Barriers Faced by Physicians in Screening for Substance Use Disorders Among Adolescents

Psychiatr Serv. 2019 May 1;70(5):409-412. doi: 10.1176/ Epub 2019 Feb 20.


Objective: This study identifies key barriers faced by primary care providers (PCP) in implementation of screening, brief intervention, and referral to treatment (SBIRT) services for substance use disorders among adolescents.

Methods: The authors used mixed methods, including 12 key informant interviews and a survey with 75 PCPs, to identify key barriers to PCP implementation of SBIRT services.

Results: Time constraints, challenges related to parental involvement, a perceived lack of effectiveness of brief intervention services, and lack of training in providing brief intervention were barriers to screening and brief intervention. Referral to treatment was frequently perceived as a challenge. Increased reimbursement and dedicated resources were important interventions for improving screening rates.

Conclusions: Increased reimbursement could support workflow enhancements to improve the consistency of SBIRT procedures and alleviate time constraints. Consistent SBIRT applications for all adolescents could also be supported by increasing PCP training in brief intervention.

Keywords: Alcohol and drug abuse; Assessment/psychiatric; adolescent; parent; substance-related disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Humans
  • Interviews as Topic
  • Mass Screening / methods
  • Physicians, Primary Care*
  • Referral and Consultation
  • Substance-Related Disorders / diagnosis*
  • Substance-Related Disorders / therapy
  • Surveys and Questionnaires
  • Time Factors
  • Young Adult