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USPSTF 2020 recommends screening for unhealthy drug use in adults by asking questions (B recommendation)
Question clinique
Should primary care clinicians screen for unhealthy drug use adults?
L’Essentiel
In this updated 2020 review, the United States Preventive Services Task Force (USPSTF) found sufficient evidence to recommend screening by asking questions (not by testing biological specimens) for unhealthy drug use, including illegal drugs and the nonmedical use of prescription medications, in adults 18 years or older, including pregnant persons (B recommendation). Screening should occur when services for accurate diagnosis, effective treatment, and appropriate care can be offered or referred. This does not apply to persons with a history of regular or harmful illicit drug use or who have a substance use disorder. The task force found insufficient evidence to assess the balance of benefits and harms of screening for unhealthy drug use in adolescents (I statement). These recommendations replace the 2008 USPSTF recommendations. 2c
Référence
Plan de l'etude: Practice guideline
Financement: Government
Cadre: Population-based
Sommaire
: In this updated review, the task force found several screening instruments with acceptable sensitivity and specificity for unhealthy drug use. Pharmacotherapy and psychosocial interventions are effective for improving unhealthy drug use outcomes, but evidence of benefit comes from clinical trials that enrolled participants because they sought treatment, not because of primary care–based screening. The task force specifically states that screening should only occur when services for accurate diagnosis, effective treatment, and appropriate care are available. Screening should include asking questions, not testing biological specimens. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists recommend screening adolescents through their early 20s for substance use and universal screening of women before pregnancy, early in pregnancy, and postpartum, as indicated.
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