November 10, 2011
Bruce Goldman, LCSW
All adolescents should be screened for alcohol, tobacco and other drugs every time they visit the doctor, according to a new recommendation in the journal published by the American Academy of Pediatrics.
This is an excellent and timely recommendation. It is no secret that adolescents experiment with alcohol and drugs. In fact 41.2 percent of high school seniors report past month use of alcohol with 22.3 percent reporting binge drinking in the prior month (more than 5 drinks in a row). Marijuana use among high school seniors is now more prevalent than tobacco use (21.4 percent vs. 19.2 percent). Additionally, we cannot read a newspaper or listen to a news report without hearing about the prescription drug abuse and opiate epidemic in our communities. To not ask youths about their exposure and or use of these substances would seem almost negligent.
There is no down side to routine, standardized screenings while there is much to be gained. Most importantly, it opens up communication and conveys the message to teens that it is okay to talk about their experiences with alcohol and drugs. It also clearly identifies the use of substances as a medical issue. Lastly, routine screenings affords us the opportunity to educate and intervene with teens early on and possibly prevent a lifelong struggle with substances.
While there are some tricky issues around confidentiality that need to be carefully considered, this new recommendation for universal substance abuse screenings of adolescents makes a lot of sense. Now we all need to request and expect that our healthcare providers follow through with this policy.