Policy Statement Encourages More Doctors to Screen for Alcohol Abuse

MADISON - New evidence on the impact of alcohol on the developing brain is adding urgency to a recommendation that doctors screen all adolescents for alcohol use.


Dr. Patricia Kokotailo, director of adolescent medicine and associate dean for faculty development and faculty affairs at the University of Wisconsin School of Medicine and Public Health, is the lead author of a new policy statement released this month by the Committee on Substance Abuse for the American Academy of Pediatrics.


The document recommends screening all children as young as middle-schoolers on their use of alcohol to ward off potentially long-lasting negatives such as memory loss, increased dependence on alcohol, poor academic and job performance, depression, and criminal and violent behavior.


"A remarkable amount of brain development is still occurring for young people through their twenties," Kokotailo says. "The parts of the maturing brain most impacted by drinking are essential for developing organizational skills, emotional regulation, abstract thinking, and impulse control."


The policy statement also cites research that concludes the younger people are when they start drinking, the more likely they are to have significant problems in their lifetimes, including abuse and addiction. The document suggests physicians use a series of six questions, known as the CRAFFT instrument, to screen for alcohol-use issues in youth.


"This policy statement provides better evidence about how alcohol affects the brains of young people and why it is important to screen children," says Kokotailo.


Physicians and other health care providers are also prompted to do the following:

  • Obtain a complete family medical and social history during prenatal and health supervision visits to explore genetic and family influences regarding alcohol and other substance abuse.
  • Assess patients whose screening results are positive for alcohol use to determine the appropriate level of intervention.
  • Become familiar with motivational- interviewing techniques to work with patients who use alcohol but do not meet criteria for immediate referral.
  • Discuss the hazards of alcohol and other substance abuse with patients and parents, especially before school events such as proms and graduations.
  • Support the legal drinking age of 21 and enforcement of programs that decrease minors' access to alcohol.