Substance Use Disorders

At Childhood Health Associates of Salem, we recognize that substance use and abuse are becoming a growing problem in the population of children, adolescents, and young adults. We are aware that only one agency in our service area currently offers comprehensive outpatient services for drug and alcohol treatment for youth under the age of 18, and that traditional mental health providers will often not serve patients with a ‘dual diagnosis’ of both mental illness and SUD. We have frequently had difficulty in persuading youth to seek care for SUD in the community/external to our clinic resources and we recognize that they may prefer to seek care from a known and trusted source. Finally, we recognize the easy availability of cannabis products in our service area that may also contribute to youthful drug experimentation and/or use/abuse. In light of these factors, our patients receive the following as part of their care in our clinic:

1. All youth 11 years of age and older are screened at their preventive exams both for mood problems (using the PHQ-9) and substance abuse (using the CRAFFT). Our PCPs are trained to carry out brief discussions and interventions in both of these areas and can access the members of the behavioral health team for more extensive services to the patient; this can be achieved either by a future appointment with a BHC or, if needed, by a ‘warm hand-off’ that same day. 
2. Our behavioral health team provides services to youth with a dual-diagnosis and/or a primary SUD that addresses their needs in an integrated and coordinated manner while also involving the primary care provider in the treatment plan and facilitating communication with the PCP by use of a shared medical record.
3. By performing early screening for SUD and involving the behavioral health provider in the care of youth at the earliest possible time, we hope to reduce the incidence of more serious abuse and dependence.
4. In cases where SUD may already be more severe, behavioral health providers are able to assist in co-management with PCPs as well as to provide targeted interventions for health behavior change and coordination of care with appropriate resources for higher levels of care as appropriate.
5. For those youth willing and able to be seen by a specialized substance abuse treatment center, we facilitate that outside referral yet continue to be involved in their overall care.
6. While we currently do not provide medication-assisted therapy (MAT) we recognize that by meeting the other treatment needs of youth with SUD we are able to reduce the care burden on agencies that do provide such treatment.