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“ Health care providers should have a one-on-one discussion with teens who indicate any substance use to assess level of risk, provide brief advice, and, if necessary, recommend further assessment for a treatment intervention. “

Talkin’ ‘Bout My Generation

NIDA Researchers Develop Screening Tool for Teen Substance Use This article is a condensed version of a piece that originally appeared on the National Institute on Drug Abuse (NIDA) website.

-Dr. Sharon Kelly, Friends Research Institute

Analysis of the data showed that almost all teens who reported on the BSTAD that they had consumed an alcoholic beverage on two or more days during the past year had an AUD. Conversely, teens who reported drinking on fewer than two days were unlikely to have this disorder.The corresponding BSTAD cut point for an NUD was nicotine use on two or more days during the past year and for a CUD was marijuana use on two or more days. BSTAD enables early detection Using these cut points, the researchers found that the BSTAD was highly sensitive. Ninety-six percent of teens with an AUD, 95 percent with an NUD, and 80 percent with a CUD would be flagged as likely in need of further assessment for a brief intervention or referral to treatment. BSTAD’s specificity was also high: 85 percent of teens without an AUD, 97 percent without an NUD, and 93 percent without a CUD reported use below the cut points, and so would be correctly classified. “Very low substance use frequencies were found to be optimal in identifying these disorders,” Dr. Kelly comments. The BSTAD does not distinguish

Researchers encourage regular screening Both the World Health Organization and the American Academy of Pediatrics recommend screening all adolescent patients for substance use since problems later in life often originate in adolescence. Still, many providers do not regularly screen their patients for substance abuse. “Providers are extremely busy and need a quick and valid screening measure for identifying teens who use substances,” says Dr. Kelly. She and colleagues developed the BSTAD in response to a NIDA call for new tools to fill this need. To create the BSTAD, Dr. Kelly and colleagues added the questions about tobacco and marijuana to the widely disseminated National Institute on Alcohol Abuse and Alcoholism screen for youth alcohol use. In the validation study, the FRI research team administered the BSTAD in person to half of the participants, and the rest of the participants self-administered the instrument on an iPad. The teens reported a strong preference for the iPad. The iPad version offers the potential extra convenience that results can be automatically transferred into a teen’s electronic medical record. 

Teens’ use of addictive substances often goes undetected by health care providers. But NIDA-supported researchers have developed a Brief Screener for Tobacco, Alcohol and other Drugs (BSTAD), to help spot teens’ problematic habits. In a recent study, BSTAD developers Dr. Sharon Kelly and colleagues at the Friends Research Institute in Baltimore examined the frequencies of use likely to qualify a teen for a diagnosis of an alcohol use disorder (AUD), nicotine use disorder (NUD), or cannabis use disorder (CUD). The frequencies proved to be surprisingly low, according to the researchers.

the severities of the disorders, she notes, so when it flags a teen, providers need to follow up with questions to determine appropriate interventions or referrals to treatment. Furthermore, Dr. Kelly says, “Health care providers should have a one-on-one discussion with teens who indicate any substance use to assess level of risk, provide brief advice, and, if necessary, recommend further assessment for a treatment intervention.” Providers also should rescreen teens regularly, because onset of substance use can occur abruptly during adolescence. Pediatrics recommend screening all adolescent patients for substance use since problems later in life often originate in adolescence. Both the World Health Organization and the American Academy of

Teen drug substance use revealed For the study, the BSTAD survey employed a few, simple questions about teens’ use of alcohol, tobacco or drugs within the past year.The teens’ BSTAD responses revealed that 22 percent had used alcohol in the past year, 16 percent had used marijuana, 10 percent had used tobacco, and 3 percent had used at least one illicit substance other

than marijuana. (Original article by Eric Sarlin, M.Ed., M.A., NIDA Notes Contributing Writer) 28

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