Screening for Young Adults for Illicit Drug Use: A Good Idea Although Evidence Is Lacking.

Abstract

* Abbreviations: AAP — : American Academy of Pediatrics USPSTF — : US Preventive Services Task Force In the latest review, the US Preventive Services Task Force (USPSTF) concluded that the evidence is “insufficient to assess the balance and benefits and harms of screening for illicit drug use in adolescents” and of “primary care-based behavioral counseling interventions to prevent or reduce illicit drug use” in adolescents and young adults (defined as ages 12–17 and 18–25, respectively).1–3 In these statements, illicit drugs are substances that are illegal drugs or medications used non-medically but do not include alcohol or nicotine. These recommendations were based on 2 new evidence reviews.2,3 The USPSTF had previously concluded the evidence was insufficient for screening and brief intervention for unhealthy alcohol use among adolescents.4,5 These statements notwithstanding, the American Academy of Pediatrics (AAP) 2016 policy statement on substance use screening and brief intervention recommends that pediatricians “increase their capacity in substance use detection, assessment, and intervention; and become familiar with adolescent” screening, intervention, and referral practices and “their potential to be incorporated into universal screening and comprehensive care.”6 The AAP also advocates for brief intervention research and for insurers to pay for screening and brief intervention. More importantly, the AAP, in its recommendations for preventive pediatric health care, recommends “tobacco, alcohol or other drug use assessment…with appropriate action to follow, if positive” for adolescents.6 Herein we report how the USPSTF has summarized the … Address correspondence to Richard Saitz, MD, MPH, Department of Community Health Sciences, School of Public Health, Boston University, 801 Massachusetts Ave, Crosstown 4th Floor, Boston, MA 02118. E-mail: rsaitz{at}bu.edu