Pediatrician Group Calls for Routine Drug and Alcohol Screening for Teens

The American Academy of Pediatrics (AAP) says doctors should routinely screen their teenage patients for drug and alcohol use at every visit, and look for signs of dependence or addiction.

In a new policy statement, the group provides a guide to help doctors ask adolescents about substance abuse issues. Dr. Sharon Levy, co-author of the statement and Director of the Adolescent Substance Abuse Program at Children’s Hospital Boston, told Reuters the guide is needed because doctors don’t feel comfortable talking about drugs and alcohol with their teenage patients.

Whenever doctors see adolescent patients, they should inquire whether the teen is using alcohol or drugs, and if so, under what circumstances, the article notes. They should give advice or encouragement based on the teen’s response, and provide referrals for additional treatment when needed.

The guide recommends doctors should give teenagers who say they are using drugs or alcohol, but not in very risky ways, advice on how to stop. They should also give them information on the negative health effects of substance abuse.

If a teen is using drugs and alcohol in risky situations, such as driving, the doctor should have the teen sign a contract that states he or she will avoid such behavior in the future. If the teen won’t sign the contract, the AAP suggests the doctor consider talking to the teen’s parents.

Earlier this month, the AAP and the National Institute on Alcohol Abuse and Alcoholism unveiled a new tool designed to help pediatricians talk to teenagers about alcohol use. The “Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide” provides doctors with basic questions about whether and how much a patient drinks, and how much their friends drink.

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    November 4, 2011 at 6:26 PM

    Doesn’t seem like a good idea. What would prevent the physician from then talking to the parents breaking a bond of trust between doctor and teen-aged patient? If the Federal CFR confidentiality laws apply here – and they might (especially if the physician provided counseling as indicated), the doctor cannot disclose information to anyone with a confidentialy release or specific court order. Further, why do we always seem to imply that America’s drug problems (and solutions) lie with adolescents. It’s time for some self-honesty about who owns the problem – it’s us adults.

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    November 4, 2011 at 4:58 PM

    I’m sure that many pediatricians would find it very hard to do this. Adolescent medicine is a rather new addition to the specialty, but a doctor might get an honest answer from an adolescent that someone with an enforcement agenda like school or parents wouldn’t. This kind of screening by questionnaire, talking about relative risks, making contracts and following up on them, which with the Pediatrician would be an ongoing relationship, might well be a good model if it could be provided for even most youth. This seems doubtful, though, in view of the state of health care in America.

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