By Amy Orciari Herman
Physician First Watch
Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM
The U.S. Preventive Services Task Force is recommending for the first time that primary care clinicians screen adults, including pregnant and postpartum women, for unhealthy drug use. The grade B recommendation, published in JAMA, updates the group’s 2008 “I” statement on the topic.
Clinicians should ask at least one question about unhealthy drug use, defined as use of illegally obtained substances or nonmedical use of prescription drugs. The task force specifies that such screening should occur “when services for accurate diagnosis, effective treatment, and appropriate care can be offered or referred.” Data are limited on the optimal screening interval.
In terms of screening adolescents aged 12 to 17 years, the task force says the evidence is insufficient to weigh the benefits and harms of doing so (I statement).
In an accompanying editorial, Dr. Richard Saitz — an addiction medicine specialist and associate editor with Physician’s First Watch — advises several cautions for clinicians who implement screening. Among them: “Given that any evidence for efficacy is limited to individuals seeking treatment, screening becomes less relevant, and clinicians should focus on treatments for those seeking help.”