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The American Academy of Pediatrics (AAP) recently released guidelines aimed at helping pediatricians screen adolescents for substance abuse. Sharon J. L. Levy, MD, MPH, director of Children's Hospital Boston's Adolescent Substance Abuse Program, discusses the recommendations for screening and brief intervention.
What are the unique risks of substance abuse among adolescents?
Substance abuse, including abuse of alcohol and illicit drugs and misuse of prescription drugs, poses especially significant risks to adolescents because their brains are still developing. Adolescents are also at a higher risk of the acute consequences of substance abuse, such as driving under the influence and of developing chronic substance abuse disorders.
How should children and adolescents be screened for substance abuse?
Screening and brief intervention for substance abuse should be performed regularly for all adolescent patients. The AAP's policy statement provides physicians with validated screening tools and advice on conducting risk-based brief interventions. Use of a validated screening tool, such as the CRAFFT screen, is recommended to achieve accurate risk assessment. Adolescents who screen positive should be given brief medical advice to stop or referred for further evaluation. Positive reinforcement is also important for adolescents who screen negative.
What advice should pediatricians offer following screening?
Adolescents who screen positive for high-risk drug or alcohol use should be counseled to reduce use and offered immediate treatment referral. Patients who screen positive for lower-risk use should be given medical advice to stop and referred for further evaluation when appropriate. Positive reinforcement is also important for adolescents who screen negative. In all cases, pediatricians should express concern for a patient's safety and well-being, focusing primarily on health-related advice.
When should a child be referred?
If a patient screens positive for drug abuse, additional evaluation may be needed. In any case where you are concerned, patients can be referred to Children's Adolescent Substance Abuse Program. Our pediatric experts are experienced in addressing a wide range of substance abuse disorders in pediatric populations.
More information:
childrenshospital.org/asap See Clinical Trials
Make a referral: 617-355-2727
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