USPSTF Recommends Screening Adults for Illicit Drug Use

The U.S. Preventive Services Task Force (USPSTF) recommends screening for illicit drug use in adults, but the evidence is inadequate to ascertain the balance of benefits and harms of screening in adolescents. These findings form the basis of a draft recommendation statement published online Aug. 13 by the USPSTF.

Researchers from the USPSTF reviewed the evidence for primary care screening for illicit drug use in adults. The researchers found that when services for accurate diagnosis of unhealthy drug use or drug use disorders, effective treatment, and appropriate care can be offered or referred, screening has moderate net benefits. Adequate evidence suggested that available screening tools can detect illicit drug use. Three opioid pharmacotherapy agents (naltrexone, buprenorphine, and methadone) show moderate benefit for reducing relapse and increasing treatment retention. In addition, psychosocial interventions provide moderate benefits.

Among adolescents, the researchers found that the benefits and harms of screening are uncertain. Evidence for the accuracy of screening tools for detecting use of illicit drugs was inadequate. Furthermore, the evidence was inadequate for the efficacy of opioid pharmacotherapy in reducing relapse or increasing retention in treatment or for the benefits of psychosocial interventions. Based on these findings, the USPSTF recommends screening for illicit drug use in adults (B recommendation) but concludes that the current evidence is insufficient to weigh the balance of benefits and harms of screening in adolescents (I statement). The draft recommendation is available for public comment from Aug. 13 to Sept. 9, 2019.

"Clinicians should continue to use their professional judgement to determine what's best for their teen patients," USPSTF member Carol Mangione, M.D., M.S.P.H., said in a statement.

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