Screening shows 1 in 7 teens might have substance abuse problem

About 1 in 7 teenagers in Massachusetts and Vermont might have a substance abuse problem, according to screening questionnaires filled out during routine doctors’ visits, a study has found. The adolescents' answers were more likely to indicate a problem during an appointment when they were sick or injured than when they were having a checkup.

“Substance abuse screening should occur whenever the opportunity arises, not at well-child care visits only,” wrote Dr. John R. Knight of Children’s Hospital Boston, lead author of the study in this month’s Archives of Pediatrics & Adolescent Medicine.

Researchers from Children’s, Tufts-New England Medical Center, Cambridge Health Alliance, the University of Vermont and Fallon Clinic in Worcester asked more than 2,000 12- to 18-year-old patients to answer six questions: five about using alcohol or other drugs and one about engaging in risky behaviors, such as riding in a car with someone who was impaired. Two 'yes' answers meant the teen screened positive for substance abuse.

Overall, 14.8 percent of patients said yes to at least two of the six questions. The most positive responses to the questions came in school-based health centers, at just under 30 percent of patients, followed by rural family practices, at about 25 percent. At sick visits, 23.2 percent of the screenings were positive, compared with 11.4 percent of well visits.

Positive screenings do not establish a diagnosis, the authors write, but they do require follow-up. Noting that sick visits are generally allotted less time than well visits, they suggest healthcare providers be trained in how to help patients who test positive by either offering brief advice or referring them for counseling or treatment.