title: Evaluation of substance-abusing adolescents by primary care physicians.
abstract: Physicians are in a unique position to identify substance-abusing adolescents. To evaluate physician performance from the patient's perspective, we interviewed 54 substance-abusing adolescents and their parents about previous medical encounters. Although nearly all patients had seen a physician during the time they were using drugs or alcohol, 43% did not recall being asked by a doctor about alcohol or drug use. Of the 26 patients who recalled being asked, 12 (46%) stated that they responded dishonestly, usually because a parent was present. Of the 23 who didn't recall being asked, five (18%) wished they had been asked. Physicians tended to ask about substance abuse more often (p = .08) when they had previously discussed the problem with the parents, but many parents did not initiate such discussions. This survey suggests that physicians may not adequately assess high-risk adolescents for substance abuse because of physician-, patient- and/or parent-dependent factors.
authors.affiliation: Division of General Internal Medicine, New England Deaconess Hospital, Boston, MA 02215.
authors.forename: L S
authors.initials: LS
authors.lastname: Friedman
authors.forename: B
authors.initials: B
authors.lastname: Johnson
authors.forename: A S
authors.initials: AS
authors.lastname: Brett
mesh_terms: D000293:Adolescent; D000437:Alcoholism / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D010819:Physician's Role; D010817:Physician-Patient Relations; D010821:Physicians, Family; D012380:Role; D019966:Substance-Related Disorders / Q000175:diagnosis*; D011795:Surveys and Questionnaires