Metrics details. Despite recent reductions, youth substance use continues to be a concern in the United States. Structured primary care substance use screening among adolescents is recommended, but not widely implemented. The purpose of this study was to describe the distribution and characteristics of adolescent substance use screening in outpatient clinics in a large academic medical center and assess related factors i.
We abstracted a random sample of records of patients aged 12—17 and coded clinical notes e. We then analyzed descriptive patterns within the data to calculate screening rates, characteristics of screening, and used multiple logistic regression to identify related factors. The primary method of screening was use of clinical mnemonic cues rather than standardized screening tools. Despite recommendations, low rates of structured screening in primary care persist.
Failure to use a standardized screening tool may contribute to low screening rates and biased screening. These findings may be used to inform implementation of standardized and structured screening in the clinical environment.
Alcohol, drug and other substance use is a key concern for providers of adolescent medical and behavioral health care in the United States US. This is a particular concern because compared to other age groups, adolescents are at particularly high risk for substance use-related health problems [ 2 ]. Substance use among teens is associated with other risk behavior and related morbidity, including teenage pregnancy, sexually transmitted infections, and domestic violence, [ 3 ] as well as social and legal issues related to substance abuse including criminal behavior, school failure, and family problems [ 4 ].
Beyond the immediate implications of adolescent substance use, early drug use is a predictor of future addiction as well as long-term sequalae [ 6 , 7 ]. While undergoing crucial periods of development, the adolescent brain is particularly vulnerable to developing substance use disorders [ 8 ] and substance abuse has the potential to trigger long-term neurocognitive changes in adolescents.
