Parenting a teen is without a doubt one of the most stressful things someone with kids will go through in their life. Not only do they dismiss anything and everything their parents say, but they’re also making decisions that will affect the rest of their lives. For many of them, these decisions include whether or not to try alcohol, tobacco, marijuana, and other drugs — obviously, while keeping it quiet from their parents. A new study, however, has updated the way doctors can screen for risk of substance use disorders (SUDs).
Teens’ risks of an SUD are often hard to assess because screening for them can take time; something most doctors or patients don’t have. This leads many teens who don’t get caught up in the criminal justice system — where most teens with SUDs are found — to continue their lives engaging in risky behaviors, which usually stick with them into adulthood. Catching them early, before they become a routine, is important. So researchers at Boston Children’s Hospital created a screening tool based on modifications of other tests.
Their tool relies on one quick question, which was administered to 213 teen participants aged 12 to 17 from a tablet. It asked the teens specifically, how many times in the past year they had used certain substances in a list — this list included alcohol, tobacco, marijuana, illicit drugs (cocaine, ecstasy), inhalants, and synthetic drugs. Depending on these answers, the participants were then asked a series of other modified quick-answer questions based on screening tests from the National Institutes on Drug Abuse; the CIDI-SAM, an interview that helps diagnose SUDs; and RAFFT, a form of the CRAFFT screening tool, which is a mnemonic acronym for questions related to substance use. It asks if the substance use occurs when the person wants to relax, to be alone, and to forget things, as well as whether their family or friends have mentioned their problem, or if they’ve gotten in trouble while on a substance.
The screening tool accurately classified the participants into either no-past year substance use, reported use but did not have an SUD, met criteria for a mild or moderate SUD, and met criteria for a severe SUD. It also identified teens who had an SUD or severe SUD with as much as 90 percent accuracy.
The researchers wrote that “despite recommendations for universal screening as part of routine health care, self-reported screening rates as reported by physicians were very low,” in a study from 2003, which looked at the prevalence and quality of alcohol prevention services among teens in the U.S. “Another study found higher screening rates, but also noted that most physicians do not use validated tools. Time constraints are one of the most frequently cited reasons for forgoing screening.”
Thankfully, teen drug use has decreased for the most part. Alcohol usage remains at historically low levels, while fewer teens are smoking cigarettes and using cocaine, according to the National Institute on Drug Abuse. Synthetic drug use and prescription drug abuse, meanwhile, remain a constant problem, even while their use remains stagnant. Meanwhile, marijuana use is the only drug that is seeing increasing numbers of users, most likely due to states’ efforts to legalize it medicinally and recreationally.
Considering that these drugs have the power to trap people in addiction — especially teens — crafting a screening tool that can catch problem behaviors early is essential for improving their health for the rest of their lives.
Source: Levy S, Weiss R, Sherritt L, et al. An Electronic Screen for Triaging Adolescent Substance Use by Risk Levels. JAMA Pediatrics. 2014.