Evaluation of the CRAFFT Tool in the Screening of Substance Use Among Adolescents in a Rural Care Setting

Substance abuse refers to the hazardous and harmful use of psychoactive substances, including illicit drugs and alcohol. Substance abuse is also defined as the sporadic or persistent use of drugs that are not in line with or are unrelated to the accepted use of medication. More than 1.3 million adolescents aged 12 years to 17 years are diagnosed with substance use disorder in the United States (Coleman, 2018). Tobacco initiation often occurs in the adolescent stages of life. There is also an increased acceptance of the use of alcohol in social settings. The impact of substance use and abuse among adolescents includes involvement in risky behaviors such as crime, unprotected sex, and driving under drug influence. The health of adolescents using drugs is also affected, where they may have changes in cognitive ability and brain development. Memory problems and suicide are high among adolescents who use and abuse drugs. Therefore, substance abuse is associated with reduced life expectancy, suicides, accidents, mental disorders, unemployment, and poor health (Das et al., 2016). Hence, there is a need to take approaches and initiatives that reduce the negative effects and prevalence of substance abuse among adolescents. The purpose of this work is to evaluate the use of the CRAFFT tool as a method to improve the screening of adolescents in a rural care setting.

Problem Statement

Substance abuse among adolescents is a major public health concern not only in urban cities but in rural areas as well. Primary care nurses in rural areas lack the skills and knowledge in substance abuse screening (Lynch, 2020). Early screening and subsequent detection of the possible use of drugs and alcohol helps in directing patients to access the right healthcare services (Levy & Williams, 2016). Adolescence is a challenging time for most persons in this age category, and this can be further complicated by substance abuse (Radel et al., 2018). When healthcare providers are left to their discretion on screening for substance abuse, they will often fail to do so (Lynch, 2020). Screening does not occur as often as it ought to be done despite the recommendations by professional guidelines for substance abuse screening (D’Amico et al., 2016). In the current research, education for nurses on the use of the CRAFFT screening tool and how the device is applied in clinical practice for adolescent populations will be the focus.

The research has the potential to impact the nursing practice through empowering nurses, as stated earlier. Pre-licensure nurses are inadequately prepared for effective patient substance abuse screening. Most academic programs have a 1–5-hour session of instruction that focuses on substance abuse in patients with infrequent teaching of skills necessary for addressing patient substance abuse (Knopf-Amelung et al., 2018). Therefore, nurses, upon graduating, are ill-equipped, and this calls for research such as this that seeks to empower RNs. When RNs gain important and valuable information and also understand the need and their role to help reduce the frequency of substance abuse among adolescents, then the war against this epidemic will be fast won.

The research seeks to fill the gap created by practice settings in rural areas where adolescent patients are not screened for substance abuse because the nurses fail to do so. Several factors have been identified as contributing to the existence of this gap, and these include lack of referral places; inadequate training; refusing or assuming to discuss the issue of substance abuse, that is, denial of its existence; and time constraints, among others (D’Amico et al., 2016). When nurses lack the necessary training on substance abuse, their understanding and confidence are greatly hindered as to how they can integrate into their daily practice drug and alcohol abuse screening (KnopfAmelung et al., 2018).

Project Purpose Statement

The purpose of the project is to evaluate a method or tool to improve the screening of adolescents using and abusing drugs in a rural care setting. The objective of the project is to assess the knowledge of nurses and the screening efficiency of substance-use adolescents before and after the implementation or use of the CRAFFT screening tool.

Background and Significance

In the United States, about 9.4 % of the adolescent population use and abuse drugs (Coleman, 2018). The trend shows that the number of adolescents using marijuana, alcohol, and stimulants such as methamphetamine, cocaine, heroin, and hallucinogens increases each year (Coleman, 2018). Substance abuse is associated with reduced life expectancy, suicides, accidents, mental disorders, unemployment, and poor health (Das et al., 2016). Substance abuse among adolescents increases both societal and healthcare costs. A l