Turning the Tide on Youth Substance Use: The Power of SBIRT

Take a moment to review the youth substance use data below. These percentages highlight a few key findings from the most recent Monitoring the Future report. Each year, a total of approximately 50,000 students in 8th, 10th and 12th grades are surveyed. The data shown in the table below describes the prevalence of youth substance use (within the past year) with the top 3 most-used substances – alcohol, vaped nicotine, and cannabis.

8th Graders10th Graders12th Graders
Alcohol Use15%31%52%
Vaped Nicotine12%21%27%
Cannabis Use8%20%31%
Any Illicit Drug
(other than marijuana)
Source: 2022 Monitoring the Future Survey, National Institute on Drug Abuse

Do these numbers surprise you? 

Youth substance use has been declining over the past 2 decades. But the millions of youth who are actively participating in underage drinking, vaping, and other drug use means that youth substance use is still common, and it is still a serious problem. 

The need for early and effective intervention is urgent. Every year that substance use is delayed while the adolescent brain develops, the risk of addiction and substance use decreases

As professionals dedicated to serving youth, our job is not only to understand the complexity of risk factors and risk behaviors associated with substance use and provide treatment, but also to lessen the scope of the problem with prevention measures. We have our work cut out for us!
One of the most potent tools at our disposal is SBIRT (Screening, Brief Intervention, and Referral to Treatment). In this blog, we cover:

  • The critical role of SBIRT in addressing youth substance use
  • Practical strategies to prevent substance use among young people
  • How to create a supportive environment conducive to healthy youth development

Let’s dive in!

Substance use in adolescents is not just about consumption; it’s a complex interplay of social, psychological, and environmental factors. Various studies suggest that the reasons for substance use in youth can range from curiosity and peer pressure to mental health issues and stress relief.

Key factors contributing to substance use in youth include:

  • Peer Influence: The desire to fit in or be accepted by peers can lead to experimentation with substances.
  • Mental Health Challenges: Conditions like anxiety, depression, or ADHD can make youth more susceptible to substance use as a coping mechanism.
  • Family Dynamics: A lack of parental supervision, exposure to substance use within the family, or conflict within the family can increase a youth’s risk for substance use.
  • Social and Environmental Factors: Exposure to substance use in media, easy access to substances, and societal norms can play a significant role in substance use.

Understanding these underlying factors is important for professionals when developing strategies to address substance use. It’s not just about discouraging the behavior but also addressing the root causes.

An Overview of SBIRT

SBIRT stands as a comprehensive, integrated public health approach designed to provide early intervention and treatment services for individuals with substance use disorders, including those at risk. It’s particularly effective in the context of youth substance use due to its adaptable and proactive nature. 

Let’s break down the components of SBIRT:

Screening: This initial step involves quickly assessing the severity of substance use and identifying the appropriate level of treatment. For youth, this often means utilizing tailored, age-appropriate and culturally-sensitive screening tools in schools, clinics, or community settings. 

Brief Intervention: This involves engaging individuals who show signs of substance use in a short conversation, providing guidance, education, and brief intervention (like motivational interviewing strategies). For adolescents, this is crucial as it provides an opportunity to discuss the risks and consequences of substance use in a non-judgmental setting. 

Referral to Treatment: For those who need more help than a brief intervention can provide, SBIRT ensures a referral to comprehensive treatment services. This step is vital for youth who may be dealing with addiction or co-occurring mental health issues. 

Implementing SBIRT effectively requires a tailored approach that is age-appropriate, culturally sensitive, and considerate of the unique challenges and experiences of youth.

Implementing SBIRT in Practice

Successfully implementing SBIRT across the different environments that youth attend, including schools, healthcare settings, and community centers, is key to its effectiveness. Here’s how professionals can integrate SBIRT into their practice:

Tailored Screening Approaches: Utilize age-appropriate and culturally sensitive screening tools. For instance, in school settings, screenings may be incorporated into health education, homeroom, or counseling sessions. Screenings should be:

  • Universal
  • Standardized
  • Routine
  • Confidential

Given the high co-occurrence of substance use, trauma, and mental health challenges, screening for depression and other co-occurring conditions is an essential component to youth substance use screening.

Engaging Conversations during Brief Interventions: The brief intervention is an opportunity for the provider to initiate a short conversation with a youth that encourages healthy choices and the reduction of risks from substance use. Professionals should strive to foster an open, non-threatening environment. Using motivational interviewing techniques to encourage honest dialogue with youth about substance use and its consequences is an evidence-based approach.

It is recommended that all youth who participate in the screening receive some sort of brief intervention. Based on the results of the screening tool, the professional can respond in a number of ways, including anticipatory guidance, brief advice, or brief intervention.

Referral Networks: Develop a strong referral network for treatment services. This network should include not just substance abuse treatment centers but also mental health professionals and youth counseling services, ensuring a holistic approach to treatment. Deciding where to refer a youth in need of substance use (or co-occurring treatment) may be complicated by limited availability, lack of developmentally appropriate supports for adolescents, insurance coverage, and preferences of the youth and their family. Professionals at school-based health centers and other entities employing SBIRTs should strive to develop internal capacity to provide treatment, as well as become familiar with what specialized treatment resources are available in their communities.

Training and Education for Staff: Equip staff and educators with the necessary training to conduct SBIRT effectively. This includes understanding substance use issues in youth, being adept at motivational interviewing, and knowing when and how to make referrals.

Parent and Community Involvement: Engage parents and the community in the SBIRT process. This can include informational sessions for parents and partnerships with community organizations to broaden the support network for youth.

Continuous Monitoring and Support: Post-intervention, it’s important to monitor progress and provide ongoing support. This could involve follow-up meetings, check-ins, and coordination with other care providers.

Implementing SBIRT effectively requires a concerted effort, not only in direct intervention but also in creating an ecosystem that supports the well-being of young people.

Possibilities For Change currently provides technical assistance and training for school-based health centers (SBHCs) across the state of Colorado to implement the SBIRT model with school-aged youth. In partnership with the Colorado Department of Public Health & Environment (CDPHE), SBHCs utilize ΛDΛM to deliver universal screening for students in middle and high school to identify at-risk students. 

Possibilities For Change also cultivates a community of practice for Colorado SBHCs by offering invaluable learning and networking opportunities, including:

  • Expert speakers delving into specific topics 
  • Facilitating case conferences and peer mentoring sessions
  • Empowering participants to collaboratively navigate challenging client scenarios utilizing their skills in motivational interviewing techniques

Learn more about ΛDΛM

Complementary Strategies for Prevention

SBIRTs are most effective when implemented alongside other preventive measures.

Education and Awareness Programs: Implement educational programs like interactive workshops in schools, focusing on the science behind addiction and the real-life impacts of substance use. Some schools have used virtual reality experiences to simulate the consequences of impaired driving to help students internalize the powerful influence of alcohol and other substances while driving. 

Strengthening Social and Emotional Skills: Most school districts implement social and emotional wellness curriculums to help students build resilience and coping skills. For instance, role-playing scenarios can teach students how to refuse substances assertively.

Family Engagement and Support: School-based health centers can host family nights at schools where parents and children participate in activities that promote open communication about substance use. Support groups like ‘Families Anonymous,’ for example, can also provide a platform for sharing experiences and strategies.

Community-Based Interventions: Collaborate with local YMCAs or Boys & Girls Clubs (for example) to offer after-school programs that provide mentorship and healthy activities, such as sports leagues or art classes, as alternatives to risky behaviors.

Policy Advocacy and Environmental Changes: Support local initiatives to create alcohol-free zones at community events frequented by youth. Advocate for policies that require more rigorous ID checks at retail outlets selling alcohol and tobacco.

Early Intervention for At-Risk Youth: Partner with child welfare agencies to offer targeted programs for youth in foster care, a group often at higher risk for substance use, focusing on resilience-building and mentorship.

By blending these strategies with SBIRT, professionals can create a multi-faceted approach to youth substance use prevention, addressing the issue from various angles.

Creating a Supportive Environment

Creating a supportive environment is an integral to preventing and treating substance use among youth. This means establishing spaces in schools, community centers, health sites, and other locales where youth not only feel safe but truly heard and empowered.

How do we do that?

  • Regular forums for discussion and ‘safe space’ groups can offer youth the opportunity to express their concerns and experiences without fear of judgment. 
  • Empowering the youth voice by inviting youth into the decision-making processes, especially for decisions that affect their lives, such as the creation of policies or programs in their schools or communities. Involvement can take many forms, such as youth councils or advisory boards where their insights and creativity are not just welcomed but actively sought after and implemented. 
  • Positive role models within the community, such as teachers, community leaders, and even peers, play an important role in building resiliency and serving as protective factors against risks. 
  • Ensuring that youth have access to mental health resources is another component of creating supportive environments. This can be facilitated through the presence of counselors and therapists in educational settings and workshops focusing on managing stress and anxiety.
  • Collaboration with local organizations can also enrich the support system available to youth. For example, partnerships with arts organizations can provide creative outlets for self-expression, while collaborations with sports leagues offer avenues for physical activity and team-building.

Building supportive environments for youth transcends the objective of substance use prevention. It’s about nurturing youth’s overall wellbeing and resilience, naturally making the choice of substance use less appealing and less likely.

ΛDΛM :: The Key to Your SBIRT Solution

ΛDΛM is a first-in-nation health technology system designed with a trauma-responsive lens to support the successful implementation of SBIRT models with youth. With culturally sensitive age- and risk-targeted screening tools, ΛDΛM provides professionals with immediate access to student/patient response data that then informs evidence-based brief interventions. School-based health centers, universities, health clinics, and other organizations can fold in local and national referral resources to support youth who need higher levels of care. ΛDΛM will streamline your SBIRT to reduce and prevent youth substance use. Schedule a call to learn more.