There’s only so much time in a well adolescent visit, and there are so many topics to discuss. Many of us ask about substance use, but may not have the time to do adequate counseling on the topic. And then there are many adolescents who do not come for routine well adolescent visits.
A group of pediatricians from Missouri decided to begin screening hospitalized adolescents for substance use, with the premise that hospitalization may be an opportune time to both screen and counsel adolescents. They also wanted to ascertain whether there was documentation of substance use in the patient’s history documentation. This report by Dr. Abbey Masonbrink et al, entitled “Self-Reported and Documented Substance Use among Adolescents in the Pediatric Hospital,” is being early released by Pediatrics this week (10.1542/peds.2020-031468).
The authors surveyed 306 hospitalized adolescents aged 14-18 years about ever, weekly, and monthly use of alcohol, marijuana, tobacco, e-cigarettes, other illicit drugs, and non-medical use of prescription medicines.
You may be surprised that nearly 40% of adolescents reported ever using alcohol, and approximately one-third reported using marijuana or e-cigarettes. Older adolescents were more likely to report using any of these substances than younger adolescents.
You will want to read the entire report. If you admit adolescent patients to the hospital, how often are you asking about substance use? While it is particularly important to ask about tobacco or e-cigarette use when your patient is being admitted for a respiratory illness, the hospitalization may also provide an opportunity to allow for counseling by a social worker or another health care professional in a non-rushed manner.