Clinicians Must Focus on Substance Use Screening in Youths?
Although most clinicians caring for youths aged 17 years or younger reported screening for substance use disorders, many did not do so at every checkup, and 36.9% did not use a standardized screening tool — falling short of recommended screening practices.
METHODOLOGY:
Researchers conducted a cross-sectional survey to describe screening practices for substance use disorders among clinicians caring for youths aged 17 years or younger in the United States.
They included 1047 clinicians: 467 family physicians, 250 pediatricians, 132 internal medicine physicians, 107 nurse practitioners, and 91 physician assistants. The median duration of practice was 13 years.
Participants were asked questions about delivering care to adolescents, focusing on substance use screening frequency and types of screening tools used.
Concordance with the recommended screening practices set by the American Academy of Pediatrics and Substance Abuse and Mental Health Services was defined as screening at every checkup, regardless of purpose, using a screening tool.
TAKEAWAY:
A majority (56.9%) of clinicians reported screening for substance use disorders at every checkup; the proportion of clinicians who endorsed screening at every checkup was higher among pediatricians than among other specialists.
Among the 43.1% of clinicians who reported not screening at every checkup, 29.7% endorsed screening at an initial visit, 34.2% endorsed screening at intermittent visits, 61.0% endorsed screening if concerns about risky behaviors existed or when a parent/guardian raised concerns, and 13.8% endorsed never screening for substance use disorders among adolescents.
Among the clinicians who screened youths for substance use disorders, 36.9% did not use a screening tool. The use of screening tools was associated with greater odds of screening at every checkup (odds ratio, 1.87; 95% CI, 1.44-2.44).
Only 39.3% of clinicians reported screening at every checkup using a screening tool in line with the recommended screening practices; only 30.7% of clinicians screened youths for substance use, provided brief interventions to those at risk, and referred individuals with more severe issues to appropriate treatment programs.
IN PRACTICE:
'Identifying youths with SUDs [substance use disorders] and referring them to treatment remain crucial components to reduce substance use–related morbidity and mortality, including overdose,' the authors wrote.
'Screening offers opportunities for clinicians to engage in primary prevention of SUDs through anticipatory guidance, refer patients who use substances to appropriate care, and offer interventions to reduce adverse outcomes to all at-risk youth[s],' they added.
SOURCE:
This study was led by Kathleen Ragan-Burnett, MSPH, of the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention in Atlanta. It was published online on May 20, 2025, in JAMA Network Open .
LIMITATIONS:
The results of this study may not apply to all clinicians because only those with a greater chance of responding were contacted first. There were limited details available about screening behaviors, including the motivations for and barriers to specific practices.
DISCLOSURES:
No sources of funding were reported in this study. The authors report having no relevant conflicts of interest.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Bloomberg
26 minutes ago
- Bloomberg
Indivior Plans to Cancel London Listing After Moving Primary to US
Indivior Plc said it plans to cancel its secondary listing in London nearly a year after the drugmaker shifted its primary trading to the US, marking the latest departure from the UK's capital markets. The opioid-addiction therapy maker moved its main listing to New York last year in search of more analyst and investor coverage, but had a rocky start amid guidance cuts. It's planning to ditch the secondary trading it had maintained on the London Stock Exchange to better reflect where its revenues come from and eliminate the cost of the secondary listing, given most of its volume and investors are now in the US, according to a statement.
Medscape
26 minutes ago
- Medscape
Centanafadine ‘Clinically Meaningful' for Adult ADHD
LOS ANGELES — The novel norepinephrine, dopamine, and serotonin reuptake inhibitor (NDSRI) centanafadine (Otsuka Pharmaceutical Co., Ltd.) is effective and 'clinically meaningful' for adult attention-deficit/hyperactivity disorder (ADHD), new research suggested. In a combined analysis of two phase 3 trials with a total of 859 adults, more patients who received the NDSRI had at least an 18-point improvement at week 6 on the ADHD Investigator Symptom Rating Scale (AISRS) total scores compared with patients on placebo. Additionally, a significantly greater percentage of the active treatment groups showed improvement in the measure's hyperactivity/impulsivity and inattention subscales. Lenard A. Adler, MD But we weren't just interested in statistically significant change but in change 'that means something,' said principal investigator Lenard A. Adler, MD, director of the Adult ADHD program and professor of psychiatry at the New York University (NYU) Grossman School of Medicine, New York City. 'In other words: What do we know is a significant amount of change in patients receiving a compound? That's always a question because we want to get patients well and not just better,' Adler told Medscape Medical News . The findings were presented on May 19 at the American Psychiatric Association (APA) 2025 Annual Meeting. A high-dose, pediatric version of the drug was similarly effective for both children and adolescents in two additional phase 3 trials also presented at the meeting by Adler and colleagues. 'Gives a Benchmark' Centanafadine 'is a triple reuptake inhibitor, so it's not a classical stimulant,' said Adler. 'It's a compound that offers a unique profile.' Investigators pooled data from two identically designed phase 3 trials looking at the drug in patients with a primary diagnosis of ADHD. Together, this included 859 adult patients, with a mean age of 35 years (52% men; 80.3% White). The mean baseline total score on the semi-structured AISRS scale was 38.8 ('moderately ill'), with the mean AISRS inattention score 21.6 ('severely ill') and the mean AISRS hyperactivity/impulsivity score 17.2 ('moderately ill'). The AISRS is conducted as an interview between patient and clinician. 'We also recorded data on clinicians' global impression of severity and global impression of change and then used those as anchors to look at the clinically meaningful within-patient change for the AISRS,' co-investigator Caroline Ward, PhD, director of the Global Clinical Development at Otsuka Pharmaceutical Companies, told Medscape Medical News. All participants were randomly assigned to receive centanafadine at 200 mg (n = 287) or 400 mg (n = 287) or a matching placebo (n = 285). Results showed that the mean change on the AISRS total score at week 6 was −12.1 and −12.5 for the centanafadine 200 mg and 400 mg groups, respectively, vs −8.1 for the placebo group ( P = .002 and .0009). In addition, 24% of the 200 mg group and 25.4% of the 400 mg group achieved an 18-point or greater improvement in AISRS total score from baseline to week 6 compared with 15.4% of the placebo group (ratio of response rate [RR], 1.70; P = .002 and RR, 1.71; P = .001, respectively). A 10-point or greater improvement on the AISRS inattention subscale was achieved by 26.1% of the 200 mg group and 23.3% of the 400 mg group compared with 16.5% of the placebo group (RR, 1.71; P = .001 and RR, 1.45; P = .03, respectively); and an 8-point or greater improvement on the hyperactivity/impulsivity subscale was achieved by 26.5% and 28.6% of the 200 mg and 400 mg groups, respectively, compared with 20% of the placebo group (RR, 1.38; P = .03 and RR, 1.47; P = .01, respectively). The 200 mg and 400 mg groups also reached the 'clinically meaningful within-patient change AISRS threshold' for the first time earlier than the placebo group ( P = .0006 and P < .0001, respectively). Looking at meaningful change 'gives clinicians a benchmark,' said Adler. Pediatric Safety and Efficacy The investigators also presented results from two other randomized phase 3 trials that assessed the drug in children between the ages of 6 and 12 years (n = 480; 58% boys) and adolescents between 13 and 17 years (n = 459; 59% boys). Of these, 77% and 81%, respectively, completed their studies. All were from the United States and Canada. The adolescents received high-dose centanafadine (328.8 mg once daily), low-dose centanafadine (164.4 mg once daily), or placebo for 6 weeks. The children received a placebo or a high or low dose of centanafadine, with doses based on their weight. A larger number of children who received high-dose centanafadine had an 18-point or greater improvement at week 6 on the ADHD Rating Scale–5 (ADHD-RS-5) total score compared with the children who received placebo (34.5% vs 23.3%; P = .03), with even stronger effects found in the adolescents (47.7% vs 31.7%; P = .004). A greater number of the high-dose active treatment group vs the placebo group also had at least a 10-point improvement in ADHD-RS-5 inattention subscale scores (children, P = .03; adolescents, P = .003) and at least an 8-point improvement in hyperactivity/impulsivity subscale scores ( P = .04 and .03, respectively). In addition, the mean change from baseline to week 6 on the ADHD-RS-5 total score was −16.3 for the children receiving the high-dose drug vs −10.8 for those receiving placebo ( P = .0008) and was −18.5 vs −14.2 in the adolescents ( P = .0006). When assessing caregiver-rated improvements, investigators found that a greater number of children and adolescents receiving high-dose centanafadine vs placebo achieved at least a 14-point improvement on the Conners 3–Parent Short Inattention T-scores ( P = .02 and .001, respectively) and at least a 13-point improvement on the Conners 3–Parent Short Hyperactivity/Impulsivity T-scores ( P = .02 and .007, respectively). Most treatment-emergent adverse events were deemed to be mild to moderate. The most common adverse events in the high-dose centanafadine group were decreased appetite and rash in the children and decreased appetite, rash, nausea, and headache in the adolescents. Ward reported that data from these studies, along with some they conducted previously and some that are ongoing, will be part of a package they're preparing to send to the US Food and Drug Administration in the near future. Altogether, 'it tells a nice story,' she said. Real-World Data Commenting for Medscape Medical News, Soonjo Hwang, MD, associate professor of psychiatry at the University of Nebraska Medical Center, Omaha, Nebraska, noted that among treatments already available for ADHD, the most well-known are stimulant medications, which 'are purely' dopaminergic reuptake inhibitors. Soonjo Hwang, MD 'That said, norepinephrine, dopamine, and serotonin have a close relationship with each other in the brain. So, if you inhibit one, it will have an impact on the others as well,' said Hwang, who was not involved with the new research. He pointed out that centanafadine has a similar profile to other medication groups, such as antidepressants, that have been assessed previously for ADHD. 'In terms of the mechanism, it's similar to some we've had in the past. Still, it is really important for us to have new tools to treat this disorder because we currently have limited options,' Hwang said. He noted that being 'clinically meaningful' is a concept worth thinking about. 'This was a randomized-controlled clinical trial that [focused] towards more real-world data. And it's important to have data on how the medication performs in a real-world situation before launching it to market,' he said. Hwang added that he'd also like to know, moving forward, how well the medication works in patients with comorbidities, which is common in those with ADHD.
Yahoo
an hour ago
- Yahoo
Defence Therapeutics Opens U.S. Laboratory in Boston-Cambridge Biotech Hub
Montreal, Quebec--(Newsfile Corp. - June 2, 2025) - Defence Therapeutics Inc. (CSE: DTC) (OTCQB: DTCFF) (FSE: DTC) ("Defence" or the "Company"), a leading biotechnology company specializing in advanced endosomal escape technologies, is pleased to announce the opening of its first U.S. laboratory in the Boston-Cambridge area. This strategic expansion marks Defence Therapeutics' initial physical presence in the United States, reinforcing its commitment to advancing cutting-edge research and development in one of the world's foremost biotech clusters. The new laboratory, located at Cambridge Scientific Labs in Watertown, will allow Defence Therapeutics to further develop and optimize its proprietary Accum® technology for antibody-drug conjugates ("ADCs"). Establishing a presence in the Boston-Cambridge area provides the company with access to top-tier scientific resources and opportunities for collaboration within the region's renowned biotech ecosystem. The Cambridge Scientific Labs location will serve as a short-term base while Defence Therapeutics evaluates options for a long-term facility in the area. "Our expansion into the Boston-Cambridge area is a significant milestone for Defence Therapeutics," said Sebastien Plouffe, CEO of Defence Therapeutics. "Establishing a U.S. laboratory positions us at the heart of the global biotech community and supports our mission to advance the Accum® platform for next-generation ADCs. We look forward to deepening our presence in the region as we continue to grow and pursue a long-term facility in this dynamic market." About Defence: Defence Therapeutics is a publicly-traded clinical-stage biotechnology company developing and engineering the next generation of radio-immuno-conjugate and ADC products using its proprietary platform. The core of Defence Therapeutics platform is the ACCUM® technology, which enables precision delivery of radio-immuno-conjugates or ADCs in their intact form to target cells. As a result, increased efficacy and potency can be reached against cancer. For further information: Sebastien Plouffe, President, CEO and DirectorP: (514) 947-2272Splouffe@ Cautionary Statement Regarding "Forward-Looking" Information This release includes certain statements that may be deemed "forward-looking statements". All statements in this release, other than statements of historical facts, that address events or developments that the Company expects to occur, are forward-looking statements. Forward-looking statements are statements that are not historical facts and are generally, but not always, identified by the words "expects", "plans", "anticipates", "believes", "intends", "estimates", "projects", "potential" and similar expressions, or that events or conditions "will", "would", "may", "could" or "should" occur. Although the Company believes the expectations expressed in such forward-looking statements are based on reasonable assumptions, such statements are not guarantees of future performance and actual results may differ materially from those in the forward-looking statements. Factors that could cause the actual results to differ materially from those in forward-looking statements include regulatory actions, market prices, and continued availability of capital and financing, and general economic, market or business conditions. Investors are cautioned that any such statements are not guarantees of future performance and actual results or developments may differ materially from those projected in the forward-looking statements. Forward-looking statements are based on the beliefs, estimates and opinions of the Company's management on the date the statements are made. Except as required by applicable securities laws, the Company undertakes no obligation to update these forward-looking statements in the event that management's beliefs, estimates or opinions, or other factors, should change. Neither the CSE nor its market regulator, as that term is defined in the policies of the CSE, accepts responsibility for the adequacy or accuracy of this release. To view the source version of this press release, please visit Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
