From the July 6 Lancet editorial:
“Last week the American Academy of Paediatrics published new guidance for clinicians treating adolescents and childrenwho misuse substances, including alcohol, marijuana, and tobacco. The report focuses on the public health impactof substance use on this high-risk population group, and recommends a cycle of substance use screening, brief intervention, and referral to treatment (known as SBIRT)…
“Screening is the first SBIRT step to identify individuals at risk, and can be used to define ongoing clinical care. The guidance includes tables that link frequency of substance use with corresponding follow-ups, and provides standard pathways for alcohol, marijuana, and tobacco. Positive reinforcement is recommended for adolescents who report no substance use, as evidence shows it delays onset of eventual use.
“This guidance is brief and clear, and will provide practical help to clinicians. Against a backdrop of liberalisation of cannabis laws in some states, clinicians face increased pressure to make correct assessments. Further evidence is still needed to support intervention, as research has shown that brief interventions are not always effective. Until then, clarifying implementation of risk assessments and recommendations for subsequent treatment options will be welcomed by paediatricians in the USA.
SBIRT is the brainchild of Dr. Bertha Madras, an indefatigable and zealous leader of the neo-prohibtionists, closely allied with the neuroimaging specialists at Harvard Medical School who generate glowing evidence of harm caused by cannabis. In the current O’Shaughnessy’s Madras appears at a hearing in Sacramento, justifying marijuana’s Schedule One status (See Gilg v. Prohibition) and in Boston, and berating Lester Grinspoon, MD, for corrupting the youth.
Note to SCC Members
The official wisdom on cannabis use by adolescents is coming not from cannabis specialists but from addiction specialists. In order for the SCC to speak on behalf of cannabis specialists, individual members have to share findings and observations. This is to request for publication in the next O’Shaughnessy’s (and on the SCC website), one case report from your practice involving cannabis use by an adolescent or child. The case can be typical or unusual. Any comments you want to add on the subject of use by adolescents in general would be welcome.