Drug Screening May Curb Risky Teenage Behavior
University of Michigan Health System
According to a study
released by U-M Health System researchers, one way to
help curb risky teenage behavior
drunk driving is to do substance abuse screening for all
hospitalized patients ages 14-17, and offer brief
alcohol and substance abuse intervention programs to
those who test positive.
For immediate release
abuse screening may help teenage trauma patients curb
Newswise — U-M study
finds value in routine screening for teen trauma
patients with 11.2 percent tested positive for alcohol,
29 percent for opiates, and 20 percent for cannabis
ANN ARBOR, Mich. –
Teenagers are known for testing their limits – coming
home after curfew, swearing and skipping school. But
some teens will go even further and engage in
risk-taking behavior like reckless driving that, when
combined with alcohol or drugs, can result in serious
injury or even death.
Researchers at the
University of Michigan Health System believe one way to
help curb such risky behavior is to do drug screening
for all hospitalized pediatric trauma patients, and
offer brief alcohol and substance abuse intervention
programs to those who test positive.
Their study revealed that
nearly 40 percent of the pediatric trauma patients ages
14 to 17 screened for substance abuse tested positive.
Of those patients, 29 percent of positive tests were for
opiates like opium or heroin, 11.2 percent for alcohol,
and 20 percent for cannabis, or marijuana.
These findings, published
in the May issue of the Journal of Pediatric Surgery,
support the value of routine substance abuse screening
for all injured teenage hospital patients regardless of
age, gender or type of injury, says study lead author
Peter F. Ehrlich, M.D., MHS, clinical associate
professor, Department of Pediatric Surgery at the U-M
“The two major
preventable health issues facing adolescents are
injuries that result in death or disability, and
lifestyle choices that have long-term, adverse health
consequences,” says Ehrlich. “To help alter this
risk-taking behavior, it is essential that drug testing
and brief substance abuse intervention programs be
included in the treatment of all injured adolescents.”
As a Level 1 pediatric
trauma center, routine drug screening for all injured
patients ages 14 to 17 is part of the U-M Health
System’s trauma protocol. Indeed, according to the
National Institute on Alcohol Abuse and Alcoholism,
trauma centers are an ideal site for alcohol screening
and brief intervention programs. Previous studies have
proven, too, the cost-effectiveness for such programs,
with health care savings of $3.81 for every $1 spent for
screening and intervention.
However, a recent survey
of adult trauma surgeons found that fewer than 20
percent screened their patients for alcohol or drug
problems – and even fewer screening and intervention
projects have been conducted at pediatric trauma
But to develop effective
screening and intervention programs for adolescents,
medical experts first must gain a better understanding
of their target population, says Ehrlich.
By studying 443 patients
ages 14 to 17 who were admitted to the hospital for
treatment of a severe injury, Ehrlich and his colleagues
worked to determine the frequency of pediatric substance
abuse screening, as well as define the injury
characteristics of those patients who tested positive
for substance abuse.
The patients, who were
admitted to the hospital between 1999 and 2003, were
placed into three categories: eligible to be screened,
but not tested; eligible to be screened and tested
negative; and eligible to be screened and tested
In all, only 40 percent
of eligible adolescents were tested. While there were
more 17 year olds with positive drug tests than 14 year
olds, researchers found fewer 14 year olds were actually
tested than older teens.
The rate of cannabis use
among females was significantly higher, but there were
no significant differences between the sexes for opiate
or alcohol use. Among all three groups, researchers
found no differences with respect to gender, length of
stay in the hospital or type of injury. However, teens
involved with bicycle crashes were more likely to test
positive for drugs.
Of the patients who were
screened and tested positive, most were referred to
counseling after being discharged from the hospital.
“To really make an impact
on the care of these adolescents, drug screening cannot
be performed selectively and irregularly,” says Ehrlich.
“Those who drink under the age of 19 are significantly
more likely to report driving after drinking or getting
into car with someone who’s been drinking – and their
odds of them being injured are two to three times
greater than adults of legal drinking age. So we need to
take the opportunity when adolescent patients are in our
care, to intervene and help prevent risk-taking behavior
that may lead to future injury or even death.”
Along with Ehrlich,
co-authors from the UMHS Department of Pediatric Surgery
were Joanna K. Brown, M.D., house officer, and Robert
Drongowski, senior research associate.
Reference: Journal of
Pediatric Surgery, May 2006, Vol. 41, Issue 5.