Alcohol, Other Drugs, and Health: Current Evidence

Why Don’t Primary Care Clinicians Screen Teens for Substance Abuse?

 

Screening rates for substance abuse in teens are poor in primary care settings. To assess possible reasons for this lack of screening, researchers conducted focus groups with a total of 38 clinicians (13 physicians, 10 nurses, 8 social workers, 6 nurse practitioners or physician assistants, and 1 psychologist) at 6 primary care sites. Each of the 6 focus groups identified and ranked barriers to screening teens.

 

The most common barriers to screening included the following (listed in order of perceived importance):

 

• lack of time
• insufficient training to assist teens who screen positive
• competing medical problems faced by teens
• lack of treatment resources for substance abuse
• a “tenacious” parent of a teen who will not leave the exam room, hindering confidential discussions
• poor knowledge of screening tools  

Comments:

The barriers identified in this study will not surprise most primary care clinicians. Improvements in many areas, including training in screening and brief intervention, information technology, and decision-support systems, are needed to address these barriers and increase substance abuse screening and intervention in teens.  Kevin L. Kraemer, MD, MSc

Reference:

Van Hook S, Harris SK, Brooks T, et al. The “Six T’s”: barriers to screening teens for substance abuse in primary care. J Adoles Health. 2007;40(5):456–461.