Introduction: CRAFFT-Screening test for risk behavior evaluation
The issue of substance abuse is one of primary adolescent behavioral problems that need to be treated well in advance for avoiding further complications. CRAFFT is a very important screening tool because it uses the series of 6 questions that can be administered either by a response questionnaire or via an interview. These 6 questions are developed from the six alphabets used in the name of the tool where C stands for Car, R stands for Relax, A stands for Alone, F stands for Forget, F stands for Friends, and T stands for Trouble (Children’s Hospital Boston, 2009). These 6 questions analyze the different stages of drugs or alcohol consumption and help in grading the level of abuse. Thus, the screening test paves the way for a comprehensive assessment which is further used to address the problem of drug or alcohol use, its frequency, and probable consequences over the health of the screened adolescent (Michigan Quality Improvement Consortium Guideline , 2014).
Validating the application of CRAFFT in scholarly research
In order to validate the application of CRAFFT via scholarly research, two different tests are examined below:
The first research assesses the results of CRAFFT applied over a pool of around 2,133 participants from colleges (Fields & Teitelbaum, 2012). The screening tool was administered by using clinical interviews and the CRAFFT score results were mapped. Those students who had a CRAFFT score of 2 and above had following results.
Approx 15% of the 12 to 18 years old students were screened positive.
Approx 43.5 % of them were reported for a lifetime use of alcohol or other drugs.
Approx 24.1% of them were reported for impaired driving risk due to substance abuse.
Thus, the validity of CRAFFT and its reliability over almost accurate screening is justified in the given research as score of 2 or more indicated substantive drug or alcohol abuse and needs immediate intervention for further comprehensive treatment.
The second research used a pool of 538 participants aged 14-18 who were arriving for routine health care in the adolescent hospital (Knight, J. et al., 2002). The CRAFFT results gave a score of 2 or higher for almost 25% of interviewed people and the final results came as follows:
During the past 12 months 49.6% were reported for NO use.
23.6% were reported for occasional use.
10.6% were reported for problem use.
9.5% were reported for occasional abuse.
6.7% were reported for dependence.
Thus, the validity of CRAFFT and its reliability over accurate results are justified for almost all of the students reported for drug or alcohol abuse.
Applying the tool to a patient situation
In a situation where an 18 year old student is reported for clinical screening due to unintentional injuries resulting from vehicle crashes, the standard CRAFFT questions need to be asked via interview with a special focus on the scoring for Car related question. Finally, the scores on the individual questions need to be tallied to get the final score. A CRAFFT score greater than 2 reflect a higher degree of drug or alcohol abuse and the comprehensive assessment is recommended. The situation of drug abuse in this case is concluded based on the diagnostic criteria of recurrent use of drugs or alcohol during the hazardous situations.
Conclusion: Suggested care plan for the patient
A 6 step care plan is recommended for the patient suffering from drug or alcohol abuse (Knight, Roberts, Gabrielli & Hook, 2009):
Adequate feedback over the currently pursued substance abuse and their potential harms should be communicated to the patient.
The patient should be educated about potential threats and ways to evade any further use.
There should be recommendation for the healthy alternatives to his substance abuse so that he abstains from any further abuse.
In case of a denial for above recommendations, a commitment should be negotiated with the patient via using cultural, religious, or family oriented values.
A brief time table should be agreed upon and duly signed by the patient regarding the step-by-step recovery and ratification of undertaken cure.
Proper follow-up appointment plan for clinical review of the current care plan.
References
Children’s Hospital Boston (2009). The CRAFFT Screening Tool.Retrieved online from http://www.ceasar-boston.org/CRAFFT/
Fields, B.J & Teitelbaum, S.A. (2012).The Physician's Approach to Substance Use in Adolescents. Northeast Florida Medicine, 63(1), 23-26.Retrieved online from http://www.dacco.org/LinkClick.aspx?fileticket=Dye7YTuHNoE%3D&tabid=197.
Knight,J., Roberts ,T., Gabrielli, J. & Hook, S. (2009).Adolescent alcohol and substance use and abuse. Performing preventive services: a bright futures handbook. Retrieved online from https://brightfutures.aap.org/Bright%20Futures%20Documents/Screening.pdf.
Knight, J. et al.(2002).Validity of the CRAFFT Substance Abuse Screening Test among Adolescent Clinic Patients FREE. Arch Pediatric Adolescent Medicine, 156 (6), 607-614.
Michigan Quality Improvement Consortium Guideline (2014).Adolescent and Young Adult Health Risk Behavior Assessment. Retrieved online from http://mqic.org/pdf/mqic_adolescent_health_risk_behavior_assessment_cpg.pdf.
