Brief Screening Guages Teenage Substance Abuse risk

Sharon Levy, M.D., M.P.H. Director, Adolescent Substance Abuse Program Assistant Professor in Pediatrics Boston Children’s HospitaMedicalResearch.com Interview with:
Sharon Levy, M.D., M.P.H.
Director, Adolescent Substance Abuse Program
Assistant Professor in Pediatrics
Boston Children’s Hospital

 
Medical Research: What are the main findings of the study?

Dr. Levy: We found that questions that asked about the frequency of alcohol, tobacco and drug use accurately triaged adolescents into “risk categories”.  In other words, kids who reported using alcohol or marijuana “once or twice” last year were unlikely to have a substance use disorder, those who reported “monthly” use were very likely to meet diagnostic criteria for a “mild” or “moderate” substance use disorder while those who reported use weekly or more were very likely to meet diagnostic criteria for a “severe” substance use disorder.

Medical Research: Were any of the findings unexpected?

Dr. Levy: Yes – actually we had built a more complicated tool that combined questions from a number of screeners using a skip pattern to see if we could accurately triage kids into these diagnostic categories. The full tool worked pretty well, but we were surprised to find that just the initial frequency question worked as well, or in some cases even better than the longer tool.

Medical Research: What should clinicians and patients take away from your report?

Dr. Levy: This new screen substantially simplifies practice guidelines.  The answer that an adolescent gives to the frequency question immediately points clinicians to the appropriate intervention.  In fact, we call the tool “S2BI” – which stands for “Screening to Brief Intervention”.  Because it is brief and very clear cut, we hope that S2BI will encourage more clinicians to use a validated tool when they screen so that they don’t miss problems associated with substance use as often happens when even experienced clinicians “screen” based on clinical instincts alone.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Levy: In my opinion, the most important research step is to determine which brief interventions are most effective for each risk category.  We have some “leads”, but more research needs to be done.

Citation:

An Electronic Screen for Triaging Adolescent Substance Use by Risk Levels

Sharon Levy MD, MPH, Roger Weiss MD, Lon Sherritt MPH, Rosemary Ziemnik BS, Allegra Spalding BA, Shari Van Hook MPH, Lydia A. Shrier MD, MPH

JAMA Pediatr. 2014;168(9):-. doi:10.1001/jamapediatrics.2014.774

 

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