Why screen for underage drinking?

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 It’s common: Alcohol is by far the drug of choice among youth. It’s often the first one tried, and it’s used by the most kids (Johnston et al., 2010). Over the course of adolescence, the proportion of kids who drank in the previous year rises tenfold, from 7 percent of 12-year-olds to nearly 70 percent of 18-year-olds (NIAAA, 2011). Dangerous binge drinking is common and increases with age as well: About 1 in 14 eighth graders, 1 in 6 tenth graders, and 1 in 4 twelfth graders report having five or more drinks in a row in the past 2 weeks (Johnston et al., 2011).

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It’s risky: In the short term, adolescent drinking too often results in unintentional injuries and death; suicidality; aggression and victimization; infections and pregnancies from unplanned, unprotected sex; and academic and social problems (Brown et al., 2008). In the long term, drinking in adolescence is associated with increased risk for alcohol dependence later in life (Hingson et al., 2006; Grant & Dawson, 1997). In addition, heavy drinking in adolescence may result in long-lasting functional and structural changes in the brain (Squeglia et al., 2009).

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It’s a marker for other unhealthy behaviors: When adolescents screen positive for one risky behavior—whether drinking, smoking tobacco, using illicit drugs, or having unprotected sex—it’s generally a good marker for the others (Biglan et al., 2004). For many kids, drinking alcohol is the first risky behavior tried.

 It often goes undetected: Most adolescents visit a primary care practitioner every year or two (O’Connor et al., 1999), and many are willing to discuss alcohol use when they are assured of confidentiality (Ford et al., 1997).

 

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