{"id":2828,"date":"2026-04-03T21:19:26","date_gmt":"2026-04-03T21:19:26","guid":{"rendered":"http:\/\/www.tcysapc.org\/?p=2828"},"modified":"2026-04-03T21:19:26","modified_gmt":"2026-04-03T21:19:26","slug":"adolescent-substance-use-shifting-the-paradigm-from-clinic-to-classroom","status":"publish","type":"post","link":"https:\/\/www.tcysapc.org\/?p=2828","title":{"rendered":"Adolescent Substance Use: Shifting the Paradigm From Clinic to Classroom"},"content":{"rendered":"<p><img data-recalc-dims=\"1\" decoding=\"async\" class=\"sFlh5c FyHeAf iPVvYb alignleft lazyload\" data-src=\"https:\/\/i0.wp.com\/www.pinelandsrecovery.com\/wp-content\/uploads\/2019\/09\/schools-and-substance-abuse.jpg?resize=165%2C110&#038;ssl=1\" alt=\"Schools and Substance Abuse - What Are They Teaching? - Pinelands\" width=\"165\" height=\"110\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 165px; --smush-placeholder-aspect-ratio: 165\/110;\" \/><a href=\"https:\/\/www.clinicaladvisor.com\/features\/adolescent-substance-use\/\">The rates of substance use among US high school students<\/a> have been declining over the last decade, with decreasing overall trends observed in use of alcohol, marijuana, illicit drugs, and prescription opioids. \u00a0Despite these improvements, the latest data (2023) indicate that 22% of high school students currently consume alcohol and 17% use marijuana.<\/p>\n<p>In addition, disparities exist among populations, specifically female, White, and LGBTQ+ students, who report alcohol use at rates of 24%, 26%, and 26%, respectively. LGBTQ+ students were about twice as likely as cisgender and heterosexual students to have ever used illicit drugs and prescription opioids (18% vs 8%). Furthermore, marijuana use exceeded the national average among LGBTQ+ (25%), multiracial (21%), and female (19%) students.<\/p>\n<p>Teresa Whited, DNP, and Alley Grassetti, CPNP-PC, argued that the management of adolescent substance use disorder (SUD) must transition from specialized clinics into school-based settings during a presentation at the National Association of Pediatric Nurse Practitioners (NAPNAP) 47th National Conference on Pediatric Health Care held from March 18 to 21, 2026, in Pittsburgh, Pennsylvania.<\/p>\n<p>In their presentation, the authors emphasized that adolescence represents a critical neuro-developmental window. Substance exposure during this period can dysregulate dopamine pathways and the cortico-striatal-thalamo-cortical (CSTC) circuit, a closed-loop pathway connecting the cerebral cortex, basal ganglia (striatum), and the thalamus, resulting in protracted impairments in executive function, memory, and emotional regulation. Low dopamine receptors may contribute to the loss of control, for example, in cocaine users, according to the National Institute on Drug Abuse.<\/p>\n<h2 id=\"h-clinical-framework-for-school-based-management\" class=\"wp-block-heading\">Clinical Framework for School-Based Management<\/h2>\n<p>The presenters outlined a multifaceted approach to addressing SUD within the educational environment:<\/p>\n<ul class=\"wp-block-list\">\n<li><strong>Screening and Diagnosis<\/strong>: The authors advocate for validated screening tools\u2014such as S2BI (Screening to Brief Intervention), BSTAD (Brief Screener for Tobacco, Alcohol, and Other Drugs), and CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble)\u2014over informal clinical judgment. Informal assessments typically identify only one-third of youth requiring intervention, they reported. Diagnosis remains governed by the <em>Diagnostic and Statistical Manual of Mental Disorders<\/em>, 5<sup>th<\/sup> ed (<em>DSM-5<\/em>) criteria across 4 domains: impaired control, social impairment, risky use, and pharmacological indicators. (Tables 1 and 2)<\/li>\n<li><strong>Risk Levels<\/strong>: Four risk levels were discussed: Abstinence, substance use without disorder-limited use; mild-to-moderate SUD-use in high-risk situations associated with problems, use to relieve stress or depression; Severe SUD associated with loss of control or compulsive use, neurologic changes seen in the brain\u2019s reward system.<\/li>\n<li><strong>Intervention Strategies:<\/strong> Effective management utilizes Brief Intervention (BI) grounded in motivational interviewing to elicit \u201cchange talk.\u201d For moderate-to-severe SUD, Medication-Assisted Treatment (MAT) is recommended in conjunction with behavioral interventions, including cognitive behavioral therapy (CBT) and family-based counseling.<\/li>\n<li><strong>Collaborative Care:<\/strong> A partnership between health care providers, schools, and families is essential. This model prioritizes non-punitive, harm-reduction strategies and ensures continuity of care.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>The rates of substance use among US high school students have been declining over the last decade, with decreasing overall trends observed in use of alcohol, marijuana, illicit drugs, and prescription opioids. \u00a0Despite these improvements, the latest data (2023) indicate &hellip; <a href=\"https:\/\/www.tcysapc.org\/?p=2828\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[8],"tags":[],"class_list":["post-2828","post","type-post","status-publish","format-standard","hentry","category-news"],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 5.0.2 - aioseo.com -->\n\t<meta name=\"description\" content=\"The rates of substance use among US high school students have been declining over the last decade, with decreasing overall trends observed in use of alcohol, marijuana, illicit drugs, and prescription opioids. Despite these improvements, the latest data (2023) indicate that 22% of high school students currently consume alcohol and 17% use marijuana. 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