As a champion of your patients’ health, your care often extends beyond merely diagnosing and treating illnesses; you also play a crucial role in proactively identifying and mitigating health risks.

Your actions can be particularly critical early in your adolescent and young adult patients’ lives, when it can make a significant difference to screen for potential problems related to alcohol and tobacco use, anxiety, and depression.

Early screening can make a significant difference

Research demonstrates that psychological and substance use disorders that develop in adulthood often have onset symptoms during childhood and adolescence. When symptoms are recognized early in life, providers can initiate a pathway to effective interventions, which may more effectively reduce the risk of severe long-term health consequences for your patient.

Alcohol and tobacco use

According to the National Institute on Alcohol Abuse and Alcoholism, the age at which individuals begin drinking or using tobacco is a strong predictor of future substance abuse problems. Early exposure is linked to higher risks of addiction and correlated health complications, including respiratory diseases and mental health disorders.¹

Anxiety and depression

The prevalence of anxiety and depression during adolescence is alarmingly high. The National Institute of Mental Health reports that nearly one in three adolescents will experience an anxiety disorder by the age of 18.² Early screening can facilitate timely management of these disorders, preventing the compounding effects of mental health difficulties throughout adulthood.

Recommendations from leading health organizations

Recognizing the importance of early intervention, leading health organizations like the American Academy of Pediatrics (AAP) and the U.S. Preventive Services Task Force (USPSTF) provide specific recommendations regarding screening ages for various health concerns.

Provider discretion: Understanding your patients’ unique needs

Health organizations provide important guidelines, but you understand your patients’ unique needs, including family history and behavioral patterns. Tailor your approach and determine the timing for screenings based on these factors. By proactively engaging adolescents in discussions about mental health and substance use as early as school age, you can create a supportive environment for young patients.

Resources for providers

There are numerous validated screening tools you can use to assess your patients effectively. The resources below are designed to facilitate discussions about substance use, anxiety, and depression.

• Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide
• Mental Health Tools for Pediatrics 
• Bright Futures Toolkit: Links to Commonly Used Screening Instruments and Tools

You can make a difference

Addressing challenges related to alcohol, tobacco, anxiety, and depression is crucial, and early screenings can help prevent escalation of these issues, while promoting resilience and well-being. By implementing early screening practices, you can play a pivotal role in shaping the future of your young patients.

1   Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality (CBHSQ). 2023 National Survey on Drug Use and Health. Table 2.8B—Alcohol use in lifetime, past year, and past month: among people aged 12 or older; by detailed age category, percentages, 2022 and 2023. Retrieved from https://www.SAMHSA.gov/data/sites/default/files/reports/rpt47100/NSDUHDetailedTabs2023/NSDUHDetailedTabs2023/2023-nsduh-detailed-tables-sect2pe.htm.

2   Kathleen Ries Merikangas, et al. “Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A).” Journal of the American Academy of Child and Adolescent Psychiatry. October 2010. Retrieved from https://Pubmed.ncbi.nlm.nih.gov/20855043/.