As part of our series on Substance Abuse Prevention, we interviewed Fred Walters, M.D. at Bainbridge Pediatrics. Here's what Dr. Walters had to say about a physician's role in detecting and addressing substance abuse issues with patients.
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What are you seeing among youth in our community?
The youth on Bainbridge, like youth across the country, often experiment with or regularly use substances during their teenage years. The most frequently used substances include alcohol, marijuana and vaping. Increased vaping use is an alarming trend with serious health risks that needs to be addressed.
How do you screen for substance use?
Physicians regularly monitor for substance use during our exams with teenagers and work with teenagers & parents to address substance use when it is identified. Our primary means of screening is confidential discussions about substance use with teenagers. Actual drug screens (i.e. urine screens) are also sometimes used, but often aren’t as accurate and reliable in detecting substance use as honest communication can be. Drug tests can be difficult to interpret and can also read negative even if the teen is using drugs – primarily because they usually will only detect substances used with the last two to three days.
So, you don’t automatically suggest drug testing?
It’s important for physicians to maintain trust with their patients. Drug testing can be useful at times; however, honest conversations between a teen and their parent or between a teen and their health care provider often provides more useful information. It’s important that physicians can have confidential conversations with teenagers so that we can help provide education and treatment; our goal is to involve parents when there is a problem, but also respect confidentiality. Washington state law allows minors to request and receive treatment for outpatient drug-and-alcohol-abuse treatment beginning at age 13 without parental consent.
What do you recommend?
The best approach is open communication between parents and their children and their health care providers (doctors and counselors). Parents play a big role in preventing, detecting, and intervening when it comes to substance use. Recognizing and addressing changes in behavior is important.
What’s the next step?
When substance use is identified, it is important to understand the degree of the problem (for example experimentation vs. problem use vs. dependence). Your child’s health care provider can help with this step. Counseling and therapy are often also recommended and helpful. The following article about substance abuse prevention on our (Bainbridge Pediatrics) website provides some additional information. Click here for the article.
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