Drug Screening May Curb Risky Teenage Behavior

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 Medical School.

"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 centers.

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 positive.