Screening for Underage Drinking
Screening for Underage Drinking
Underage drinking — is a screening really necessary? And what could it tell you?
1 in 3 children starts drinking by the end of 8th grade … and of them, half report having been drunk. NIAAA
This is the opening quote in the National Institute on Alcohol Abuse and Alcoholism’s (NIAAA)’s recently released alcohol screening tool called Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide. While this guide is provided for use by Practitioners (doctors), it sheds light on the problem and can be an informational resource for parents, teachers, administrators — anyone who works with youth. Quoting from the Guide,
Why screen for underage drinking?
It’s common: Alcohol is by far the drug of choice among youth. It’s often the first one tried, and it’s used by the most kids (Johnston et al., 2010). Over the course of adolescence, the proportion of kids who drank in the previous year rises tenfold, from 7 percent of 12-year-olds to nearly 70 percent of 18-year-olds (NIAAA, 2011). Dangerous binge drinking is common and increases with age as well: About 1 in 14 eighth graders, 1 in 6 tenth graders, and 1 in 4 twelfth graders report having five or more drinks in a row in the past 2 weeks (Johnston et al., 2011). Chances are, your practice has its share of youth at risk.
It’s risky: In the short term, adolescent drinking too often results in unintentional injuries and death; suicidality; aggression and victimization; infections and pregnancies from unplanned, unprotected sex; and academic and social problems (Brown et al., 2008). In the long term, drinking in adolescence is associated with increased risk for alcohol dependence later in life (Hingson et al., 2006; Grant & Dawson, 1997). In addition, heavy drinking in adolescence may result in long-lasting functional and structural changes in the brain (Squeglia et al., 2009).
It’s a marker for other unhealthy behaviors: When adolescents screen positive for one risky behavior—whether drinking, smoking tobacco, using illicit drugs, or having unprotected sex—it’s generally a good marker for the others (Biglan et al., 2004). For many kids, drinking alcohol is the first risky behavior tried. So the quick alcohol screen in this Guide can alert you to patients who may need attention for other risky behaviors as well.
It often goes undetected: Most adolescents visit a primary care practitioner every year or two (O’Connor et al., 1999), and many are willing to discuss alcohol use when they are assured of confidentiality (Ford et al., 1997). However, the majority of clinicians do not follow professional guidelines to screen all of their adolescent patients for alcohol use, often citing a lack of confidence in their alcohol management skills as a barrier (Millstein & Marcell, 2003). To offer support in this area, this Guide includes an overview of a promising, teen-friendly approach to promoting positive change in young drinkers (see page 29).
Please download a copy and share it with your child’s pediatrician or family practitioner, and if you know an ER doctor, please pass it along to them, as well>>> Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide.
Lisa Frederiksen
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Hi Lisa,
Great information as usual. This does seem important that doctors along with parents are on the same page for screening for alcohol use. Doctor visits these days are so quick and generic, that often these types of problems are often missed. Thanks for sharing.
I so agree with you, Cathy. I had an opportunity to work with a team of ER doctors at one of our local hospitals and we developed a simple, two-sided brochure – informational-type piece — that was then made available in the waiting room to hopefully be read by family members/friends and also to be given to the young person by the attending ER doctor as part of their treatment. Thanks for taking the time to comment!