Substance Abuse CLINICAL PEARLS • Tobacco, alcohol and marijuana are the most common non-prescription agents abused by Oklahoma high school students. Pain medications and stimulants are the most common prescriptions abused by Oklahoma high school students. • Substance abuse correlates with risk-taking behaviors (e.g. unprotected sex, impaired driving). • Confidential care and screening are recommended every time an adolescent receives medical care. Drug and substance use or abuse of alcohol meets criteria for self-consent by minor in Oklahoma. Parent involvement should be encouraged when appropriate, but not mandated. • Substance abuse goes undetected by nearly two-thirds of primary care providers. • Providers are encouraged to use medications with lower abuse potential when treating comorbid conditions (e.g. atomoxetine for ADHD). RATING SCALES: • Screening to Brief Intervention (S2BI): https://www.mcpap.com/pdf/S2BI_postcard.pdf • Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT): https://www.crafft.org TREATMENT APPROACH: Screening, Brief Intervention, Referral to Treatment (SBIRT) Use of the SBIRT process is an evidence-based practice model shown to identify, reduce, and prevent substance abuse. The model is designed for use across multiple medical settings including primary care and community health centers. Physician and administrative champions are helpful when implementing an SBIRT approach, however specific screening and assessment functions can be effectively accomplished by medical assistants and other clinical and administrative staff.
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