Annals of Internal Medicine
Summaries for Patients Primary Care Interventions to Reduce Drug Use in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement
The full report is titled “Primary Care Behavioral Interventions to Reduce Illicit Drug and Nonmedical Pharmaceutical Use in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement.” It is in the 6 May 2014 issue of Annals of Internal Medicine (volume 160, pages 634-639). The author is V.A. Moyer, on behalf of the U.S. Preventive Services Task Force. This article was published online first at www.annals.org on 11 March 2014.
Who developed these recommendations? The U.S. Preventive Services Task Force (USPSTF) developed these recommendations. The USPSTF is a group of health experts that reviews published research and makes recommendations about preventive health care. What is the problem and what is known about it so far? According to a National Survey on Drug Use and Health, each day in the United States more than 4300 children and adolescents aged 12 to 17 years use drugs for the first time. Drug use is associated with many negative social and health consequences. It contributes to the 3 leading causes of death in young people: suicide, homicide, and motor vehicle accidents. Because drug use by children and adolescents is a substantial problem in the United States, interventions that can be administered in primary care settings have been developed to educate young people about this issue and reduce future drug use. These interventions include face-to-face counseling, printed materials, videos, and computer-based tools. However, it is not clear whether these interventions effectively reduce drug use. Although the harms of these interventions are probably small, if these interventions are not effective then clinicians may want to consider whether their time would be better spent addressing other health issues that affect young people. In 2008, the USPSTF concluded that there was not enough evidence to recommend for or against screening for drug use in the general population, which included adolescents, adults, and pregnant women. Screening means looking for drug use in people who have no signs of having a drug problem. In updating this recommendation, the USPSTF shifted the focus to only children and adolescents. Rather than focusing on screening, the current recommendation focuses on primary care–based interventions to prevent and reduce drug use. How did the USPSTF develop these recommendations? The USPSTF reviewed published studies to evaluate the benefits and harms of primary care– based interventions aimed at preventing and reducing drug use by children and adolescents.
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What did the authors find? Interventions in primary care settings aimed at reducing use of illicit drugs and use of pharmaceuticals for nonmedical purposes in children and adolescents include face-to-face counseling, videos, printed materials, and interactive computer-based tools. Unfortunately, studies of these interventions are limited and have not consistently shown improvements in health outcomes, such as reduced drug use. The USPSTF found that existing studies do not permit identification of the balance of benefits and harms associated with such interventions. What does the USPSTF recommend that patients and doctors do? The USPSTF recommends neither for nor against routine interventions in primary care settings aimed at reducing the use of illicit and prescription drugs by children and adolescents. What are the cautions related to these recommendations? These recommendations concern the use of interventions in primary care patients to prevent drug use. They do not apply to screening. Children and adolescents who show signs of a possible drug use problem should receive care to determine whether a problem actually exists and to reduce future use.
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