The U.S. Preventive Services Task Force came out with a rather disappointing statement on interventions to help adolescents who have never used drugs to remain abstinent and to help adolescents who are using drugs (but do not meet the criteria for a substance disuse order) to reduce or stop their use. Their bottom line- the evidence is insufficient to assess the balance of benefits and harms of primary care interventions to prevent or reduce illicit drug or nonmedical pharmaceutical use in children and adolescents

Really? Oh come on! Yes as a scientist I get the level of evidence needed to make a recommendation but this suggests it is all futile to try and invest in our youth who are at risk.

Stop right there. What is out there that both health care practitioners and families can use to support our youth? Does the lack of evidence mean family doctors should give up? Hello- no!

So what is out there that we can harness? As even the USPTFS says- individualize decision making happens with the specific patient and there ARE considerations above the evidence of clinical benefits and harms.

In the U.S. more than 4300 adolescents aged 12 to 17 use drugs for the first time each day.

So let's look at what we can do. How about having discussions early on about drug and alcohol use in families. And what about modeling our own alcohol use in front of our children? Social media campaigns and Internet interventions open up a world of possibility in prevention. Just because the evidence has not yet evolved does not mean it cannot be useful. The American Academy of Pediatrics has identified a tool called CRAFFT.

It asks- during the past 12 months did you:

  1. drink alcohol
  2. smoke drugs
  3. use anything else to get high


  • Car-have you ridden in a car driven by yourself or someone who was high
  • Relax do you use drugs or alcohol to relax
  • Alone-do you use alone
  • Forget-do you forget things you did while drinking or drug use
  • Friends-do family or friends tell you to cut back
  • Trouble-have you ever gotten into trouble when using?  

If your child may be at risk, despite the lack of evidence - reach out to your health care practitioner for support and guidance and while the evidence lags behind, until the studies catch up to tell us which strategies work best - be they home based, school based, social media based - we keep the conversation ope.