Docs Miss Teen Substance Abuse

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Docs Miss Teen Substance Abuse

• November 2, 2004
• http//www.cbsnews.com/stories/2004/11/02/health/w
  ebmd/main652979.shtml

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Diagnosing Substance Abuse

• Pediatricians may be overlooking cases of teen
  substance abuse by relying on their intuition
  rather than on standard screening tools.
• In a new study, researchers found that most of
  the time pediatricians significantly
  underestimate the severity of teen substance
  abuse problems.

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Screening at Primary Care Level

• Very often we depend on primary care physicians
  to screen illnesses.
• Patients may or may not present physical explicit
  symptoms.
• Screening instruments may help with such
  patients.
• Screens have to be predictive, and easy to use.

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June 2004 issue of the Archives of Pediatric
Adolescent Medicine

• Knight and colleagues found, The high prevalence
  of alcohol and drug disorders in the patients we
  studied is of great concern.
• More than half of the teens coming to us for
  routine health care had used alcohol or drugs
  during the past year, and more than one in four
  (26.8) had experienced one or more serious
  problems associated with their use.
• Of greatest concern, almost one in six (16.2)
  had a diagnosis of either substance abuse or
  substance dependence, according to criteria
  established by the American Psychiatric
  Association.

http//web1.tch.harvard.edu/cfapps/CHdeptPagePress
Display.cfm?DeptPress20RoomPageNbr73ParentPag
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The CRAFFT Instrument

• C - Have you ever ridden in a CAR driven by
  someone (including yourself) who was ''high'' or
  had been using alcohol or drugs?
• R - Do you ever use alcohol or drugs to RELAX,
  feel better about yourself, or fit in?
• A - Do you ever use alcohol/drugs while you are
  by yourself, ALONE?
• F - Do you ever FORGET things you did while using
  alcohol or drugs?
• F - Do your family or FRIENDS ever tell you that
  you should cut down on your drinking or drug use?
• T - Have you gotten into TROUBLE while you were
  using alcohol or drugs?

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Interpretation

• Answering yes to two or more questions is
  highly predictive of an alcohol or drug-related
  disorder.
• This brief screening test, takes five minutes to
  administer, and is expected to greatly increase
  the number of providers who screen for substance
  abuse.