Alcohol Use Disorder: A Pediatric-Onset Condition Needing Early Detection and Intervention.

Abstract

* Abbreviations: AUD — : alcohol use disorder CRAFFT — : car, relax, alone, forget, friends, trouble NIAAA — : National Institute on Alcohol Abuse and Alcoholism Despite the enormous attention currently paid to drug overdose mortality in the United States, it is humbling that in 2016, deaths caused by alcohol were more than double those involving opioids.1,2 Alcohol contributes to up to one-half of all deaths among the 3 leading causes of adolescent and young adult mortality: unintentional injury (the majority of which are motor vehicle crash fatalities), homicide, and suicide.1,3 Heavy alcohol use also contributes to liver disease, cancer, and stroke among numerous other fatal chronic illnesses arising during adulthood.3 Alcohol use disorder (AUD) is a pediatric-onset condition. AUD is defined as recurrent alcohol consumption coupled with physiologic dependence, risky use, loss of control, and/or impaired social functioning.4 Nearly 4 in 5 people in treatment for AUD report that they first began drinking during adolescence.5 It is therefore incumbent on pediatricians and other providers caring for adolescents to detect and intervene in AUD as early as possible in the life course. In this issue of Pediatrics , Linakis et al6 report a large, pediatric emergency department–based study of screening for alcohol use. Using a validated 2-question screen from the National Institute on Alcohol Abuse and Alcoholism (NIAAA),7 the authors follow >1300 adolescents aged 12 to 17 years and determine the extent to which baseline … Address correspondence to Scott E. Hadland, MD, MPH, MS, Department of Pediatrics and Grayken Center for Addiction, Boston Medical Center, Vose Hall 322, 88 E. Newton St, Boston, MA 02118. E-mail: scott.hadland{at}bmc.org