Credit: tippi t

In IRETA’s newest online training, Introduction to SBIRT for Adolescents, pediatrician Sharon Levy talks about brain development, marijuana, and SBIRT as a strategy to curb teen substance use

The good news, according to the 2013 National Survey on Drug Use and Health, is that alcohol and substance use is trending downward among American adolescents. In 2013, among youths ages 12-17, substance dependence or abuse was at 5.6%, down from 6.1% in 2012 and 6.9% in 2011.

The bad news is that teens still use substances at unsafe levels, and the earlier they start, the more likely it is that they’ll develop substance use disorders as they mature (Principles of Addiction Medicine, 4th ed. p 1383-1389).

“Addiction is a complex brain disease that, in most cases, originates in adolescence,” concludes a 2011 CASAColumbia study on adolescent substance use.

By conducting national surveys of youth, families and educators in addition to secondary data set analysis and key informant interviews, CASAColumbia found that:


Among the study authors’ recommendations is: “Our health systems must work to prevent or delay the onset of substance use through effective public health measures.”

Considering the breadth of alcohol- and other substance-related health issues–not just addiction, but accidents, diabetes, cardiovascular disease, cancer, mental health disorders, domestic violence, hepatitis, HIV/AIDS, to name a few–it’s clear that adolescent substance use isn’t just a problem of the here-and-now. Its consequences can stretch into the decades ahead.

That’s why preventing and delaying the onset of use is so important.

Evidence is accumulating (e.g., here, here, and here) that screening and intervention can help reduce teens’ usage and prevent substance use problems down the line. IRETA has teamed with Dr. Sharon Levy, the Director of the Adolescent Substance Abuse Program at Boston Children’s Hospital, to offer a training on adolescent substance use and how to implement screening, brief intervention and referral to treatment (SBIRT) to reach adolescent populations.

The Training

Levy describes the case of James, a varsity athlete and B+ student—an all-around average-seeming young man who’s beginning the process of applying for colleges. He doesn’t use narcotics or other drugs. He visits his primary care physician for a check-up and vaccinations.  The pediatrician congratulates him on his hard work in school and on his safe choices concerning drugs. He gives James his shot and sends him on his way.

One week later, James is killed while driving drunk, with a blood alcohol level of .24.

Levy is apologetic about the story; it’s emotional and dramatic.  But, she says, it’s common. “It happens every day in this country.”

She’s interested in finding ways to sort the high risk teens from low risk teens and address substance use with them. “Part of our job,” she says, “is to see if there’s anything we can impress on adolescents to help them develop the brakes to think a little bit before they engage in those behaviors.”

With emphasis on alcohol and marijuana, Introduction to SBIRT for Adolescents looks at why teens are so susceptible to substances and how substances affect their brains (hint: it’s a lot different from effects on adults). It then discusses the prevalence of substance use in the adolescent population and discusses why formal screening rather than clinical intuition is essential for providers to get a clear picture of their patients’ levels of risk.

Levy provides instruction on conducting the SBIRT process for adolescents.  She outlines appropriate screening tools for different age groups and breaks down brief intervention using motivational interviewing (MI) techniques. Of special focus is the 5-minute brief MI, which can be done during a PCP visit or other health care visit where substance use is not the presenting problem.

The self-paced, online training is free and open to everyone.  Included are eight content videos that range from 12-17 minutes in length, totaling approximately two and a half hours of video. Each video is followed by a short quiz with a total of 15 questions. The course does not need to be completed in one sitting and takes 3-4 hours to complete.  NAADAC, PA CADC, and Social Work continuing education credits are available.

You can access it here.