The American Academy of Pediatrics (AAP) says doctors should routinely screen their teenage patients for drug and alcohol use at every visit, and look for signs of dependence or addiction.

In a new policy statement, the group provides a guide to help doctors ask adolescents about substance abuse issues. Dr. Sharon Levy, co-author of the statement and Director of the Adolescent Substance Abuse Program at Children’s Hospital Boston, told Reuters the guide is needed because doctors don’t feel comfortable talking about drugs and alcohol with their teenage patients.

Whenever doctors see adolescent patients, they should inquire whether the teen is using alcohol or drugs, and if so, under what circumstances, the article notes. They should give advice or encouragement based on the teen’s response, and provide referrals for additional treatment when needed.

The guide recommends doctors should give teenagers who say they are using drugs or alcohol, but not in very risky ways, advice on how to stop. They should also give them information on the negative health effects of substance abuse.

If a teen is using drugs and alcohol in risky situations, such as driving, the doctor should have the teen sign a contract that states he or she will avoid such behavior in the future. If the teen won’t sign the contract, the AAP suggests the doctor consider talking to the teen’s parents.

Earlier this month, the AAP and the National Institute on Alcohol Abuse and Alcoholism unveiled a new tool designed to help pediatricians talk to teenagers about alcohol use. The “Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide” provides doctors with basic questions about whether and how much a patient drinks, and how much their friends drink.

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