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Should doctors screen adolescents for risky drinking?

Recently, the U.S. Preventative Services Task Force, an independent panel of national experts that makes evidence-based recommendations about clinical preventive services, recommended that adults and pregnant women be routinely screened for risky alcohol use.

However, although risky drinking is a big problem among adolescents, the task force didn't endorse universal screening of this group by primary care physicians. The reason was a lack of research into what interventions are effective with adolescents.

There is an effective screening tool. The Single Alcohol Screening Question, which asks "How many times in the past year have you had 5 (for men)/4 (for women) or more drinks in a day?"

People answer, "more than once" about 80 percent of the time when they are using alcohol in an unhealthy manner as defined by the National Institute on Alcohol Abuse and Alcoholism. And, 80 percent of non-problem drinkers answer once or less. The screening tool is apparently pretty accurate.

According to a pediatrics professor who wrote an article on the subject for the New York Times, adolescents are willing enough to answer such questions, as long as the doctor has gained their trust and promised confidentiality.

What's missing is evidence-based information about what to do when a teen discloses problematic drinking behavior. Would providing education about alcohol's dangers be effective? Should therapy or treatment be recommended? Should the physician warn the teen about driving drunk?

The stakes are high for underage drinking and DUI

According to research, over 9% of adolescents between the ages of 12 and 17 report drinking alcohol. Nearly 5 percent of this same group report engaging in binge drinking at least once in the past month. Binge drinking can lead to health problems and make teens more vulnerable to all sorts of harm.

Research has also found that 8% of teens who drive admitted having driven after drinking alcohol and another 20% said theyhad ridden in a car with someone who had been drinking.

The statistics about fatal accidents are stark. Of those teen drivers who die in crashes, 20 percent had been drinking. And, excessive drinking by adolescents is responsible for over 4,300 fatalities each year.

Both underage drinking and underage DUI are very serious problems in our society. Unfortunately, there is little research available showing that any particular intervention by doctors would reduce the risk.

Meanwhile, teens can be arrested, charged and convicted of drunk driving, with the many serious, long-term consequences that a DUI conviction includes.

Is your teen drinking or driving drunk? It's time to have a conversation about the serious consequences of alcohol use. If your teen has been arrested for drunk driving, an experienced criminal defense attorney may be able to get the courts to focus on treatment rather than punishment.

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