Many Doctors Don’t Ask Teens About Alcohol

In a new study, more than one-third of 10th graders reported recent alcohol use. But many didn’t recall their doctors asking them about drinking or counseling them about related harms. The finding reveals important missed opportunities to prevent underage alcohol use.

Unhealthy alcohol use is the third-leading preventable cause of death nationwide. Alcohol is the most widely used substance of abuse among youth, and dangerous binge drinking is common among underage drinkers.

Research has shown that asking adult patients about alcohol use and advising them to cut back on risky drinking can have lasting effects. This type of screening and brief counseling by health care providers is linked to reduced drinking. Growing evidence suggests that adolescents might also benefit from alcohol screening and counseling.

In 2011, a team led by Dr. Ralph W. Hingson of NIH’s National Institute on Alcohol Abuse and Alcoholism (NIAAA) surveyed more than 4,000 adults (ages 18 to 39) and found that doctors often failed to ask about their alcohol use. Young adults (ages 18 to 25) were most likely to report excessive drinking, but only about one-third of them were asked about drinking by their doctors.

To take a similar look at an even younger age group, Hingson and colleagues at NIAAA and NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) studied a nationally representative sample of more than 2,500 students in 10th grade. The students were 16 years old on average. They were asked about their alcohol use and whether their doctor discussed drinking at their last medical exam.

In the February 2013 issue of Pediatrics, the researchers reported that 34% of the students said that they had used alcohol in the past month. In addition, 23% reported drunkenness and 26% said they had binged. Binge drinking is defined as 5 or more drinks per occasion for males and 4 or more for females.

Of the 82% who had seen a doctor in the past year, 54% said they were asked about drinking and 40% said they were advised about related harms. Those who had been asked about their drinking were also more likely to be advised about alcohol use, the researchers found. Of the students who reported past-month problem drinking (frequent alcohol use, binging or drunkenness), about 25% were advised to reduce or stop drinking.

One limitation of the study, the researchers note, is that the data depend on the conversations students remember having with their physicians. Still, the results strongly suggest that physicians may be missing opportunities to discuss alcohol use and abuse with this at-risk age group.

“Alcohol is by far the drug of choice among youth," says NIAAA Acting Director Dr. Kenneth R. Warren. “The findings reported by Dr. Hingson and his colleagues indicate that we must redouble our efforts to help clinicians make alcohol screening a routine part of patient care for young people in the United States.”