A 17-year-old boy presents to the psychiatric-mental health nurse practitioner at the request of his mother. He has a chief complaint of anxiety. During the evaluation, he states that he worries about his friends who engage in risky behavior when they drink. He says he “sometimes” drinks on weekends, but his father was an alcoholic so he would never let it get “that far.” Which of the following is an effective screening tool for substance use and high-risk behaviors in children and adolescents?

Choice A reason: The CAGE questionnaire is designed for adults and lacks sensitivity for adolescent substance use patterns. It does not address the social and behavioral context relevant to youth. Choice B reason: The AUDIT is a validated tool for identifying alcohol use disorders but is more appropriate for adults. While it can be adapted for adolescents, CRAFFT is preferred due to its developmental appropriateness. Choice C reason: The CRAFFT screening tool is specifically developed for adolescents and young adults. It assesses both substance use and associated risky behaviors, making it ideal for this scenario. It is brief, easy to administer, and validated for use in pediatric populations. Choice D reason: The CIWA-AR is used to assess alcohol withdrawal severity in individuals already diagnosed with alcohol dependence. It is not a screening tool and is inappropriate for initial assessment in adolescents.