No Verdict on Behavioral Strategies to Prevent Kids' Drug Use

Megan Brooks

October 02, 2013

There is insufficient evidence to make a definitive recommendation for or against behavioral interventions in the primary care setting to prevent or reduce illicit drug use in children and adolescents younger than 18 years, according to the US Preventive Services Task Force.

"The Task Force clearly recognizes the significance of preventing illicit drug use or misuse of medicines among children and teens," Susan J. Curry, PhD, Task Force member and dean of the College of Public Health, University of Iowa, in Iowa City, said in a statement.

"However, we found that there was not enough evidence to determine effective measures primary care professionals can take to prevent children and teens who have never used drugs from trying them and reduce use among teens who are already experimenting," she added.

Dr. Curry emphasized that the Task Force recommendation does not apply to children and adolescents already using illicit drugs.

On Tuesday, the Task Force posted its draft recommendation statement and draft evidence report on primary care behavioral interventions to reduce illicit drug and nonmedical pharmaceutical use in children and adolescents. The public is invited to comment on the draft recommendation statement and evidence report until October 28.

"This is an update to a Task Force recommendation from 2008," Dr. Curry told Medscape Medical News.

"One of the commitments the Task Force has is to reexamine after 5 years recommendations and in particular recommendations where we did not have sufficient evidence to recommend for or against this particular preventive service and see what we've learned since that time," she said.

Prevention Studies a 'Challenge'

It is estimated that more than 1 in 10 teenagers aged 12 to 18 years in the United States use illegal drugs or misuse prescription or over-the-counter medicines, with serious health, educational, and social consequences. Every year, more than 150,000 teens are seen in hospital emergency departments as a result of illicit drug and nonmedical pharmaceutical use.

"This is obviously a very important issue; it's been deemed high priority for the Preventive Services Task Force to look at, and we wanted to see if we had any new evidence that might help us come to a recommendation," Dr. Curry said.

"Unfortunately, we are still confronted with insufficient evidence," she said, so there is no change from 2008 in the updated recommendation, which also was an "I" or "insufficient evidence" statement.

"We did find a small number of new studies, but there wasn't sufficient information in those studies to allow us to make a recommendation other than to issue another insufficient evidence recommendation," Dr. Curry said.

The Task Force "can't endorse a treatment approach because the studies aren't there," Sherry Pagoto, PhD, from the Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School in Worcester, told Medscape Medical News.

"There is certainly a need for more research in this area," said Dr. Pagoto, who is not a Task Force member but who reviewed the report for Medscape Medical News.

Why aren't more studies being done on the prevention of illicit drug use? "I think it's a challenge when you are trying to do prevention studies in populations that are doing fine to start with and see if there is something you can do in primary care to prevent them from starting illicit drug use," Dr. Curry said.

"Probably in 3 to 4 years, the Task Force will start to look at this topic again and see if there are new studies in progress or published," she said.

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