Cohen Children’s Medical Center’s New Substance Abuse Initiative


It’s Long Island’s biggest substance problem: the opioid epidemic. To combat this dangerously growing issue, Cohen Children’s Medical Center (CCMC), the stand-alone children’s hospital of Northwell Health, has begun asking patients ages 12 and older about their substance use.

The new initiative is an age-appropriate adaptation of the health system’s existing Screening, Brief Intervention, and Referral to Treatment (SBIRT) program, which promotes the “We Ask Everyone” process. Originally instituted for adult patients presenting to select Northwell Emergency Departments and Primary Care Practices, the protocol is designed to universally screen patients. Evidence-based questions are utilized to determine the patient’s level of risk and if they may benefit from support or treatment for their substance use.

“This is one of many steps we are taking across the Northwell health system to help our communities combat this national health crisis,” said Jay Enden, MD, chair of the health system’s Opioid Management Steering Committee. “It is a vital step to standardized practices that better address substance use and the opioid crisis. It is a service to our communities, patients and employees.”

In 2015, the Center for Disease Control’s (CDC) Youth Risk Behavior Surveillance System (YRBSS), revealed that for New York State high school students (grades 9-12), 7.6 percent reported using cocaine, 4.8 percent used heroin and 3.4 percent injected illegal drugs compared to 5.2, 2.1 and 1.8 percent respectively, for students nationwide.

“We need to rethink the way we approach the topic. It’s important to address this crisis with a team-based approach to better support our patients and their families,” said Sandeep Kapoor, MD, director of Northwell’s SBIRT program. “By normalizing the conversation, building trust with our patients, and valuing the importance of identifying substance use and its clinical relevance, we are taking a step in the right direction.”

At Cohen, social workers and front-line Emergency Department nursing and physician teams have been trained to use the SBIRT screening tool. In addition to screening at its hospitals, Cohen and the Northwell Opioid Management Steering Committee reached out to all school superintendents in Nassau and Suffolk counties during the first week of January with a survey. By reaching out to determine current issues communities and districts are facing regarding substance use, they hope to identify opportunities that may benefit from partnership.

“We are creating structured opportunities to engage and discuss substance use with our patients,” said Jahn Avarello, MD, division chief of Pediatric Emergency Medicine at Cohen. “Adolescence is a critical time due to the exponential risk for abuse and addiction among those who start using substances before the age of 18 compared to those who do not start use until adulthood.”

For more information on the new program, visit

—Submitted by Northwell Health

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