NIH study finds missed opportunities for underage alcohol screening

Physicians often fail to ask high school-aged patients about alcohol use and to advise young people to reduce or stop drinking, according to a study led by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health.
In a random survey of more than 2,500 10th grade students with an average age of 16 years, researchers from NIAAA and the Eunice Kennedy Shriver National Institute of Child Health and Human Development found that 34 percent reported drinking alcohol in the past month. Twenty-six percent said they had binged, defined as five or more drinks per occasion for males, and four or more for females.
“While more than 80 percent of 10th graders said they had seen a doctor in the past year, just 54 percent of that group were asked about drinking, and 40 percent were advised about alcohol harms,” says lead author Ralph W. Hingson, Sc.D., M.P.H., director of NIAAA’s division of epidemiology and prevention research. He adds that, among students who had been seen by a doctor in the past year and who reported drinking in the past month, only 23 percent said they were advised to reduce or stop drinking. The findings are now online in the February issue of Pediatrics.
The researchers also reported that students who said that they had been asked about their drinking were more likely to be advised about alcohol. Nevertheless, among the 43 students who said that they were drunk six times or more in the past month and who said they had been asked about their drinking by a doctor, about 30 percent were not advised about drinking risks, and two-thirds were not advised to reduce or stop drinking.
The researchers caution that in the survey students were asked about past-month drinking, not what they may have told their physicians about their drinking.
Studies have shown that screening and brief interventions by health care providers — asking patients about alcohol use and advising them to reduce risky drinking mdash can promote significant, lasting reductions in drinking levels and alcohol-related problems among adults. Accumulating evidence supports the use of alcohol screening among adolescents.
In 2011, NIAAA and the American Academy of Pediatrics released a two-question screening tool designed to help clinicians overcome time constraints and other common barriers to youth alcohol screening. Examples of these questions, which vary slightly for elementary, middle, and high school ages, include:
"Do you have any friends who drank beer, wine, or any drink containing alcohol in the past year?"
"How about you — in the past year, on how many days have you had more than a few sips of beer, wine, or any drink containing alcohol?"
“Alcohol is by far the drug of choice among youth," says NIAAA acting director Kenneth R. Warren, Ph.D. “The findings reported by Dr. Hingson and his colleagues indicate that we must redouble our efforts to help clinicians make alcohol screening a routine part of patient care for young people in the United States.”
The National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health, is the primary U.S. agency for conducting and supporting research on the causes, consequences, prevention, and treatment of alcohol abuse, alcoholism, and alcohol problems. NIAAA also disseminates research findings to general, professional, and academic audiences. Additional alcohol research information and publications are available at http://www.niaaa.nih.gov.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

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Reference:
Physician Advice to Adolescents About Drinking and Other Health Behaviors Ralph W. Hingson, et al. Pediatrics (online January 28, 2013) Alcohol Screening and Brief Intervention for Youth: A Practitioner's Guide, and its accompanying pocket-sized version, can be downloaded or ordered from the NIAAA website at: http://www.niaaa.nih.gov/publications/clinical-guides-and-manuals/alcohol-screening-and-brief-intervention-youth