Adolescence is a period of limit testing in which children and young adults are at increased risk of substance abuse. The most frequently used substance by adolescents is alcohol.  Adolescents who drink alcohol have an increased rate of binge drinking compared to adults. Adolescent alcohol abuse is associated with an increased risk of chronic alcohol abuse leading to serious illnesses as adults. Also, alcohol use can be associated with the leading causes of death and serious injury in ages 15 to 24 (unintentional injury, homicide, suicide).

The AAP Committee on Substance Abuse recently released a Clinical Report titled Binge Drinking (http://pediatrics.aappublications.org/content/136/3/e718.full). In the report, binge drinking is defined and characterized, risk factors are discussed, and neurobiology is addressed.  The authors provide screening guidance for pediatricians.   The report explains that at age 9, children start having positive feelings about alcohol and start thinking that alcohol may not be just for adults. This means that ages 9-15 is a critical period for screening and intervention.   The report recommends that pediatricians should screen every patient for alcohol use starting at age 9.

The NIAAA collaborated with the AAP to develop a quick two-question screening tool that varies by the  patient’s age.  The questions focus about asking the patient about their own alcohol usage and their friend’s alcohol usage.

Here is an image summarizing the screening tool:

In addition to screening patients, pediatricians can support the Sober Truth on Preventing (STOP) Underage Drinking Reauthorization Act (H.R. 1717, S. 728).
This bill will reauthorize an act targeted at reducing underage drinking through research, a highly-visible national media campaign, and grants to public health care providers/community organizations/ and partnerships with higher education institutions.
( https://www.congress.gov/bill/114th-congress/house-bill/1717?q={%22search%22%3A[%22sober+truth%22]}&resultIndex=1 )

What YOU can do:

• Educate yourself about alcohol use in adolescents and it’s health effects.
• Screen every patient starting at age 9 for alcohol use; intervene as necessary.
• Talk to your patients and their parents about alcohol-related risks.
• Contact your federal representatives and ask them to co-sponsor and support  the Reauthorization of the STOP Act.

Sources and Resources:
AAP Clinical Report, Binge Drinking. http://pediatrics.aappublications.org/content/136/3/e718.full
http://pubs.niaaa.nih.gov/publications/Practitioner/YouthGuide/YouthGuideOrderForm.htm
http://www.niaaa.nih.gov/alcohol-health/special-populations-co-occurring-disorders/underage-drinking
http://www.stopalcoholabuse.gov/Default.aspx
http://www.samhsa.gov/underage-drinking

https://www.congress.gov/bill/114th-congress/house-bill/1717?q=%22search%22%3A%5B%22sober+truth%22%5D&resultIndex=1)

Paul Teran, MD