Screening children and teens for alcohol use

By Chelsea Conaboy, Globe Staff

Some pediatricians find it easier to talk with their young patients about the dangers of sugary sodas than to talk about the dangers of alcohol, said Dr. Sharon Levy, chair of the American Academy of Pediatrics Committee on Substance Abuse and director of the Adolescent Substance Abuse Program at Children’s Hospital Boston.

The National Institute on Alcohol Abuse and Alcoholism, in partnership with the academy and others, today released a new tool for doctors to make the conversation about alcohol, which can be a morally sticky one, simpler.

“Routine screening and intervention for alcohol use in young people is critical to preventing the constellation of problems associated with adolescent drinking,” Dr. Howard Koh, assistant secretary for health at the US Department of Health and Human Services, said in the release. The new screening tool offers “an opportunity to engage young patients before it is too late.”

The screening tool outlines two basic questions that get at whether and how much a patient drinks and how much their friends consume as a predictor of future use.

“Although they seem like common-sense questions they are actually empirically derived,” Levy said.

If the patient responds that they don’t drink, that’s an opportunity for the pediatrician to reinforce healthy choices, Levy said.

For those patients who report alcohol use, the guide includes a chart for determining how at risk for adverse consequences they may be, based on age and consumption. It also offers options for follow up, ranging from a discussion about the medical implications of using alcohol, designed to be more motivational than accusatory, to referrals for follow-up treatment.

“It’s not a moral issue,” Levy said. “It’s not shame on you. It’s medical.”

Levy will demonstrate the screening tool Sunday at the American Academy of Pediatrics conference in Boston. The full guide and a pocket version are available on the institute’s website.