171 Ashley Ave.
Charleston, SC 29425
843-792-1414
800-424-MUSC
|
 |
January 2006
Mental Health Resource News Brief
Screening and Intervention for Substance Abuse and Dependence
Substance abuse/dependence is a devastating problem that affects millions of Americans every day. It places a huge burden on
society as well as the individual as it is one of the nations' number one health problems contributing to serious and costly
health problems, family violence, mistreatment of children and less productive work place and involvement of the criminal justice
system. Unfortunately much of this use begins while a teen is still living at home.
Unlike illicit drugs, where we have seen an 11 percent decline in use over the past two years, underage drinking has not changed
over the years. About 11.6 percent of 12 year olds report using alcohol at least once in their lifetime and that percentage more
than doubles by age 13. By age 15 more than half of teens report alcohol use according to SAMHSA's National Survey on Drug Use
and Health. Approximately 45 percent of alcoholism is genetic. There is some evidence that knowledge of family history might help
children make better choices about alcohol consumption.
The initial conversion rate from use to addiction varies according to the nature of the drug itself. Tobacco is by far the most
addictive of the commonly used substances with one of three people that try it, becoming addicted! One in four initial users of
opiates and cocaine become addicted. Alcohol causes dependence in one in seven to eight initial users. Stimulants cause dependence
in one in nine. And cannabis causes dependency in approximately one in 10 users. The biggest change from the post 60's era has to
do with abuse of prescription drugs such as stimulants, and relievers and sedatives. Statistics indicate that tobacco is more
often the "gateway' drug to more serious substances, than marijuana.
Education about the implications of substance use is critical during the adolescent period. Almost all substance use begins in
adolescence and delaying initiation of substance use may help future substance related problems. The CRAFFT poses questions to
identify adolescents with substance abuse problems.
| C | Have you ever ridden in a CAR driven by someone (including yourself) that was "high" or had been using alcohol or drugs? |
| R | Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in? |
| A | Do you ever use alcohol or drugs while you are by yourself, or ALONE? |
| F | Do you ever FORGET things you did while using alcohol or drugs? |
| F | Do your FAMILY or FRIENDS ever tell you that you should cut down on your drinking or drug use? |
| T | Have you ever gotten into TROUBLE while you were using alcohol or drugs? |
(Two or more yes answers suggest that the adolescent may have a serious problem with substance abuse and additional assessment is warranted.)
The primary care physician possesses a uniquely important role in the assessment of substance abuse in adolescents. Given the
alarming prevalence of this problem, as well as the potential tragic adverse outcomes it is imperative that primary care physicians
become well versed in screening and diagnosis.
For more information and references for above information please see:
- "Too Smart to Start" Toolkit. SAMSHA 800-729-6686.
- Tobacco, Alcohol, and Other Drugs: The Role of the Pediatrician in Prevention, Identification, and Management of Substance Abuse, Pediatrics 2005; 115; 816-821.
- American Academy of Pediatrics, Committee on Substance Abuse. Tobacco, alcohol, and other drugs: the role of the pediatrician in prevention and management of substance abuse. Pediatrics 1998; 101:125-8.
- Bright Futures in Practice: Mental Health Tool Kit page 148. www.brightfutures.org.
- A smoking cessation study is available for adolescents and young adults through the Neuroscience Division of Psychiatry by calling 792-BETT (2388).
PLEASE JOIN our peer supervision Promoting Happy and Healthy Youth breakfast study group on the third Tuesday of each month in room 377 Rutledge
Tower at 8 a.m. The primary purpose of the group is to develop new strategies for addressing common mental health issues that present to medical clinic
settings. Contact spratte@musc.edu or maciasm@musc.edu or call Josie Kirker,
MSW at 876-1507 for additional information.
|
|
Print Version