The Provider’s Role

The Provider’s Role

Pediatricians and other primary care providers can restrict adolescent access to opioids through regular screening for substance use, adopting non-opioid approaches to pain management when possible, and counseling patients and parents about opioid storage, use, and disposal.

Screen adolescents for substance use and misuse at routine clinical encounters.

The American Academy of Pediatrics and other professional organizations recommend use of the CRAFFT questionnaire to screen teens for substance use. A positive answer to two or more of the five questions indicates the need for further assessment and possible intervention.

Texas Health Steps requires psychosocial/behavioral health screening at each preventive medical checkup. Screening using the CRAFFT or another Texas Health Steps-approved mental health screening tool is required once for all adolescents 12 through 18 years. If a mental health screening tool is not completed at the 12-year checkup it should be performed at a later checkup. In addition, screening is recommended whenever a health-care provider suspects substance use.

Texas Health Steps also supports Screening, Brief Intervention, and Referral to Treatment (known as SBIRT), an evidence-based approach to detecting adolescent substance use. You can find links to the CRAFFT questionnaire and more information about SBIRT in the resources at the end of this course.

Learn about non-opioid therapies to help patients manage pain.

Physicians’ desire to help patients overcome their pain has contributed to an over-prescribing of opioids. Modern clinical pain management focuses on helping patients resume and maintain function, which may be accomplished through physical therapy with little or no opioid medication. If opioids are indicated, prescribe the minimum effective dose and duration.