Adolescent Substance Use Disorder in Primary Care: Challenges in Treatment Referral Beyond Access Availability.

Autor:	Lai B; Department of Family Medicine, Mayo Clinic, Rochester, MN, USA., Good J; Department of Family Medicine, Mayo Clinic, Rochester, MN, USA., Singh G; Department of Family Medicine, Mayo Clinic Health System - Red Wing, Red Wing, MN, USA., Deyo M; Department of Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA., Marshall R; Department of Pediatric & Adolescent Medicine, Mayo Clinic Health System - Red Wing, Red Wing, MN, USA., Oesterle T; Division of Addiction Services, Mayo Clinic, Rochester, MN, USA.
Jazyk:	angličtina
Zdroj:	Journal of primary care & community health [J Prim Care Community Health] 2024 Jan-Dec; Vol. 15, pp. 21501319241276817.
DOI:	10.1177/21501319241276817
Abstrakt:	Objective: Fatal overdoses are the third leading cause of death in the pediatric population. Substance use disorders (SUD) screening is not routinely done in primary care practices. Early screening and intervention for adolescent SUD could mitigate future harm. Methods: We conducted a 3-month pilot adapting universal screening using the CRAFFT tool in patients aged 12 to 17 presenting to an urban and a rural primary care practice during well-child and acute/sick-child visits. We collaborated with our pediatric addiction service to ensure access availability for further assessment and treatment for all positively screened patients; this was broadly communicated to primary care providers. Results: There was a higher CRAFFT completion rate in the urban site (90%, vs 52.6% in our rural site). The majority of CRAFFT questionnaires were completed during acute/sick-child visits in both study sites. Moreover, we found a higher positive screen rate in our rural practice (14.6%, vs 2.4% in our urban practice). Only 27% of positively screened patients had substance use addressed by their providers. No pediatric addiction referrals were made. Conclusions: Findings suggest provider-level barriers exist despite having adequate specialty referral sources and institutional encouragement. Future work is needed to explore these barriers. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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