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Screening for sex, drugs and alcohol in the pediatric population

Physicians are our gatekeepers. They are supposed to educate us about acute and chronic diseases to keep us and our loved ones safe. They are supposed to ask us difficult questions about sex, drugs and rock ’n’ roll. Physicians are not there to pass judgment but rather need to know if their patients are using intravenous drugs, drinking too much alcohol or engaging in dangerous sexual activity to schedule the proper screenings and tests to look for specific diseases that are linked to these explicit behaviors.

According to a study, many adult patients leave their doctor’s office without being asked any questions pertaining to their lifestyle behaviors or mental health. If adults are not being adequately asked these questions on a regular basis, it isn’t surprising to find out that children are not being asked about this either.

Keeping kids off drugs

Drug and alcohol abuse not only affects adults, but drastically affects the pediatric populations as well. Although parents and teachers should be aware of the behaviors and characteristics exhibited by their children, physicians should be using screening tools at every office visit. Due to the strict time constraints involved with insurance companies and patient scheduling, many physicians do not have time to screen for these behaviors in their pediatric patient population. Many pediatricians and family physicians will give out a handout regarding this information so the child and parents can read it at home. However, teaching while in the office is the best way to get the message across about the harmful effects of drugs and alcohol.

According to the American Society of Child and Adolescent Psychiatry, “Use and abuse of drugs and alcohol by teens is very common and can have serious consequences. In the 15-24 year age range, 50 percent of deaths (from accidents, homicides and suicides) involve alcohol or drug abuse. Drugs and alcohol also contribute to physical and sexual aggression such as assault or rape. Possible stages of teenage experience with alcohol and drugs include abstinence (non-use), experimentation, regular use (both recreational and compensatory for other problems), abuse, and dependency. Repeated and regular recreational use can lead to other problems like anxiety and depression. Some teenagers regularly use drugs or alcohol to compensate for anxiety, depression, or a lack of positive social skills.”

CRAFFT screening interview

The CRAFFT screening interview is widely used by pediatricians and family physicians across the country. The American Academy of Pediatricians not only states that providers could use this tool but they should be using this tool to screen for unhealthy behaviors in children and adolescents. The CRAFFT acronym is used to screen for behaviors of substance abuse in the context of the following:

  1. Driving a Car
  2. Using to Relax
  3. Using while Alone
  4. Forgetting about things done while under the influence
  5. Receiving feedback from Family or Friends about substance abuse
  6. Getting into Trouble while under the influence

If two or more of these question are answered with “yes,” then a more in-depth evaluation should take place.

Bringing it back home

Realistically, conversations about alcohol and drug use among the young population should always be discussed at every health care visit; however, due to the constraints of our health care system this is not always feasible. Therefore, it is necessary that parents, teachers, coaches and other adult role models step up and talk with kids about these topics.

The Sovereign Health Group is one of the leading treatment centers for addiction and mental health disorders across the United States. Adolescent patients are treated within certain facilities. For information about our events and webinars, call the 24/7 helpline.

Written by Kristen Fuller, M.D., Sovereign Health Group writer

For more information and other inquiries about this article, contact the author at

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