Substance Use Screening More Common in Marginalized Teens

TOPLINE:

Injured adolescents who present at trauma centers who are Black, American Indian, or Hispanic are more likely to undergo screening for biochemical alcohol or drugs than their White peers. Adolescent girls and Medicaid-insured adolescents also have higher screening rates.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using the Trauma Quality Programs dataset from 2017 to 2021 to examine the sociodemographic disparities in biochemical substance use screening among injured adolescents.
• They included 85,362 adolescent patients aged 12-17 years with trauma (66.7% White; 81.8% non-Hispanic; 28% girls; 51.3% privately insured) from 121 pediatric trauma centers.
• Overall, 24.5% and 21.8% participants underwent biochemical screening for alcohol and drugs, respectively.

TAKEAWAY:

• The odds of alcohol and drug screening were 8% (P = .02) and 13% (P P
• Hispanic adolescents were 20% and 12% more likely to be screened for alcohol (P P = .001), respectively, than non-Hispanic adolescents.
• Compared with boys, girls had 32% higher odds of alcohol screening and a 28% increased likelihood of drug screening (P
• Medicaid-insured and uninsured adolescents were more likely to be screened than adolescents with private insurance.

IN PRACTICE:

“Our findings indicate potential disparities in biochemical substance use screening at pediatric trauma centers. With drug overdose and poisoning the third leading cause of childhood death, high-quality screening is critical for both injury prevention and public health,” the authors of the study wrote.

The differences in rates of screening “may reflect clinician biases as inequities persisted despite adjusting for clinical characteristics and after nesting patients within trauma centers to account for institutional screening practices,” the researchers wrote.

SOURCE:

This study was led by Jordan M. Rook, MD, VA Greater Los Angeles Healthcare System, Los Angeles, and was published online on October 4, 2024, in JAMA Network Open.

LIMITATIONS:

The dataset used in the analysis did not report whether a positive test was followed by intervention or treatment, which made it unclear if the benefits of screening outweighed the potential harm. It also did not monitor interview-based substance use screening, which limited the assessment to biochemical screening only. Moreover, it remained unclear whether the disparities in screening rates differed by hospital case-mix, which could have affected the generalizability of the findings.

DISCLOSURES:

Some authors received research support or funding from the VA Office of Academic Affiliations through the National Clinician Scholars Program Fellowship, the Association for Academic Surgery Clinical Outcomes and Health Services Research Award, and other sources. One author reported receiving grants from the National Institutes of Health, outside the submitted work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.