Clinical Research and Perspectives

Agley, J., Gassman, R. A., Jun, M., Nowicke, C., & Samuel, S. (2015). Statewide administration of the CRAFFT screening tool: highlighting the spectrum of substance use. Substance use & misuse50(13), 1668-1677.

Alayan, N., & Shell, L. (2016). Screening adolescents for substance use: The role of NPs in school settings. The Nurse Practitioner41(5), 1-6.

Babor, T. F., McRee, B. G., Kassebaum, P. A., Grimaldi, P. L., Ahmed, K., & Bray, J. (2007). Screening, Brief Intervention, and Referral to Treatment (SBIRT) toward a public health approach to the management of substance abuse. Substance abuse28(3), 7-30.
BRIEF NOTE: This article provides an excellent overview of the history of SBIRT over the past 60 years, and the public health rationale behind the SBIRT model.

Beaton, A., Shubkin, C. D., & Chapman, S. (2016). Addressing substance misuse in adolescents: a review of the literature on the screening, brief intervention, and referral to treatment model. Current opinion in pediatrics28(2), 258-265.
BRIEF NOTE: This comprehensive review provides an extensive overview of SBIRT’s potential public health benefits and considerations for implementation. Notably, the authors conclude that while the growing field of research has demonstrated the potential benefits of discrete screening and brief intervention approaches, more rigorous research is still needed to generate more knowledge about the overall impact of SBIRT for adolescents and its long-term effects. Nonetheless, the authors conclude by supporting the American Academy of Pediatrics’ recommendation that SBIRT be widely implemented to address the impact of substance use on adolescent health and well-being.

Bernstein, J., Heeren, T., Edward, E., Dorfman, D., Bliss, C., Winter, M., & Bernstein, E. (2010). A Brief Motivational Interview in a Pediatric Emergency Department, Plus 10‐day Telephone Follow‐up, Increases Attempts to Quit Drinking Among Youth and Young Adults Who Screen Positive for Problematic Drinking. Academic Emergency Medicine17(8), 890-902.

Benningfield, M. M. (2016). Meeting Youth Where They Are. Child and Adolescent Psychiatric Clinics25(4), 661-668. 

Benningfield, M. M., Riggs, P., & Stephan, S. H. (2015). The role of schools in substance use prevention and intervention. Child and Adolescent Psychiatric Clinics24(2), 291-303.

Borus, J., Parhami, I., & Levy, S. (2016). Screening, Brief Intervention, and Referral to Treatment. Child and adolescent psychiatric clinics of North America25(4), 579-601.

Burke, B. L., Arkowitz, H., & Menchola, M. (2003). The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials. Journal of Consulting and Clinical Psychology, 71(5), 843-861.

Carroll, K. M., Ball, S. A., Nich, C., Martino, S., Frankforter, T. L., Farentinos, C., … & Polcin, D. (2006). Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: A multisite effectiveness study. Drug and alcohol dependence81(3), 301-312.

D’Amico, E. J., Miles, J. N., Stern, S. A., & Meredith, L. S. (2008). Brief motivational interviewing for teens at risk of substance use consequences: A randomized pilot study in a primary care clinic. Journal of substance abuse treatment35(1), 53-61.

Degenhardt, L., Stockings, E., Patton, G., Hall, W. D., & Lynskey, M. (2016). The increasing global health priority of substance use in young people. The Lancet Psychiatry3(3), 251-264.

D’Souza-Li, L., & Harris, S. K. (2016). The future of screening, brief intervention and referral to treatment in adolescent primary care: research directions and dissemination challenges. Current opinion in pediatrics28(4), 434-440.  
BRIEF NOTE: This review discusses next steps that the field needs to take to answer critical questions about SBIRT for adolescents and to highlight promising areas for future development and implementation. In particular, the use of technology, the use of nonphsycian behavioral health providers, and the embedding of screening and decision support tools in electronic systems hold promise to advance the field of primary-care based SBIRT for adolescent patients.

Gordon, A. J., Ettaro, L., Rodriguez, K. L., Mocik, J., & Clark, D. B. (2011). Provider, patient, and family perspectives of adolescent alcohol use and treatment in rural settings. The Journal of Rural Health27(1), 81-90.

Hall, W. D., Patton, G., Stockings, E., Weier, M., Lynskey, M., Morley, K. I., & Degenhardt, L. (2016). Why young people’s substance use matters for global health. The Lancet Psychiatry3(3), 265-279.

O’Rourke, L., Humphris, G., & Baldacchino, A. (2016). Electronic communication based interventions for hazardous young drinkers: a systematic review. Neuroscience & Biobehavioral Reviews68, 880-890.

Kohler, S., & Hofmann, A. (2015). Can motivational interviewing in emergency care reduce alcohol consumption in young people? A systematic review and meta-analysis. Alcohol and alcoholism50(2), 107-117. 

Magill, M., Barnett, N. P., Apodaca, T. R., Rohsenow, D. J., & Monti, P. M. (2009). The role of marijuana use in brief motivational intervention with young adult drinkers treated in an emergency department. Journal of Studies on Alcohol and Drugs70(3), 409-413.

Mitchell, S. G., Gryczynski, J., Gonzales, A., Moseley, A., Peterson, T., O’Grady, K. E., & Schwartz, R. P. (2012). Screening, brief intervention, and referral to treatment (SBIRT) for substance use in a school‐based program: services and outcomes. The American Journal on Addictions21(s1). 

Mitchell, S. G., Gryczynski, J., O’Grady, K. E., & Schwartz, R. P. (2013). SBIRT for adolescent drug and alcohol use: Current status and future directions. Journal of substance abuse treatment44(5), 463-472. 
BRIEF NOTE: This review highlights that the evidence base for adolescent SBIRT is not as comprehensive as it is for adults, due largely to the clinical, methodological, and logistical challenges associated with conducting well-controlled randomized trials of SBIRT protocols for adolescent populations. It highlights the need for further research on SBIRT in community-based medical and other service settings where adolescents often receive care, and the importance of measuring outcomes other than those narrowly related to substance use (e.g. patient satisfaction) and referral to treatment.

Ozechowski, T. J., Becker, S. J., & Hogue, A. (2016). SBIRT-A: adapting SBIRT to maximize developmental fit for adolescents in primary care. Journal of substance abuse treatment62, 28-37. 
BRIEF NOTE: This article presents readers with information about steps that could be taken to adapt existing SBIRT protocols designed to identify and address adult substance use for implementation with adolescent populations. These considerations may be particularly useful in settings where adult SBIRT is already being implemented, and it may be easier to modify existing protocols for adults for use with adolescents instead of creating new SBIRT protocols for adolescents from scratch. While this article focuses on medical settings, the adaptations could be used in other settings (e.g. justice settings) that serve both adult and adolescent populations.

Patnode, C. D., O’Connor, E., Rowland, M., Burda, B. U., Perdue, L. A., & Whitlock, E. P. (2014). Primary Care Behavioral Interventions to Prevent or Reduce Illicit Drug Use and Nonmedical Pharmaceutical Use in Children and Adolescents: A Systematic Evidence Review for the US Preventive Services Task Force Interventions to Prevent or Reduce Drug Use in Children and Adolescents. Annals of internal medicine160(9), 612-620.
BRIEF NOTE: This review highlights that the evidence base concerning the benefits of primary-care based interventions to prevent or reduce illicit drug use or the nonmedical use of prescription drugs among youths is limited. However, it is important to note that trials have shown promise particularly for cannabis use, which is notable since cannabis is the most widely used substance other than alcohol among adolescents and young adults. Furthermore, the research evidence on SBIRT for drug use among adults is also limited (see Hingson, R., & Compton, W. M. (2014). Screening and brief intervention and referral to treatment for drug use in primary care: back to the drawing board. Journal of the American Medical Association312(5), 488-489), so the fact that multiple trials have shown benefits of SBIRT for drug-using adolescents is promising.

Patton, R., Deluca, P., Kaner, E., Newbury-Birch, D., Phillips, T., & Drummond, C. (2013). Alcohol screening and brief intervention for adolescents: the how, what and where of reducing alcohol consumption and related harm among young people. Alcohol and alcoholism49(2), 207-212.

Ramos, M. M., Warner, T., Rosero, D., & Condon, T. P. (2017). A Clinical Instrument to Guide Brief Interventions for Adolescents with Substance Use Concerns. Substance Abuse (in press)

Sterling, S., Kline-Simon, A. H., Jones, A., Satre, D. D., Parthasarathy, S., & Weisner, C. (2017). Specialty addiction and psychiatry treatment initiation and engagement: Results from an SBIRT randomized trial in pediatrics. Journal of Substance Abuse Treatment. 82, 48-54 
BRIEF NOTE: This study is notable in that it sheds light on the difficult question of how to successfully link adolescents who need specialty care with treatment. The study highlights the potential benefits of having embedded behavioral health clinicians (rather than pediatricians) facilitate referrals to specialty care.

Sterling, S., Kline-Simon, A. H., Satre, D. D., Jones, A., Mertens, J., Wong, A., & Weisner, C. (2015). Implementation of screening, brief intervention, and referral to treatment for adolescents in pediatric primary care: A cluster randomized trial. JAMA pediatrics169(11), e153145-e153145.

Sterling, S., Valkanoff, T., Hinman, A., & Weisner, C. (2012). Integrating substance use treatment into adolescent health care. Current psychiatry reports14(5), 453-461.

Stockings, E., Hall, W. D., Lynskey, M., Morley, K. I., Reavley, N., Strang, J., … & Degenhardt, L. (2016). Prevention, early intervention, harm reduction, and treatment of substance use in young people. The Lancet Psychiatry3(3), 280-296.
BRIEF NOTE: This review highlights that evidence concerning the efficacy of brief interventions following screening for adolescents is limited, though it does not conclude that such brief interventions are ineffective either. The review also highlights that for young people drinking at harmful levels, face-to-face interventions that incorporate personalized feedback and utilize motivational interviewing approaches are most effective.

Substance Use and Mental Health Services Administration (2011). Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Behavioral Health Care.

Tanner-Smith, E. E., & Lipsey, M. W. (2015). Brief alcohol interventions for adolescents and young adults: A systematic review and meta-analysis. Journal of substance abuse treatment51, 1-18.
BRIEF NOTE: This review highlights the effectiveness of brief alcohol interventions for adolescents and young adults, showing that they are associated with significant reductions in alcohol consumption and alcohol-related problems for adolescents up to one year following interventions. In particular, motivational interviewing, decisional balances, and goal settings are associated with beneficial effects.

Tanner-Smith, E. E., Steinka-Fry, K. T., Hennessy, E. A., Lipsey, M. W., & Winters, K. C. (2015). Can brief alcohol interventions for youth also address concurrent illicit drug use? Results from a meta-analysis. Journal of youth and adolescence44(5), 1011-1023.
BRIEF NOTE: This review is notable in showing that brief interventions for a range of substances can be effective with adolescents if appropriately targeted. In particular, it highlights the potential benefits of targeting brief interventions to address both alcohol and other substances.

UCLA Integrated Substance Abuse Programs, SBIRT Brief: Screening

U.S. Surgeon General, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health, Chapter 4: Early Intervention, Treatment, and Management of Substance Use Disorders.

Volmert, A., Fond, M., Haydon, A., O’Neil, M., & Gerstein Pineau, M. (2016). “It’s a rite of passage” :Mapping the gaps between expert, practitioner, and public understandings of adolescent substance use. Washington, DC: FrameWorks Institute.