All adolescents should be screened for alcohol use, US pediatricians say

Alcohol misuse is so common among the young and so hazardous to their wellbeing that pediatricians should routinely screen every adolescent for alcohol use, the American Academy of Pediatrics has recommended in a new report on binge drinking.1

The report was prepared by the academy’s Committee on Substance Abuse and was published online on 31 August in the journal Pediatrics. Lorena Siqueira, director of the Division of Adolescent Medicine at Nicklaus Children’s Hospital in Miami, Florida, was the report’s lead author.

Binge drinking—defined as having five or more drinks on the same occasion on at least one day in the previous 30 days—is common among the young, the report said, with about 14% of youths aged 12 to 20 and as many as 28-60% of high school students reporting to have engaged in binge drinking.

Binge drinking can lead to immediate consequences, such as blackouts, hangovers, and acute alcohol poisoning, the report warned, but also contributes to accidents, suicide, and homicide, all leading causes of death among adolescents. In addition, binge drinking by adolescents may be responsible for long term health problems, including brain damage and cognitive impairment, and increases the risk of liver disease, cardiovascular disease, and cancer in adulthood, the report said.

“Surveys indicate that children start to think positively about alcohol between the ages of 9 and 13 years . . . Therefore, it is very important to start talking to children about the dangers of drinking as early as 9 years of age,” the report said. It recommended that pediatricians use structured instruments developed for screening for substance misuse or, if time is limited, instruments that focus on alcohol use only. “Just using one’s clinical impression can underestimate substance use,” the report said. Talking to parents about the dangers of alcohol misuse is also important, the report noted, as surveys indicate that 80% of teenagers said their parents were the biggest influence on their decision whether to drink.