Little evidence that primary care providers stop child and teen drug use, US task force says

BMJ 2014; 348 doi: (Published 13 March 2014) Cite this as: BMJ 2014;348:g2115
  1. Michael McCarthy
  1. 1Seattle

There is little evidence that interventions by primary care providers can prevent or reduce drug use in children and adolescents under age 18, a systematic review by the US Preventive Services Task Force has found.1

It has been estimated that 1 in 10 adolescents uses illicit, prescription, or over-the-counter drugs for non-medical purposes—misuse that leads to 150 000 emergency department visits a year in the United States.

But in a systematic review the task force found only six “fair or good quality” studies that assessed the effects of primary care interventions on reducing drug use in adolescents. These studies looked at four interventions: face to face counseling, videos, print materials, and interactive computer based tools.

“Although the interventions substantially varied in their intensity, components, populations, and sample sizes, they provide almost no evidence of significant improvements in health outcomes,” the task force said.

As a result it concluded that the evidence was insufficient to make a recommendation either for or against behavioral intervention in the primary care setting to prevent or reduce drug use in under 18s.

However, the task force added, “primary care professionals may consider screening adolescent patients to identify those who are experiencing consequences of drug use. Adolescents who have a substance use disorder should receive appropriate treatment.”

The American Academy of Pediatrics currently recommends that all adolescents be screened for drug and alcohol use and that clinicians provide guidance, counseling, and treatment as warranted.2

The task force is funded by the US Agency for Healthcare Research and Quality to evaluate the effectiveness of specific preventive services for patients who have no related signs or symptoms.


Cite this as: BMJ 2014;348:g2115


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