College of Health and Human Performance, Health Education and Behavior Department, University of Florida, Gainesville, FL 32611, United States.
Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, and Rhode Island Hospital, Providence, RI 02903, United States.
Addict Behav. 2021 Nov;122:107036. doi: 10.1016/j.addbeh.2021.107036. Epub 2021 Jul 1.
Justice-involved youth report high rates of substance use and related problems that are associated with treatment needs; however, data on screening and linkage to treatment within the justice system is lacking. To further inform the juvenile justice behavioral health cascade of care, this study examined factors associated with identified problematic substance use and treatment referral using two screening tools.
As part of a family court intake process, 348 justice-involved youth received two screening measures, the MAYSI-2 alcohol/drug use subscale and the CRAFFT. Both tools are designed to indicate early warning signs of substance use problems and signal referral for further clinical evaluation or treatment. Chart review analysis examined whether demographic variables (sex & race), severity of use, and type of substance used were associated with positive screens on either or both measures and subsequent treatment referral.
Half (51.2%) of youth were identified as having problematic substance use (a positive screen) on at least one of the screeners. Overall, 38.5% positively screened on the CRAFFT with only 0.3% positively screening on just the MAYSI-2 alcohol/drug scale. Cannabis only users were less likely to positively screen on the MAYSI-2 compared to youth who reported use of both alcohol and cannabis. Positively screening on one versus both screeners was not associated with referral, yet many (28%) who positively screened were not referred for services.
The CRAFFT may be more accurate at identifying youth specifically at risk for problematic cannabis use compared to the MAYSI-2 alcohol/drug subscale. Regardless of tool used, treatment referral was low, highlighting the need for accurate identification of treatment needs of substance-using, justice-involved youth. Interventions to facilitate referrals for youth with problematic substance use are needed.
涉及司法程序的青少年报告了高比率的物质使用和相关问题，这些问题与治疗需求有关；然而，关于司法系统中筛查和转介治疗的数据却很缺乏。为了进一步完善青少年司法行为健康的连续护理模式，本研究使用两种筛查工具，调查了与已识别的物质使用问题和治疗转介相关的因素。
作为家庭法庭立案程序的一部分，348 名涉及司法程序的青少年接受了两种筛查工具，即青少年酒精/药物使用筛查测试（MAYSI-2）的酒精/药物使用子量表和 CRAFFT。这两种工具都旨在表明物质使用问题的早期预警信号，并提示转介进行进一步的临床评估或治疗。图表审查分析检查了人口统计学变量（性别和种族）、使用的严重程度以及使用的物质类型是否与任何一种或两种测量工具的阳性筛查结果以及随后的治疗转介有关。
一半（51.2%）的青少年至少有一种筛查工具（阳性筛查）显示存在物质使用问题。总体而言，38.5%的青少年在 CRAFFT 上呈阳性，而只有 0.3%的青少年在 MAYSI-2 酒精/药物量表上呈阳性。与同时报告使用酒精和大麻的青少年相比，仅使用大麻的青少年在 MAYSI-2 上阳性筛查的可能性较小。与仅对一种筛查工具呈阳性相比，对两种筛查工具都呈阳性与转介无关，但许多（28%）呈阳性的青少年并未被转介接受服务。
与 MAYSI-2 酒精/药物子量表相比，CRAFFT 可能更能准确识别有特定大麻使用问题风险的青少年。无论使用哪种工具，治疗转介率都很低，这突显了准确识别有物质使用问题的、涉及司法程序的青少年治疗需求的必要性。需要采取干预措施，促进有物质使用问题的青少年转介接受治疗。
