Biological, medical, and genetic factors as well as psychological, social, familial, cultural, and other environmental features all influence the development and manifestation of substance abuse.

Visits to primary care clinicians provide unparalleled opportunities to intervene with substance abuse problems at a relatively early stage in disease progression. Office or clinic visits also give clinicians an opening to discuss substance abuse prevention with patients and younger adolescents. In a recently published report, the American Academy of Pediatrics (AAP) reaffirmed the important role that primary care providers can play in prevention, early detection and referral to treatment for substance use disorders.* The AAP recommends that pediatricians include discussion of substance abuse as a part of routine health care and as part of ongoing anticipatory guidance. The CRAFFT Screening Tool is a valid, reliable, and developmentally appropriate tool for accomplishing the recommended yearly screening, and teens who screen positive can be referred to the ASAP program for comprehensive evaluation and treatment.

* Kulig JW, and the Committee on Substance Abuse, American Academy of Pediatrics. Tobacco, alcohol, and other drugs. Pediatrics 2005; 115:816-821.