Access the Provider Guide

Access the Communications Guide

The urgency to advance adolescent substance use screening within the primary care setting is becoming widely acknowledged across the health care field. Most substance use concerns arise during adolescence, yet less than 10 percent of youth receive the treatment they need.

Do you want to develop the skills to have a conversation that may identify and prevent these behaviors from turning into more acute health problems among your patients?

If substance use prevention and early intervention isn’t a consistent part of your treatment plan, or if you would like to explore ways to enhance these services watch this webinar recording to hear national experts dive into specific guidance on implementing Screening, Brief Intervention and Referral to Treatment (SBIRT). You’ll learn how the National Council’s newly released Improving Adolescent Health: Facilitating Change for Excellence in SBIRT Change Package can help transform your practice.

You’ll get practical examples to:

  • Start the conversation about adolescent substance use with your clients and steer youth to healthier behaviors.
  • Navigate operational barriers and sustain SBIRT practices in your organization.
  • Develop policies and procedures for embedding SBIRT as a normalized practice based on real-world success stories.

Even during these uncertain times, it’s a sure thing that adolescents—young people between childhood and adulthood—are still developing biologically, socially, and emotionally. We can also be sure that some of the necessary conditions for healthy adolescent development have been disrupted by the current pandemic. Check out this framing guide from FrameWorks Institute and Funders for Adolescent Science Translation, designed to help us all talk more effectively about adolescent development in the era of COVID-19.


This resource represents a change package. A change package is a practical toolkit that is specific enough for clinicians and practices to implement, test, and measure progress on an evidence-based set of changes while being generalizable enough to be scaled in multiple settings. Change packages are proven effectual tools to actuate practice transformation in primary care.

This website is an interactive resource on SBIRT (Screening, Brief Intervention, and Referral to Treatment). It is targeted at individuals working in primary care settings and is focused specifically on adolescents and young adults. The site includes all key elements of a SBIRT intervention as well as links to additional resources and deeper dives. A simulation component can also be accessed and used as a supplement to training. The online forum offers the opportunity for collaborative learning where users can ask questions and share lessons learned. Its goal is to create an engaging virtual community.


Adolescence represents both a critical at-risk period for substance use initiation as well as an opportune time to intervene and prevent behaviors from developing into more acute health problems. Not all adolescents who experiment with drugs and alcohol will develop a substance use disorder; however, all psychoactive substances have negative effects on the still-developing adolescent brain. Systematic screening can lead to beneficial health outcomes and reduce future misuse.1

Sobering Facts about Teen Substance Use

  • Marijuana use in adolescence may be associated with loss of IQ.
  • Teens who use tobacco report poorer health outcomes than their nonsmoking peers.
  • More than 90% of adult smokers reported smoking before they were 18 years old.
  • Teen alcohol use is associated with a greater likelihood of adult alcohol dependence or addiction.
  • Teens who use marijuana at or before the age of 14 are six times more likely to develop illicit drug dependence or abuse later in life than those who first try marijuana at age 18 or later.2, 3, 4
The National Institute of Alcoholism and Alcohol Abuse (NIAAA) recommends that screening for alcohol use begin as early as age 9, or as soon as children are interviewed alone, without a parent present.


Despite evidence suggesting its effectiveness, SBIRT is not yet widely implemented. Although the intervention can be challenging, there are several key reasons for why SBIRT should be considered for uptake and implementation.

The SBIRT process includes:

  1. SCREENING to identify an adolescent’s place on a spectrum from non-use to substance use in order to deliver an appropriate response.
  2. BRIEF INTERVENTION to raise patient awareness of risks, elicit internal motivation for change, and help set behavior-change goals.
  3. REFERRAL TO TREATMENT to facilitate access to and engagement in specialized services and coordinated care for patients at highest risk.

(See Tables from the Surgeon General’s Report for more information on adolescent risk and preventative factors.)

  • Substance use’s impact on overall health. See Substance Use 101 below.
  • SBIRT’s support of a full clinical picture of a patient, rather than compartmentalized care.
  • Early substance use interventions can prevent development of more severe substance use disorders.
  • Protocol standardization supports substance use identification.
  • You don’t have to be a specialist. SBIRT can be integrated into routine care and fits into workflows.
  • Cost savings and increased accountability from a range of payers
Substance Use 101
Psychoactive substances create changes in the brain, particularly neurotransmitters—chemicals that carry messages between brain cells.5 Among youth, the most commonly used psychoactive substances are the big three: alcohol, tobacco, and marijuana, though some youth use other substances.

Past Month Substance Use Among Youth in the United States, 20146

SubstanceAge 12-17Age 18-25
Prescription Drugs2.6%4.4%

Pills IconOther psychoactive substances have recently become available and are increasingly used by youth. These include salvia, a plant that has hallucinogenic effects, and synthetic cathinones such as “Bath Salts,” which are strong stimulants. The most common of these newer substances are synthetic cannabinoids, such as “Spice” and “K2,” which are also referred to as “synthetic marijuana.” Synthetic cannabinoids are not actually marijuana, but they have similar effects. In recent years, synthetic cannabinoids have become increasingly popular because they are available in retail stores and online, and because they do not show up in drug tests (while marijuana does).

Learn more about training opportunities

SBIRT Consulting

Home |  Next >