Substance Use Prevention Screening and Intervention in Primary Care: The Prevention 2U Model

Despite decades of prevention campaigns, substance use in the United States remains high and is one of the leading causes of preventable death and injuries. Because of their broad reach, primary care practices are ideal settings in which to screen for and prevent substance use. However, time constraints, limited primary care team training, and a lack of treatment options prevent many primary care providers from implementing universal substance use screening. To fill this gap, we developed the Prevention 2U Model, an integrated substance use prevention model that can be implemented in rural, urban, and suburban primary care settings with adolescents and their parents/caregivers. The model includes several innovations to address gaps in the prevailing systems: (1) It starts young, focusing on youth ages 10–18 and their parents/caregivers, to emphasize prevention and enable earlier treatment; (2) It screens for both general and substance use-specific risk factors, strengthening the model’s ability to predict future substance use and offer tailored interventions; (3) It recognizes the limited time and resources of primary care providers, by incorporating qualified prevention specialists to conduct screenings and provide interventions; (4) It includes clear, practical directions detailing how to implement the model in primary care practices as well as options for modifications so the model can be customized to align with the unique characteristics and policies of each primary care setting. Taken together, these elements give the Prevention 2U Model the potential to prevent substance use by increasing early detection and providing timely and appropriate support and intervention.