Screening for Youth Substance Use

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Kaiser Permanente

Disqualifiers: Non-clinic patients, Non-clinic providers

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

9084 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores two methods to reduce alcohol and drug use among teens visiting a large pediatric clinic. It will test the effectiveness of support provided by either a primary care doctor or a behavioral medicine specialist (a mental health professional) compared to usual care. Teens identified as at risk for substance use will receive these interventions. Those aged 12-18 who visit the clinic and have records there may be suitable for this study. As an unphased trial, this study offers teens a unique opportunity to contribute to important research that could shape future care practices.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these screening methods are safe for adolescents?

Research shows that both family doctors and specialists in behavioral medicine safely screen young people for substance use.

Studies have found that most pediatricians regularly check teenagers for substance use, and this screening is well-received, with no major problems reported. It typically includes questions about alcohol, marijuana, and tobacco, ensuring thorough and safe care for young patients.

Specialists in behavioral medicine also provide effective support. Evidence indicates that when these specialists screen and offer brief help, it leads to positive results both in the short and long term. Many young people have safely participated in these programs, receiving the help and referrals they need.

Overall, research strongly supports the safety of these methods, making them reliable ways to address substance use in teenagers. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it's exploring innovative ways to tackle youth substance use directly in primary care settings. Unlike the usual care that often involves delayed or minimal intervention, this trial is testing how effective early screening and brief intervention by both primary care physicians and behavioral medicine specialists can be. The unique feature here is integrating these interventions right at the point of primary care, potentially allowing for immediate and personalized responses to at-risk adolescents. This approach could transform how young people receive support, making it quicker and more tailored compared to traditional methods.

What evidence suggests that this trial's treatments could be effective for reducing adolescent substance use?

Studies have shown that the Screening, Brief Intervention, and Referral to Treatment (SBIRT) method can effectively reduce substance use in teenagers. Research indicates that when primary care physicians, one of the treatment arms in this trial, use SBIRT during regular check-ups, it leads to reduced substance use and improved mental health over time. One study linked SBIRT to decreased substance use and fewer health and mental issues in young adults.

Another treatment arm in this trial involves specialists in behavioral medicine. Evidence suggests these experts can also positively impact substance use problems in teenagers. Improving screening and intervention is crucial because many young people do not receive the help they need. Both approaches in this trial aim to identify substance use early and provide timely support, which shows promise for reducing risky behavior among teens. ^{1 3 6 7 8}

Are You a Good Fit for This Trial?

This trial is for adolescent primary care providers and their patients aged 12-18 at a specific pediatric clinic. It aims to assess methods to reduce youth alcohol and drug use. Providers outside this clinic or patient records not from this site are excluded.

Inclusion Criteria

All adolescent primary care providers at the pediatric primary care clinic will be included

I am between 12 and 18 years old and my health records are at a pediatric care facility.

Exclusion Criteria

Any adolescent primary care providers not practicing at the pediatric primary care clinic research site will be excluded

Adolescents electronic records who are not part of the research site pediatric clinic will be excluded.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

Initial well-visit

1 visit (in-person)

Intervention

Screening, Brief Intervention, and Referral to Treatment (SBIRT) delivered by either Primary Care Physicians or Behavioral Medicine Specialists

Within 14 days of assessment

1-2 visits (in-person)

Follow-up

Participants are monitored for AOD use and abstinence, and specialty treatment initiation

Up to 2 years post-intervention

Periodic assessments (in-person or virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Behavioral Medicine Specialist
• Primary Care Physician

Trial Overview The study is testing two approaches of Screening, Brief Intervention, and Referral to Treatment (SBIRT) in a pediatrics clinic setting to see which is more effective at reducing alcohol and other drug use among adolescents.

How Is the Trial Designed?

Group I: Primary Care Physician Experimental Treatment 1 Intervention

If the adolescent is identified at risk for substance use, the screening and brief intervention referral to treatment delivered is by the primary care physician

Group II: Behavioral Medicine Specialist Experimental Treatment 1 Intervention

If the adolescent is identified at risk for substance use, the screening and brief intervention referral to treatment delivered by the behavioral medicine specialist

Group III: Usual Care Active Control 1 Intervention

Care is administered as usual

Who Is Running the Clinical Trial?

Kaiser Permanente

Lead Sponsor

Trials

563

Recruited

27,400,000+

Published Research Related to This Trial

In a study of 1689 pediatric patients, 14% experienced an adverse drug event (ADE), with 23% of those being preventable, highlighting a significant concern in medication safety for children.

Children receiving multiple prescriptions were found to be at a higher risk (odds ratio of 1.46) for preventable ADEs, indicating the need for better communication and monitoring in healthcare settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Risk factors in preventable adverse drug events in pediatric outpatients. Zandieh, SO., Goldmann, DA., Keohane, CA., et al.[2008]

In a study analyzing 2557 patient records, 72.7% of do-not-do recommendations (DNDs) were ignored, leading to 69 avoidable adverse events (AAEs) in 1307 patients, indicating a significant risk associated with disregarding these guidelines.

Most AAEs were minor and temporary, with a higher occurrence in older adults (5.7% in patients aged 65 and older), highlighting the potential safety risks of low-value medical practices in primary care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Avoidable Adverse Events Related to Ignoring the Do-Not-Do Recommendations: A Retrospective Cohort Study Conducted in the Spanish Primary Care Setting. Mira, JJ., Carrillo, I., Pérez-Pérez, P., et al.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7241222/

Adolescent Substance Use Disorder Treatment: An Update ... To examine the most recent published evidence (2016–2019) regarding the treatment of adolescent substance use disorders, and to provide an update on evidence- ...

2. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2834257

Substance Use Screening, Brief Intervention, and Referral ... These findings suggest that substance use disorder screening in youths needs improvement to better adhere to recommended screening practices.

3. tandfonline.com tandfonline.com/doi/full/10.1080/15374416.2025.2521855

Evidence Base on Outpatient Behavioral Treatments for ... These lifetime prevalence rates are more than tripled among 12th graders (compared to 8th): 48.7% reported using alcohol, 34.4% marijuana, 31.3% ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12093189/

Substance Use Screening, Brief Intervention, and Referral ... 57% reported that they routinely screen adolescents for substance use disorders at every well visit. Only 39% reported using a screening tool at every well ...

5. library.samhsa.gov library.samhsa.gov/sites/default/files/pep20-06-04-008.pdf

Screening and Treatment of Substance Use Disorders ... Adolescents with untreated or undertreated SUDs are at risk for experiencing adverse outcomes into adulthood, including criminal involvement (Racz et al., 2016) ...

6. samhsa.gov samhsa.gov/substance-use/prevention/communities-talk/mini-campaigns/medical-professionals

Screen Youth and Young Adults for Substance Use ... Evidence shows short-term benefits and long-term positive outcomes among adolescent patients who were screened for substance use as part of ...

7. sciencedirect.com sciencedirect.com/science/article/pii/S1054139X22003482

Substance Use Screening, Brief Intervention, and Referral ... Of the 141,230 youth screened, over 12,000 received a brief intervention, and over 2,000 received a referral to treatment.

8. abtglobal.com abtglobal.com/sites/default/files/2024-09/hilton-foundation-adolescent-sbirt-learning-brief_abt-associates_august-2019.pdf

ADOLESCENT SUBSTANCE USE SCREENING, BRIEF ... Results from this work showed that a large proportion of youth screened in JJ settings scored in need of a referral to treatment; of those referred and ...