents a unique opportunity to intervene with substance abusing adolescents as 70% of youth...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 12-18 years old
• • english speaker
• • screen positive for alcohol and/or drug use
• • We use a brief screener to identify youth at high-risk for drug or alcohol abuse. The CRAFFT was developed by Knight and colleagues to screen youth for alcohol and other drug use and is a mnemonic based on the six questions it asks. The CRAFFT is comprised from items from the RAFFT (Riggs and Alario, 1989), DAP (Drug and Alcohol Problems) (Klitzner et al., 1987) and POSIT (Problem Oriented Screening Instrument for Teenagers) (Rahdert, 1991). The CRAFFT is brief, highly correlated with the Personal Involvement with Chemicals Scale (PICS), a criterion standard (r = .84), and is practical for use in a primary care setting as it takes only a few minutes to administer (Knight et al., 1999). The measure includes the following Yes/No questions: 1) have you ever ridden in a car driven by someone (including yourself) who was high or had been using alcohol or drugs?, 2) do you ever use alcohol or drugs to relax, feel better about yourself, or fit in?, 3) do you ever use alcohol or drugs while you are by yourself (alone)?, 4) do you ever forget things you did while using alcohol or drugs?, 5) have you ever gotten into trouble while you were using alcohol or drugs?, and 6) do your family and friends ever tell you that you should cut down on your drinking or drug use?. The six items have a cut-off score of 2 or greater with a sensitivity of 92.3% and specificity of 82.5% for long-term treatment need (as identified by PICS scores) (Knight et al., 1999). We use a cut-off of 1 or greater, reflecting a less stringent criterion for "high-risk" that includes adolescents with potential problems who could benefit from a brief intervention in the primary care setting.
• Exclusion Criteria:
• • spanish speaker
• • outside of age range
• • does not qualify on screening questionnaire as using alcohol and/or drugs