Vital Signs Testing: Adding Drug Screening to Teens' E.R. Visit

The New York Times

Should teenagers who come to the emergency room with an injury be routinely screened for drug and alcohol use?

A new study argues that they should, reporting that when researchers looked at four years of pediatric trauma cases at one emergency room, they found that about 40 percent of the patients tested positive for drugs or alcohol. The study appears in May's Journal of Pediatric Surgery.

"Adolescents are often characterized by risk-taking behavior," the researchers wrote, "and when alcohol or other substances are involved, the resulting combination can be, and is often, lethal."

The goal of the screening is to look for opportunities to offer effective counseling. The lead author of the study, Dr. Peter F. Ehrlich of the University of Michigan Medical School, said a patient who had just been injured was often more willing to accept help.

As a practical matter, the study said, many hospitals already screen a lot of their patients of all ages for drugs and alcohol to help make treatment decisions. But often, nothing else is done with the information.

At the hospital that the researchers studied, all injured adolescents were supposed to be screened. But in the period examined, fewer than 45 percent were.

The study found that 443 patients had been eligible to be screened, but that only 193 had been. Of these, 29 percent tested positive for opiates, 11 percent for alcohol and 20 percent for marijuana. Because marijuana lingers in the body a month it was considered a sign of risky behavior rather than a direct link to the accidents.

The injuries were not limited to car crashes. Even teenagers in bicycle accidents were more likely to test positive, the study said.

By Eric Nagourney