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Teens often screen positive for substance use

Monday, November 5, 2007
By Megan Rauscher

NEW YORK (Reuters Health) - In a study of adolescents, slightly more than one in seven tested positive on a substance abuse screening questionnaire administered during a routine visit to their doctor, researchers found.

Substance use by adolescents is "among the foremost public health problems in the United States," the researchers note in a report in the Archives of Pediatrics and Adolescent Medicine released today. By their senior year, roughly 80 percent of adolescents have begun to drink and half have used an illegal drug.

Drug and alcohol use is associated with the top causes of death among U.S. teenagers: unintentional injuries, homicides, and suicides, Dr. John R. Knight of Harvard Medical School and Children's Hospital, Boston, and colleagues also point out.

The researchers administered a substance abuse screening test to 2,133 adolescents between 12 and 18 years old who made a well or sick visit to their doctor. The test consisted of six questions focused on the use of alcohol or other drugs and risky behavior. The questions included: Have you ever ridden in a car driven by someone (including yourself) who was "high" or had been using alcohol or drugs? Do you ever use alcohol or drugs to relax, feel better about yourself, or fit in? Do you ever forget things you did while using alcohol or drugs? Have you ever gotten into trouble while you were using alcohol or drugs?

"While there is considerable variation from office to office, overall 15 percent of 12- to 18-year-old patients screened positive for substance abuse when going to the doctor," Knight told Reuters Health.

Teens who visited their doctor due to an illness were much more likely to screen positive for substance abuse than were those who went in for a check up (23 percent vs 7 percent), the investigators found.

They estimated that 11.3 percent of the adolescents screened had "problematic" substance use, whereas 7 percent were abusing drugs or alcohol, and a little more than 3 percent were dependent on drugs or alcohol.

Overall, about 43 percent reported any use of alcohol or drugs and 24 percent reported impaired driving risk during their lifetimes.

More than half of the teens in the study were female and nearly half were non-Hispanic whites. Most came from middle- and upper-class families, Knight and colleagues note.

"Physicians should screen adolescents presenting for either routine care or sick care, whenever possible," Knight said. "Early identification and intervention of adolescent substance use presents the greatest opportunity for reducing the burden of addictive disorders later in life," he and colleagues emphasize in their report.

SOURCE: Archives of Pediatrics and Adolescent Medicine, November 2007
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