No Evidence Doctors Can Stop Young Patients From Using Drugs, Say Researchers

Forget pushing
physicians to nag their young patients about drug use. Chances are
that few doctors look forward to playing nosy aunt and even fewer
teens eagerly anticipate a lecture while they turn their heads and
cough, but now they can easily shrug off those unpleasant roles. As
it turns out, there’s little evidence that physicians have any
effect when it comes to nagging those darned kids to spurn pot or
avoid popping pills.

Research performed on behalf of the U.S.
Preventive Services Task Force, an “independent, volunteer
panel of national experts in prevention and evidence-based
medicine,” and published in the
Annals of Internal Medicine, finds:

The USPSTF found only 6 fair- or good-quality studies of 4
primary care–relevant behavioral interventions that focused on
reducing drug use in adolescents. These interventions included
face-to-face counseling, videos, print materials, and interactive
computer-based tools. Although the interventions substantially
varied in their intensity, components, populations, and sample
sizes, they provide almost no evidence of significant improvements
in health outcomes. A few changes in drug use and drug initiation
were found, but given the lack of clear and consistent findings and
the overall small evidence base, the USPSTF could not draw
definitive conclusions. It is possible that brief primary
care–relevant interventions do not significantly affect adolescent
drug use or that more effective interventions may need to be
developed.

The surveyed interventions, according to author Dr.
Virginia A. Moyer, the vice president for maintenance of
certification and quality at the American Board of Pediatrics,
ranged from 10-minute in-office discussions to 45-minute
interactive online interventions. Overall, the intent was to
discourage the recreational use of marijuana, alcohol, and
prescription drugs. While some reductions in use were reported, the
biggest changes were, apparently, hard to interpret. “It is not
clear whether the intervention helped girls who had never used
drugs to remain abstinent or helped a few girls who were frequently
using drugs to reduce or stop their drug use.”

Overall, there was little to go on in order to assess the
benefits, or harms, of using primary care physicians to convince
kids to avoid drug and alcohol use.

As of 2003, U.S. Preventive Services Task Force recommendations
for preventive services would add 7.4 hours
to a primary care doctor’s day, and they probably haven’t
become less demanding in the intervening years. The
ineffectiveness of drug interventions is plenty of reason to
refrain from trying to shoehorn them into an already busy
schedule.

Well, that and the risk of alienating patients with endless
rounds of nagging.