Screening for Unhealthy Drug Use in Adults

Purpose of the Protocol

To provide updated recommendations on screening for unhealthy drug use in adults, including adolescents and pregnant women, by focusing on the benefits and harms of screening and interventions.

Target Population

• Adolescents aged > 12 years
• Adults
• Pregnant women

Recommendations

• Adults aged >= 18 years: Primary care clinicians should screen by asking questions about unhealthy drug use (Grade B recommendation).
• Adolescents aged <= 18 years: Evidence is currently insufficient to assess the benefits and harms of screening (I statement).
• Pregnant Women: Evidence is currently insufficient to assess the benefits and harms of screening (I statement).
• Screening should be implemented when services for accurate diagnosis, effective treatment, and appropriate care can be offered or referred.

Importance

Unhealthy drug use includes the use of substances that meet criteria for substance use disorders. Drug use is associated with multiple health, social, and legal problems. Early detection can potentially reduce these problems through appropriate interventions.

Conclusion

The USPSTF concludes with moderate certainty that screening by asking questions about unhealthy drug use in adults has a moderate net benefit. For adolescents, pregnant women, and insufficient evidence exists to determine the balance of benefits and harms of screening for unhealthy drug use. Thus, screening should be accompanied by the availability of diagnostic and treatment services.