Barriers to Screening Teens for Substance Abuse in Primary CareThe “Six T’s”: Barriers to Screening Teens for Substance Abuse in Primary Care (Van Hook et al., 2007)IntroductionPrimary care providers in pediatric, adolescent or family healthcare settings face significant barriers in the screening of substance abuse. From the most common to the least, they are insufficient time, lack of training to manage positive screen, need to triage competing medical problems, lack of treatment resources, tenacious parent and unfamiliarity with screening tools.SummaryThough the barriers have different ranking, they are actually interrelated. The top rank barrier, insufficient time, staff don’t have enough time to deal with or refer positive screening result youth. It is attributed by the other barriers. The providers mentioned that they don’t know how to manage a positive result in a limited time due to lake of training. As the treatment of substance abuse is not covered by medical insurance, there is difficult to hire more particular disciplines staff or to gain more efficient materials in limited resources and give a tight clinic schedule. It impairs physicians to have further investigation in the screening to give a suitable treatment or referral in a limited time. Staff are unfamiliar with screening tools make them waste too much time on screening because they are difficult to find an effective or suitable tools.Some adolescents have sick visit due to some toxic effects of substance abuse. Physicians triage them as a medical problem and miss a chance to screen. The situation is improved when it is a well-care visit.Tenacious parent who don’t leave the room to give a private and confidential discussions for their child. It is because they think they have an open relationship with child and will not hinder the discussion. Some is due to culture problem that it is inappropriate to leave their daughter alone with strangers.
Some staff find uncomfortable to discuss substance abuse with adolescents but it hasn’t been ranked due to they refuse to disclose more in front of their colleagues.SuggestionTo give more time to medical staff, provide some computer or pencil/paper screening for adolescents to have a self-screening. Some basic test such as CAGE (Thomas, 2010) that involves low level techniques can allow office staff or teachers inside school to finish. To give more efficiency, focus screening resources in high risk groups such as 12th grade student to find out the target. (Matheson, McGrath, 2012) Adolescents who join party and disco frequently also have high potential in substance abuse. (Lee, 2001) We can spread some hair cut coupons for them as they really concern about their body image. During the hair cut, a screening can be done.
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The term ‘high risk’ in the DSM refers to the presence of a substantial risk of alcohol–type problems; it can be defined as the presence of an impairment due to alcohol consumption.\ There are four common causes of alcohol-related disorders that cause a decrease in body fat.\ The most common alcohol-related disorders include:·, Alcohol-induced liver syndrome;, Metabolic disorders;, Chronic obstructive pulmonary disease (COPD);, , , Nonalcoholic fatty liver disease (NAFLD);, Smoking, Diarrhea, Intrested/Severe Anxiety, Mood Disorders, Depression, Post-Traumatic Stress Disorder, and Related Symptoms.\ Some of the more common alcohol-related disorders include Alcohol-induced hypoglycemia, Chronic obstructive pulmonary disease, Alcohol insufficiency due to poor use of medication, Irritability/Confusion, Pregnancy complications, and Chronic Conditions of Disease.\\ Most alcohol-related disorders (such as alcohol dependence or alcohol dependent child abuse) can persist beyond 12 years but they can improve in age, often resulting in healthier individuals and society.\\ As adults, a person who has a high risk for alcohol dependence is more likely to do well in school based on a sense they have improved.\\ People who are more likely to attend college will have a more positive attitude and/or a more pleasant life.\\\\\\\\\ \\\ \// A person with a high risk for alcohol dependence might feel like a better person.\\ \\\// There is no way to know if an individual is drinking more than normal or if they are at risk for alcohol at any given time.\\\////\
Many of the “high risk” diagnoses are based on a mistaken notion that alcohol (or drugs) makes people more susceptible to addiction‬ such by making them more aware of how much they are making to themselves and how they are making decisions.\\ While some of these low and lower-risk diagnoses are actually not considered in many doctors’ offices to be common, it is nevertheless very common for high risk individuals to have lower levels of drug use (e.g., drinking or use of the marijuana habit) and higher levels of substance use (e.g., driving, gambling, or drinking from crack or marijuana joints) that makes them less likely to make the correct decisions when thinking about which actions are good choices to take.\\\\ \\// Research that has shown alcohol to be a gateway drug has been discredited by its widespread use and its role in the recent Columbine shooting.\\\ \// In 2003, The Medical Journal stated\ \\\ // that there have been no studies that have provided an accurate picture of how widespread alcohol use can lead to low-risk behavior‬ such as gambling, using large amounts of illicit drugs, smoking excessively or using alcohol, or sexual behavior.\\\