Unclear if Behaviorial Interventions Can Curb Teen Drug Use

Behaviorial interventions to reduce teenage drug use lacks evidence on effectiveness

(RxWiki News) About one out of 10 teenagers uses illegal drugs or pharmaceutical medications for nonmedical purposes. And health professionals aren't sure what the solution to this public health problem is.

The U.S. Preventive Services Task Force (USPSTF) recently concluded that there was not enough evidence to determine what primary care professionals can do to prevent or reduce drug use in children and teenagers under 18 years old.

The Task Force recommended that doctors use their own clinical experience and judgment when talking to a teenager about drug use.

"Discuss the risks of drug use with your teenager."

The lead author of this recommendation was Task Force Chair Virginia A. Moyer, MD, MPH, from the American Board of Pediatrics in Chapel Hill, North Carolina.

This recommendation is an updated version of the 2008 USPSTF recommendation that stated that there was not enough evidence to recommend for or against the screening of illicit drug use in teenagers, adults and pregnant women.

The new updated version narrowed down the subject matter to focus only on drug use among children and teenagers, but shifted the subject matter to behavioral interventions for the prevention and reduction of both illegal and nonmedical pharmaceutical drug use.

The USPSTF maintained that this recommendation only applies to children and teenagers ages 12 to 18 years who have not already been diagnosed with a substance abuse disorder.

There has not been enough evidence on the benefits versus the risks of behavior interventions for teenage drug use reduction or safety. The Task Force was not able to determine whether behavioral interventions reduced drug use-related health outcomes or drug use initiation in teenagers.

Task Force member Susan J. Curry, PhD, explained, "[W]e found that there was not enough evidence to determine what effective measures primary care professionals can take to prevent adolescents from trying drugs, or to reduce drug use among those who are already experimenting. This does not mean that the Task Force is recommending against primary care professionals speaking with their young patients about drug use."

In 2011, teenage drug use sent roughly 150,000 children and teenagers to the emergency room. Drug use among teenagers is associated with many unwanted social, health and economic consequences.

The Task Force found that teenage drug abuse has been a significant contributor of motor vehicle accidents, homicide and suicide — the three leading causes of death among teenagers.

“Keeping kids healthy and safe is so important to our families and communities,” said co-author and Task Force co-vice chair Al Siu, MD, MSPH. "Therefore, the Task Force calls on the research community to continue to search for ways to prevent and reduce illicit drug and nonmedical pharmaceutical use.”

The illegal drugs considered in this recommendation were substances such as marijuana, cocaine, heroin, hallucinogens and inhalants. Tobacco and alcohol were not considered in this recommendation.

Nonmedical pharmaceutical use, which includes prescription and over-the-count medications, involves taking a medication for reasons other than its intended purpose, often by a person to whom the medication was not prescribed or recommended.

For this recommendation, the Task Force considered the use of prescription opioid pain relievers, central nervous system depressants (commonly called tranquilizers) and stimulants. Over-the-counter medications, including dextromethorphan (cough syrup) and cough suppressants, were also considered.

The use of anabolic steroids or athletic performance–enhancing drugs was not considered.

This recommendation was published on March 11 in the Annals of Internal Medicine.

The Agency for Healthcare Research and Quality provided funding.

Review Date: 
March 19, 2014