Learning About Substance Use Screening in Children and Teens

What is substance use screening?

Teens often experiment with lots of things, including alcohol, drugs, and tobacco. The doctor will ask your teen questions to get a better idea of any substances your teen may have tried. This is called screening. The answers help the doctor know if there are signs of a substance use disorder.

If you don't think that your teen has been screened for substance use, you can ask the doctor to do a screening test.

Why is it important?

Finding signs of substance use at an early age is important. That's because early substance use may:

• Increase the risk that your child keeps using substances and has a substance use disorder later on.
• Affect your child's growth and development, memory, and learning.
• Make car crashes more likely.
• Lead to risky behaviors like having sex without a condom. This can lead to unwanted pregnancy and sexually transmitted infections.
• Increase the risk of anxiety, depression, and suicide.
• Make it hard for your child to find their identity, build relationships, and do well in school.

When is this screening done?

Substance use screenings usually start around the time of puberty. But they can be done earlier. Your child may have this screening anytime he or she visits a doctor.

The U.S. Preventive Services Task Force (USPSTF) has not recommended for or against routine screening and counseling to prevent or reduce alcohol use disorder in teens.

The American Academy of Pediatrics recommends that all adolescents should be screened for alcohol, tobacco, and drug use at every visit.

If you don't think that your child or teen has been screened for substance use, you can ask the doctor to do a screening test.

How is it done?

The doctor will ask questions about your child's thoughts toward substance use. The doctor will also ask about what substances your child may have tried, what effect those substances have had, and how often your child has used them.

The doctor will ask your child questions such as:

• Have you used alcohol, marijuana, or vapes (e-cigarettes)?
• Have you used prescription stimulants or pain medicines?
• Have you sniffed, huffed, or inhaled things like glues, spray paint, or whipped cream?

Starting in the preteen years, most doctors spend part of the visit talking to your child alone. This helps your child start to take charge of his or her own health. It also gives your child a chance to talk about things that can be hard to talk about in front of parents.

State laws differ about what your child can and can't choose to keep private. Your doctor can explain what those things are.

The doctor may also ask questions to screen for other conditions like ADHD, depression, and anxiety. These conditions can make a child more likely to use substances. Your child's doctor may want to treat them.

What happens after the screening?

What happens next depends on what the screening shows.

If the screening doesn't show any substance use, the doctor will encourage the healthy choices your child is making. If the screening raises concerns, the doctor may ask more questions. The doctor may also lead a discussion that helps your child weigh the pros and cons of substance use. And the doctor may make a plan to help your child stop using drugs or alcohol.

If the screening shows signs of substance use disorder or a health problem related to substance use, the doctor may discuss treatment options.