July 30, 2019
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Drug use within 3 days sufficient to identify substance abuse disorder in younger teens

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Questions that assessed frequency of use of alcohol, cannabis and other illicit drugs correctly determined which adolescents had substance use disorders, according to findings recently published in the Journal of the American Board of Family Medicine.

“It remains unknown whether age- or gender- specific screening thresholds are needed, and if so, for which types of substances,” Laura J. Chavez, PhD, MPH, of the College of Public Health, Division of Health Services Management and Policy at Ohio State University, and colleagues wrote.

“In particular, optimal age-specific screening cut-points are not known, and no study has been large enough to evaluate screening questions for noncannabis illicit drug use,” they added.

Researchers pooled survey data from 169,986 respondents between 12 and 20 years of age to the National Survey on Drug Use and Health from a 6-year period, focusing on tobacco use in the past month and cannabis, alcohol and other illicit drug use in the past year.

Chavez and colleagues found that across all age groups, tobacco dependence prevalence was 5.8%, alcohol use disorder was 7.1%, cannabis use disorder was 4.5% and other illicit drug use disorder was 2%.

The optimal cut point for tobacco dependence and other illicit drug use across all age groups was less than 1 day. The optimal cut-point for screening for alcohol and cannabis use was 3 days or less for persons aged 12 to 15 years (n = 79,170) and 12 or more days for participants older than 15 years (n = 80,816).

“These findings suggest that efforts to integrate behavioral health into primary care settings could use the same screens for adults and adolescents. However, optimal screening cut-points varied by age groups for alcohol and cannabis. Self-administered screening using tablets or kiosks, or article questionnaire entered into [electronic health records], could optimize screening by using these age-specific screening thresholds. Alternatively, a single screening threshold for each substance with high sensitivity in all age groups could be used in systems where it is not feasible to use age-specific cut-points,” Chavez and colleagues concluded. – by Janel Miller

Disclosures: The authors report no relevant financial disclosures.