{
  "abstract": "Substance use (SU, new name for substance misuse) is common in youth and it is a part of the experimental journey that many adolescents take, sadly laying the foundations for future adult addictive behaviour and all the associated health, social, financial and family disaster that accompanies it. There are validated tools for screening for mental health disorders, suicide risk and SU disorder, but they are underused. Beinenson D et al (JAMA Pediatr 2026;180:343-345. doi:10.1001/jamapediatrics.2025.5714) have looked at the use of the Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) screening tool in three Paediatric Emergency Departments (PEDs) in the USA. This is a validated instrument with high sensitivity and specificity for identifying SU risk in youths. Examining electronic health record (EHR) data from 1604 youths (2008 visits) aged 12–21 years during a mental health crisis, 351 (21.9%) were identified as substance users on initial screen (mean (SD) age, 14.91 (1.77) years). Overall, 386 CRAFFT screenings were administered. A score of 3 or greater was recorded in 159 visits. Of 351 patients who endorsed SU, 84 (23.9%) were referred to specialty SU treatment. In addition to CRAFFT screening, 1025 urine drug screens were conducted, with 271 (26.4%) yielding positive results. Among 271 visits with a positive urine drug screening, 76 (28.0%) had not endorsed SU upon screening. This seems to be a useful tool but also highlights that toxicology screening urine may be worthwhile even in those who deny SU. What does CRAFFT stand for? C—ridden in a CAR driven by someone intoxicated; R—use alcohol/drugs to RELAX; A—use alcohol/drugs while ALONE; F—FORGET things you did while intoxicated; F—FAMILY or friends tell you to reduce drinking/drug use; T—gotten into TROUBLE while using alcohol/drugs.",
  "authors": [
    {
      "affiliations": [],
      "name": "BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health"
    }
  ],
  "title": "Highlights from the literature",
  "uid": "2da2dcd8-3c4f-5408-abcb-3e6a7af496db"
}