Providing Alcohol-Related Screening and Brief Interventions to Adolescents through Health Care Systems Obstacles and Solutions 英文参考文献.docVIP

PolicyForum ProvidingAlcohol-RelatedScreeningandBrief InterventionstoAdolescentsthroughHealthCare Systems:ObstaclesandSolutions DuncanB.Clark1*,HowardB.Moss2 1WesternPsychiatricInstituteandClinic,UniversityofPittsburghSchoolofMedicine,Pittsburgh,Pennsylvania,UnitedStatesofAmerica,2NationalInstituteonAlcohol AbuseandAlcoholism,NationalInstitutesofHealth,Bethesda,Maryland,UnitedStatesofAmerica Adolescent binge drinking and related disorders are worldwide public health changes that occur during the course of adolescence. For example, the WHO recommendations to health care practi- tionersprovidingSBIRTtoyoungpeople are intendedtoapply topatientsaged 10 through 24 years [8]. Alcohol use and related problems increase dramatically from age 12 to age 20 [11]. In some health care settings, particularly those serving older adolescents, alcohol use disorders (AUD) occur at rates sufficient to justify the AUD focus that is standard foradults[12].Inearlyadolescence(ages 12 to 14 years), however, significant alcohol use is relatively unusual [13]. The identification of young adolescents with alcohol use, including those without an AUD diagnosis, would provide an opportunityforpreventiveactioninhigh- risk patients [13]. In middle adolescence (ages 15 to 17 years), binge drinking emerges, with its potential for acciden- tal death and injury [14]. In late adoles- cence (ages 18 to 20 years), AUD occurs at rates higher than in any adult age group[11]. should be the SBIRT goal. In middle adolescence, screening for binge drinking would provide a focus for prevention activities and would also identify most adolescents with an AUD. Exclusively focusing on AUD is appropriate for patientsinlateadolescence. problems [1]. The European School Survey Project on Alcohol and Other Drugs [2] surveyed 16-year-old adoles- cents in 35 countries. Defined as the consumption of five or more drinks per episode, binge drinking had occurred in 43% of these adolescents in the prior 30 d