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School-Based Screening, Brief Interventions and Referral to Treatment (SBIRT) Significantly Decreases Long-Term Substance Abuse in 6,227 Students Aged 11-18

Deena M. Hamza*, Marni Bercov, Victoria Y.M. Suen, Andrea Allen, Ivor Cribben, Jodi Goodrick, Stu Henry, Catherine Pryce, Pieter Langstraat, Katherine Rittenbach, Samprita Chakraborty, Rutger C. Engles, Andrew J. Greenshaw, Christopher McCabe and Peter H. Silverstone

Background: Youth alcohol and drug misuse has multiple long-term consequences. Suggestions to reduce the frequency of this include combining Screening, Brief Interventions, and Referral to Treatment (SBIRT). However, SBIRT has not been studied widely in children and youth.

Methods: The present observational study was part of a larger school-based intervention program, termed Empowering a Multimodal Pathway towards Healthy Youth (EMPATHY), whose primary goal was to reduce depression, anxiety, and suicidal thinking in youth. A secondary goal was to determine if the EMPATHY program, which utilizes all aspects of SBIRT, might also decrease alcohol and substance abuse in children and youth. Here we examine data from the 6 items of the CRAFFT scale which was specifically designed for youth assessment, and a score of ≥ 2 indicates risk of substance abuse. We examined CRAFFT scores from 6,227 students who completed at least one assessment, either at Baseline, 3 months, 7 months, and 15 months. We also report on CRAFFT scores in the 1,884 students who completed CRAFFT assessments at all 4 times.

Findings: We found that, as expected, rates of substance abuse increase with age. The EMPATHY program, which entails a version of SBIRT, led to a significant reduction in the total percentage of students who scored ≥ 2 over time, decreasing from 14% at Baseline to 7% at the 15 month follow-up. This occurred in all grades, specifically at Baseline 31% of Grade 12 students scored ≥ 2, but this decreased to 20% at 15 months, while reductions in Grade 11 were from 24% at Baseline to 15% at 15 months.

Conclusions: The findings from this large long-term program may indicate good utility for an SBIRT approach in children and youth. This may help provide an effective pathway to minimizing future use of alcohol and drugs in children and youth; however, more specific randomized controlled studies are needed to confirm these promising, but preliminary, findings.

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