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Are there any brief interventions we can do with 15-year-old adolescents transitioning from pediatrics to primary care medicine, to detect substance use and provide an initial approach?

Maribel Serra
Maribel Serra Candell
Clinical psychologist. Head of the Projects and Programs Subsection.
Centre SPOTT. Diputació de Barcelona

Primary care pediatric teams are in a privileged position for the early detection of cannabis use due to their contact with children in the development and growth phase, and their families.

All interventions should be done in a comprehensive and non-specific manner, taking into account community and specialized resources.

Primary care professionals need basic knowledge and training to screen adolescents for potential substance use. Pediatricians are essential in the prevention and early detection of potential drug use, and in referring patients to specialized centers when necessary.

These professionals should get used to including questions about drug use from the beginning of adolescence, in order to identify potential use as early as possible. There is evidence of the efficacy and effectiveness of early identification and brief intervention programs in cases of drug use.

To detect and initially address cannabis use in 15-year-old adolescents, brief interventions such as validated screening questionnaires like the CAST ( Cannabis Abuse Screening Test ) can be implemented. This is a simple, six-question scale designed to identify patterns or risk behaviors associated with cannabis use in the past year. Easy to administer, it assesses the frequency, dependence, and consequences of cannabis use. Its use in primary care would allow for the identification of young people who may be at risk of developing cannabis use disorder. Furthermore, it can help guide diagnosis and direct individuals to appropriate programs.

The American Academy of Pediatrics recommends annual screening, coinciding with regular physical examinations, although it is important for the family to exercise their role in supervising and monitoring the behavior of their children.

These actions should be carried out in an environment of trust and support , without adopting a punitive approach.

The following article is recommended: Benítez Rubio MR, Medranda de Lázaro MI, Montón Álvarez JL. Primary Care Pediatrician Intervention in the Prevention of Substance Abuse. Rev Pediatr Aten Primaria. 2006; 8 Suppl 3: S91-111.

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Maribel Serra
Maribel Serra Candell
Clinical psychologist. Head of the Projects and Programs Subsection.
Centre SPOTT. Diputació de Barcelona