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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.

8 Responses to this article

  1. billinsandiego / 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.

  2. Sandra / 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.

  3. Lisa Frederiksen - / November 2, 2011 at 4:35 pm

    An additional approach that I have found works is to incorporate the 21st century brain and addiction-related research. Check out this article, “How Teens Become Alcoholics Before Age 21,”, to better understand this relatively new brain research and why alcohol is harmful to the teen brain in a way it is not harmful to the mature, adult brain.

  4. Avatar of Logical Kyle
    Logical Kyle / November 1, 2011 at 11:28 pm

    Anyone who would be in favor of this must not have a strong relationship with their kids, or simply doesn’t want to have to own up to the responsibility of parenthood to discuss these issues with their kids.

    Be a parent – don’t shrug off your responsibilities on anyone else – the police, a doctor, a teacher, you name it.

  5. Avatar of Donna Wiesenhahn
    Donna Wiesenhahn / November 1, 2011 at 2:45 pm

    Pediatricians doing Routine Screenings: I appreciate the AAP’s stand. I do wonder where these young people will get the necessary intervention. Our state has cut Early Intervention Services so kids who are identified are left out in the cold. That should never be the next step. More is needed at this point rather than less.

  6. Jeff / November 1, 2011 at 2:26 pm

    So we now have doctors as behavioral police? If a teen is using drugs or alcohol then prevention advice is warranted just as with anyone else. However, to “report” the behavior to the parents? Since when is a doctor empowered to discuss any and all medical conditions with a third party even if they are parents? When should a patient have a reasonable expectation of privacy? When you throw in the chilling effect this could have in a patient candidly discussing patient/doctor appropriate issues you have a situation where far fewer teen patients will discuss issues with their doctor. These issues are important and potentially life-threatening for a teen and to make a recommendation that might cause a teen to think twice about seeking advice is bad policy.

  7. martha Ferratusco / November 1, 2011 at 12:42 pm

    i think routine drug testing is a good idea. I think we tend to overlook a lot in teens. My son was a functioning drug addict for many years before we realized what was going on. Maybe if we had been tipped off earlier we could have done something more for him so that he wouldn’t have tried more addictive drugs.

  8. Avatar of Linda
    Linda / November 1, 2011 at 5:41 pm

    I agree!!!

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