U.S. Preventive Services Task Force
Release Date: January 2008
Summary of Recommendations / Supporting Documents
Summary of Recommendations
- The USPSTF concludes that the
current evidence is insufficient to assess the balance of benefits and harms of
screening adolescents, adults, and pregnant women for illicit drug use. (This is a grade "I" statement)
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Rationale:
Importance: Illicit drug use and abuse are serious problems
among adolescents, adults, and pregnant women in the United States, ranking
among the 10 leading preventable risk factors for years of healthy life lost to
death and disability in developed countries. (Please note that tobacco use and
alcohol misuse are considered in separate screening recommendations of the
USPSTF.)
Detection: While standardized questionnaires to screen
adolescents and adults for drug use/misuse have been shown to be valid and
reliable, there is insufficient evidence to assess the clinical utility of
these instruments when applied widely in primary care settings.
Benefits of detection and
early treatment: There is good
evidence that various treatments are effective in reducing illicit drug use in
the short term. Evidence is insufficient, however, either to demonstrate that
treatment reliably improves social and legal outcomes for patients, or to link
treatment directly to longer term improvements in morbidity or mortality. Since
all but one published clinical trial of treatment interventions involved
individuals who had already developed problems due to their drug use, it is not
known whether the findings are generalizabe to asymptomatic individuals whose illicit
drug use is detected through screening. There is fair evidence that, regardless
of the patient's history of treatment, reducing or stopping drug use is
associated with improvement in some health outcomes.
Harms of detection and
early treatment: There is little
evidence of harms associated with either screening for illicit drug use or behavioral
interventions used in treatment. Several clinical trials of pharmacotherapy for
drug misuse have reported mild to serious adverse events, although some of these
events were likely related to underlying drug use. The specific adverse events
noted to occur more frequently in the treatment arm of trials (compared to
placebo) have been previously recognized as potential side effects of the
treatment medication and cited on its product label.
USPSTF assessment: The USPSTF concludes that for adolescents, adults,
and pregnant women, the evidence is insufficient to determine the benefits and
harms of screening for illicit drug use.
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Supporting Documents
Recommendation Statement (PDF File, 55 KB; PDF Help)
Systematic Review (PDF File, 2 MB; PDF Help)
Supplemental Evidence Update (PDF File, 230 KB; PDF Help)
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Current as of January 2008
Internet Citation:
Screening for Illicit Drug Use, Topic Page. January 2008. U.S. Preventive Services Task Force. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/uspstf/uspsdrug.htm