The american academy of pediatrics recommends healthcare providers routinely screen all adolescents for alcohol use and related problems. But how can clinicians easily and effectively determine if adolescent patients have a problem with alcohol? a recent population-based study concluded that a brief screen on drinking frequency efficiently identifies youth with alcohol-related problems.
The researchers looked at datafrom more than 166,000 youth ages 12 to 18 who participated in the annual National survey on drug Use and health from 2000 to 2007. researchers considered three factors to measure alcohol consumption: the frequency of alcohol use in the past year, the quantity consumed on each occasion, and the frequency of heavy drinking episodes in the past month. They looked at whether these three measures, based on age and gender, correlated with either of two outcomes: a diagnosis of alcohol dependence (the more severe outcome) or any DSM-iV alcohol use disorder (aUd) symptoms (the less severe outcome). More than either the quantity consumed per episode or the frequency of heavy drinking, the frequency of any drinking had higher sensitivity and specificity in identifying both alcohol dependence and aUd symptoms.
Prevalence of the two outcomes increased with age, researchers said. adolescents having any aUd symptom ranged from 1.4% at age 12 to 29.2% at age 18. The most common symptom was tolerance. Those with alcohol dependence ranged from 0.2% at age 12 to 5.3% at age 18.
Clinicians can use a range of age-specific cut-offs to help determine if patients have an alcohol problem, or alcohol dependence, researchers said. in short, one occasion of drinking in the past year for youths aged 12 to 15 may indicate problem drinking; in 16 to 17 year olds, more than six days of drinking a year (once every other month) may indicate a problem; for 18 year olds, more than 12 days of drinking a year (monthly) may indicate a problem. For alcohol dependence, cut offs were: six or more days of drinking per year among 12 to 15 year olds, 12 or more days of drinking per year among 16 year olds; 24 days of drinking per year among 17 year olds; and 52 days of drinking per year among 18 year olds (chung T et al, Pediatrics 2012;128(1):e180–e192).
CCPR’s Take: Because alcohol is the most widespread and available intoxicant for adolescents, we need to ask about alcohol use in a meaningful manner. This study gives some concrete guidelinesto help clinicians know when kidsare deviating from normal adolescent behavior.
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