Putting Prevention into Practice

An Evidence-Based Approach

Primary Care–Based Interventions to Prevent Illicit Drug Use in Children, Adolescents, and Young Adults

 

Am Fam Physician. 2020 Oct 15;102(8):493-494.

Author disclosure: No relevant financial affiliations.

Case Study

M.P. is a 14-year-old patient who comes to your office for a well-child visit. After taking a history and conducting a physical examination, you conclude that the patient is doing well. M.P. eats a healthy diet at home and is part of a local soccer league. M.P. is an overall good student and just started high school in the fall. When asked, M.P. denies ever trying any illicit substances; however, he does report trying to “get high” off of cough syrup with several of his new high school friends. This occurred once, and M.P. says that he never wants to try it again.

Case Study Questions

1. Based on the U.S. Preventive Services Task Force (USPSTF) recommendation on primary care–based interventions to prevent illicit drug use in children, adolescents, and young adults, which of the following statements should be your next step?

  • A. M.P. should be referred to or enrolled in behavioral counseling to prevent illicit drug use because the USPSTF found convincing evidence of the net benefit of primary care–based interventions in children, adolescents, and young adults.

  • B. M.P. does not meet the criteria for prevention because he has already admitted to using cough syrup recreationally; this should be addressed with intensive follow-up.

  • C. M.P. does not meet the criteria for prevention because the USPSTF recommendations do not apply to teenagers.

  • D. It is uncertain whether providing behavioral counseling interventions will prevent illicit drug use in the future; the USPSTF found insufficient evidence to assess the balance of benefits and harms of primary care interventions for preventing illicit drug use.

  • E. M.P. should not be offered behavioral counseling because the USPSTF has found that the harms outweigh the benefits.

2. Based on the USPSTF recommendation on primary care–based interventions to prevent illicit drug use in children, adolescents, and young adults, which of the following substances are considered illicit drugs?

  • A. Alcoholic beverages.

  • B. Tobacco

Author disclosure: No relevant financial affiliations.

References

show all references

1. Krist AH, Davidson KW, Mangione CM, et al. Primary care–based interventions to prevent illicit drug use in children, adolescents, and young adults: US Preventive Services Task Force recommendation statement. JAMA. 2020;323(20):2060–2066....

2. Curry SJ, Krist AH, Owens DK, et al. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US Preventive Services Task Force recommendation statement. JAMA. 2018;320(18):1899–1909.

3. Davidson KW, Krist AH, Barry MJ, et al. Primary care interventions for prevention and cessation of tobacco use in children and adolescents: US Preventive Services Task Force recommendation statement. JAMA. 2020;323(16):1590–1598.

4. O'Connor E, Thomas R, Senger CA, et al. Interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2020;323(20):2067–2079.

Related U.S. Preventive Services Task Force Recommendation Statement:Primary Care–Based Interventions to Prevent Illicit Drug Use: Recommendation Statement

This PPIP quiz is based on the recommendations of the USPSTF. More information is available in the USPSTF Recommendation Statement and supporting documents on the USPSTF website (https://www.uspreventiveservicestaskforce.org). The practice recommendations in this activity are available at https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/drug-use-illicit-primary-care-interventions-for-children-and-adolescents#fullrecommendationstart.

This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

A collection of Putting Prevention into Practice published in AFP is available at https://www.aafp.org/afp/ppip.

 

 

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