In the United States, excessive drinking is responsible for 88,000 deaths per year and costs the country almost $250 billion annually. More than 4,300 adolescent deaths each year are attributable to excessive drinking. According to Substance Abuse and Mental Health Services Administration (SAMHSA) data, more than 9 percent of 12 to 17-year-olds drink alcohol. When young people drink, they are more likely to binge drink.

Centers for Disease Control and Prevention (CDC) studies state that about 8 percent of teens who drive have driven after drinking alcohol; 20 percent say they have been in a car with someone who had been drinking; and around 20 percent of teenage drivers who have died in car crashes had been drinking.

Pediatrician Aaron E. Carroll, professor of pediatrics at Indiana University School of Medicine, notes that despite the existence of screening tools specific to adolescents, the United States Preventive Services Task Force encourages doctors to do brief screenings with adults for dangerous drinking, but has no similar recommendation for teens. Why not? Because there is little information on how effective this tactic is to stop teenagers from risky drinking.

Carroll notes that alcohol use screening is useful when a condition is prevalent, when screening can be done in a cost-effective manner, when early diagnosis makes a difference, and when it is shown that acting on that screen will make a difference.

Dr. Susan Curry, the immediate past chairwoman of the U.S. Preventive Services Task Force, told Carroll: “There have simply not been enough studies that assess the effects of screening and behavioral counseling in adolescents to address this issue. In addition, many of the existing studies have been conducted in school settings, and it is unclear if the results would translate to primary care.”

Carroll points out that while studies have shown a moderate benefit for adults who participate in behavioral counseling for alcohol use, there is almost no evidence showing the same effect in adolescents. This is because, says Carroll, studies on how interventions and screening may affect teen alcohol use are practically nonexistent.

“We are calling for additional research in all areas related to screening adolescents for alcohol use and providing counseling interventions to those who need them,” Dr. Curry said. “It is also important to explore whether such interventions could reduce other risky behaviors. In the meantime, we encourage primary care clinicians to use their clinical judgment when deciding whether to screen their adolescent patients for alcohol use.”