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USPSTF 2020: insufficient evidence to recommend counseling to prevent illicit drug use in kids and young adults (I statement)
Question clinique
Should primary care clinicians provide behavioral counseling interventions to children, adolescents, and young adults to prevent use of illicit drugs—including nonmedical use of prescription drugs?
L’Essentiel
In this updated 2020 review, the United States Preventive Services Task Force (USPSTF) found insufficient evidence to assess the balance of benefits and harms of primary care–based behavioral counseling interventions to prevent illicit drug use, including the nonmedical use of prescription medications. This review includes children (younger than 11 years), adolescents (aged 12 to 17 years), and young adults (aged 18 to 25 years), including pregnant persons. (I statement). This does not apply to persons with a history of regular or harmful illicit drug use or who have a substance use disorder. This statement is unchanged from the 2014 USPSTF statement. 2c
Référence
Plan de l'etude: Practice guideline
Financement: Government
Cadre: Population-based
Sommaire
In this updated review, the USPSTF found inconsistent evidence of the benefits of behavioral counseling interventions, including face-to-face or group counseling, print materials, and computer-based tools designed for patient use, to prevent illicit and nonmedical drug use or reduce adverse health, social, or legal outcomes. Nonmedical drug use includes the use of over-the-counter cough suppressants and household products such as glues, solvents, and gasoline. The task force also found inadequate evidence to determine the harms of interventions to prevent or reduce illicit drug use; therefore, the balance of benefits and harms cannot be determined. The American Academy of Pediatrics recommends that all adolescents be screened for alcohol and illicit drug use followed by guidance and brief counseling interventions with referrals for treatment, as needed.
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC
Commentaires
It may not be hopeless
Perhaps a skilled personable physician with a tailored message and an non-judgmental approach might be more successful in getting through to some kids, than this research would appear to anticipate.