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Questions Remain About Whether Doctors Can Curb Children's Drug Use

The exam might also include questions about alcohol and drugs.
The exam might also include questions about alcohol and drugs.

What can doctors do to help kids stay away from drugs?

There's not much evidence to say one way or the other, it turns out.

The U.S. Preventive Services Task Force, which issues guidelines on what doctors should and shouldn't do, said there aren't enough reliable studies around to come up with any solid advice. So the task force gave the interventions an "I" for insufficient evidence. The kids might call it an incomplete.

We only identified six studies that addressed this question in primary care settings or in ways that were applicable to primary care, says Carrie Patnode, a research associate at Kaiser Permanente Center for Health Research.

Some of the interventions that have been studied include brief counseling sessions during an office visit, sometimes combined with computer-based screening. Other studies looked at computer-based interventions accessed at home.

"Studies on these interventions were limited and the findings on whether interventions significantly improved health outcomes were inconsistent," the task force said in a summary. The review and the task force's conclusions were published in the latest Annals of Internal Medicine.

Patnode, who led the review of the evidence for the USPSTF, tells Shots that clinicians may still want to screen for substance abuse. None of the studies showed any harm in in it. Less than half of pediatricians are doing that now, she says.

The lack of evidence doesn't mean doctors should do nothing. "When there is a lack of evidence, doctors must use their clinical experience and judgment, and many clinicians may choose to talk with an adolescent to prevent or discourage risky behaviors, such as drug use," USPSTF member Susan Curry said in a statement.

But, of course, there's the question of what primary care doctors choose to do during their short visits with children and teens. There are only so many questions a doctor gets to ask.

The American Academy of Pediatrics recommends that pediatricians routinely screen adolescent patients for drug use, including alcohol and tobacco. One tool is a six-question list that asks, among other things, whether the child has ever ridden in car with someone who was on drugs or who had been drinking.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Scott Hensley edits stories about health, biomedical research and pharmaceuticals for NPR's Science desk. During the COVID-19 pandemic, he has led the desk's reporting on the development of vaccines against the coronavirus.