Evidence-based school approaches to psychopathology
Adolescent Substance Use Disorders in the School Setting

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School-Based Prevention Programs

Universal school-based prevention programs have become prominent over the past 25 years in an effort to prevent adolescent substance use disorders.16 School-based programs have focused on educating children on the effects of drug use and the prevalence of adolescent substance use, and increasing their awareness of the social influences that contribute to the initiation of adolescent alcohol and drug use.16, 17 The most prevalent program nationally has been the Drug Abuse Resistance Education

The School Environment and School Drug Policies

In addition to universal prevention programs, the general environment at school can help decrease adolescent substance use. Individual students who are strongly connected with school have decreased use of tobacco, alcohol, and marijuana. School connectedness has been gauged by assessing children's level of commitment to school, relationships with teachers, relationships with peers, opportunities to participate, and sense of belonging.36 Research in middle schools also demonstrated that schools

Clinical Signs and Symptoms of Substance Impairment

Teachers, school officials, and school practitioners interact with students longitudinally and may be the first to notice signs of impairment due to adolescent substance use. Changes in academic performance, attendance, peer relations, and behavior should raise concern for a substance abuse problem.40 Clinicians are often asked to help school staff recognize the signs and symptoms of acute substance intoxication. In addition, students are often unaware of the actual long-term impacts of

Drug Testing in Schools

Drug testing has become more common in schools since the Supreme Court ruled that it was constitutional to randomly drug test high school student athletes in 1995.52 Testing was expanded to include middle school and high school students participating in extracurricular activities in 2002.52 The US Department of Education provides grant funding to support school-based drug testing programs, and a sample of school districts from 2005 found that 14% of school districts were randomly drug-testing

What to do When Concerned that a Student is Intoxicated or May be Using Substances

Given the complications associated with drug testing and concerns about students' confidentiality, further evaluation of substance use, screening, and continued monitoring may be best done by a child's pediatrician or family practitioner. Schools are well-positioned to help identify students at risk for substance use disorders. Once a substance use problem has been identified, it is helpful for one person at the school to be designated to provide support for the student and to help coordinate

Substance Use Treatment

Multiple treatment approaches in various treatment settings exist to treat adolescent substance use disorders. Individual, group, and family interventions have empirical support.60 Within modalities, no one approach has been shown to be significantly more efficacious then another. Important components for individual treatment according to the American Academy of Child and Adolescent Psychiatry (AACAP) include increasing motivation and engagement in treatment, improving problem-solving and

Summary

Schools play an instrumental role in promoting children's cognitive development as well as their social and emotional development. Substance use interferes with development and impacts not only individual students but the school environment as well. School-wide efforts including the use of evidence-based universal substance use prevention programs, attempts to increase students' attachment to school, and clear school drug policies can decrease early-onset adolescent substance use. It is

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