Simple screen for alcohol use disorder

Asking teenagers how often they have consumed alcohol in the past year provides a simple screen for those at risk for alcohol use disorder (AUD), a study in 1193 adolescents in rural Pennsylvania showed.

Investigators provided participants, aged 12 to 20 years, with a tablet computer to collect data on past-year alcohol use and alcohol-related symptoms. The survey, which took from 3 to 6 minutes to complete, addressed age of first drink; how often the teenager used alcohol in the past 30 days and past 12 months; how many drinks he or she typically had on each occasion; greatest number of drinks in any 24-hour period; age of first binge; age when first “drunk”; and frequency of binge drinking in the past 30 days.

Next: New antibody eases hemophilia treatment

In analyzing the collected data, investigators found that for teenagers aged 17 years or younger, consuming at least 1 standard drink 3 or more days in the past year identified them as at risk for AUD, according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5). Specifically, among adolescents who met this 3-or-more-day threshold, 44% had AUD whereas those who reported fewer than 3 days of alcohol use rarely met AUD criteria (Clark DB, et al. J Pediatr. 2016;173:214-220).

Commentary: The idea of using a single screening question to look for problem alcohol consumption in children and adolescents is not new, but changes in the American Psychiatric Association diagnostic criteria from DSM-IV to DSM- 5 have made this easier. The DSM-IV defined alcohol abuse and alcohol dependence, a separate more serious disorder. The DSM-5 has combined the conditions into AUD with subcategories for severity. Teenagers aged 17 years or younger who report use of alcohol on 3 or more days in the past year are most likely to meet DSM-5 criteria for AUD. In 18- to 20-year-olds, those who report alcohol use on 12 or more days were most likely to meet the definition. Use this screening question to decide whether or not you need to look further into your patient’s alcohol consumption. -Michael G Burke, MD

 Ms Freedman is a freelance medical editor and writer in New Jersey. Dr Burke, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland. The editors have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.