Screening for drinking frequency identifies teens with drinking problem

Investigators used 2000-2007 data from the National Survey on Drug Use and Health to compare the screening value of 3 questions posed to 166,000 teens aged 12 to 18 years about their alcohol consumption for identifying drinking problems.

The 3 questions asked were about frequency of alcohol use (number of drinking days in the past year); quantity of alcohol consumed on each occasion (number of drinks); and frequency of heavy episodic drinking (number of days with ≥5 drinks at a single occasion). The screening performance of these 3 items was tested against 2 outcomes: any symptom of alcohol-use disorder (moderate-risk outcome) and a diagnosis of alcohol dependence (high-risk outcome), as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition.

Frequency had the highest sensitivity and specificity of the questions in identifying both the moderate- and high-risk outcomes, leading investigators to conclude that asking about drinking frequency is an efficient 1-item screen for identifying youth with alcohol-related problems.

Commentary

This article was published nearly simultaneously with a guideline on alcohol screening for youth developed by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in collaboration with the American Academy of Pediatrics (AAP). Citing studies that alcohol use is common in teens, even young teens, this guideline proposes that 2 questions be asked at health encounters with 9- to 18-year- olds: The first, about friends' use of alcohol, is targeted at identifying children likely to begin using alcohol. The second question, as described in this study, is a single query about how often the child used alcohol in the prior year. The answer to this second question is linked to the likelihood of an alcohol-related health problem. If you didn't receive the NIAAA/AAP guideline in the mail, you can order a free copy at http://www.niaaa.nih.gov/youthguide-Michael Burke, MD