School-Based Health Centers Help Prevent & Treat Substance Use
School-based health centers (SBHCs) and wellness centers are ideal places to identify youth using substances and provide evidence-based services that inform them about the health risks associated with alcohol and drug use, motivate them to change their behaviors, and support them in addressing the concerns that may be underlying their substance use.
At the same time, SBHCs/WCs are ideally positioned to address the underlying risks that contribute to substance use and strengthen protective factors by improving school climate and implementing trauma-informed practices.
Youth Substance Use Impacts Long-Term Health Outcomes
School health providers are concerned about youth substance use because it impacts a student’s long-term health outcomes and their academic performance. Substance use is linked to lower grades, student absenteeism, and higher rates for high school dropout.1 Adolescent substance use is also highly predictive of adult substance abuse because the adolescent brain is still developing making it more susceptible to addiction. Nine out of ten people meeting the clinical criteria for a substance use disorder began using one or more addictive substances before the age of 18.2 Schools, school-based health programs, and school support services are ideally positioned to educate, prevent, and intervene early in youth substance use, preventing experimentation from escalating to misuse or addiction.
Nationwide, 14% of high school students have misused an opioid prescription.3 In California, 20% of 9th graders and 29% of 11th graders used alcohol or drugs at least once in the last month.4 Risk factors such as trauma, mental health conditions, and environmental factors can increase a young person’s likelihood of substance use.
Youth Substance Use Policy Advocacy in Action
The California School-Based Health Alliance (CSHA) hosted 115 high school students from across the state at the Madera County Superintendent of Schools auditorium on November 17, 2023, for Advocating for a Brighter Future – a Youth 2 Youth (Y2Y) convening created by youth for youth.
Students gathered to share strategies they have learned about advocating for restorative school and public policies on substance use, particularly in communities across the state that have been harmed by the War on Drugs. Many who attended participate in youth advisory boards and share information about school-based health and wellness center programs and services with the student body at their campus.
Students from Fresno, Stanislaus, San Bernardino, Ventura, Los Angeles, and Contra Costa counties presented to youth participants on the skills they have learned as:
- peer educators on substance use prevention
- advocates for substance use policies not based on punitive measures
- peer counselors to improve student mental health, and
- participatory action researchers focused on school, local, and state policies impacting young people.
School staff attended to learn with other adults about peer-to-peer behavioral health support opportunities across the state, and policies to address substance use and adolescent health and well-being.
Senator Anna Caballero, who represents Fresno and Merced Counties in Sacramento, attended a session on Using Youth Participatory Action Research to Inform Substance Use Policy where young people spotlighted the importance of youth leadership and participation in creating effective public policies to reduce substance use. Senator Caballero thanked the students for being advocates for their communities.
The event was co-organized by CSHA’s Youth Board and staff and included entertainment by DJ JJ Mendez; a networking session where attendees learned about each other; fun interactive group and individual “brain break” activities; and quizzes and games with raffle prizes.
Spoken word poet and community organizer Alexandria Benn also addressed students and shared her poems about resilience and healing.
The next Y2Y will be in Southern California in the fall of 2024. CSHA is grateful to Elevate Youth California and the California Department of Education’s Tobacco Use Prevention and Education Program (TUPE) for their support of this event and our programs supporting youth advocating for restorative substance use policies around the state.
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach to the screening and identification of individuals engaged in substance use, the delivery of early brief interventions in order to reduce use, and the referral to treatment for high-risk use. These quick guides give a brief overview of each “step” and implementation considerations for SBIRT within school-based health centers (SBHCs).
- Screening Quick Guide
- Brief Intervention Quick Guide
- Referral to Treatment Quick Guide
- Opioid Use Disorder Quick Guide
- Substance Use Identification & Treatment Guide for Native Youth
Frequently Asked Questions about Minor Consent for Substance Use Disorder Services in California has information on Family Code 6929.
CSHA’s School Discipline & Student Substance Use: A Guide for School-Based Health Providers
Many schools’ “zero tolerance” policies conflict with a public health approach to youth substance use that recognizes and addresses the underlying factors that contribute to substance use. This report highlights how – and why – schools should replace punitive discipline practices with recovery-focused approaches to student substance use. It also provides an overview of what is in California state law regarding discipline approaches to student substance use.
Alternatives to Suspension: Student Tobacco & Substance Use
This resource synthesizes some of the main points in the above report, with a specific lens to student tobacco use. It provides some helpful guidance, informed by best practices in the field, on how to create non-punitive discipline policies and important aspects to consider when implementing.
(1) D’Amico, E.J., et al. (2016). Alcohol and Marijuana Use Trajectories in a Diverse Longitudinal Sample of Adolescents: Examining Use Patterns from Age 11 to 17. Addiction, 111(10), 1825–1835; Engberg J., Morral A.R. (2006). Reducing substance use improves adolescents’ school attendance. Addiction, 101(12), 1741-1751.
(2) The National Center on Addiction and Substance Abuse (CASA) at Columbia University. (2011). Adolescent Substance Use: America’s #1 Public Health Problem. New York: CASA.
(3) Kann L., McManus T., Harris W. A., et al. (2018). Youth Risk Behavior Surveillance — United States, 2017. MMWR Surveill Summ 2018, 67(SS-8), 1–114. Retrieved from: http://dx.doi.org/10.15585/mmwr.ss6708a1.
(4) California Healthy Kids Survey. (2017). Alcohol/drug use in past month, by grade level [data file]. Retrieved from www.kidsdata.org.