Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Dr. Vanessa Loyd


Dr. Vanessa Loyd

Dr. Anne Thatcher

Dr. Lexi Grodie



Background: Substance abuse among adolescents is one of the most serious social health problems in the United States. The prevalence of alcohol use in adolescents is as high as 80%, while opioid overdose deaths among adolescents have risen by greater than 50% in the last 10 years. Alcohol, tobacco, and other substance use has also increased among youth and is not being properly evaluated in the pediatric hospital setting. The purpose of this project was to evaluate the use of a substance abuse screening tool with SBIRT trained staff in the pediatric emergency room setting.

Methods: The CRAFFT substance abuse screening tool was administered to a convenience sample of adolescent patients aged 12 to 17 years old, seeking care in the pediatric emergency department from Feb-April 2023. Quantitative data was collected via prospective chart review during the emergency department visit. Data collected included number of CRAFFT screenings administered, number of positive CRAFFT screenings, screenings done by SBIRT trained staff, and referrals to treatment needed. The Iowa Model of Evidence-Based Practice served as the framework.

Results: CRAFFT screenings were offered to (N=76) patients and (n=62) screenings were completed. Of those screened, 25% (n=16) screened positive with a CRAFFT score of two or higher and were offered a referral to treatment. Of those who were offered a referral to treatment, 44% (n=7) accepted the referral.

Implications for practice: Widespread utilization of the CRAFFT substance abuse screening tool in the pediatric emergency department setting may provide early identification of adolescents at risk for substance abuse and offer them referrals to appropriate treatment.