US health task force wants all adults screened for illegal drug use

The United States Preventive Service Task Force, an independent panel of health care experts appointed by the US Department of Health and Human Services, has recommended that all adults in the nation be screened for illicit drug use. The screening would look for both illegal drug use and the potential abuse of legally prescribed medication.

Screening adults

The USPSTF published its draft recommendation for screening all adults ages 18 years and older for illicit drug use on Tuesday. The panel is allowing the public to comment on the recommendation until September 9 at 8PM ET, according to the group's website. The USPSTF considers 'illicit drug' use to include both illegal drugs and 'nonmedical use of prescription psychoactive medications.'

Over the past year, the draft recommendation states, around 7.5 million Americans ages 12 years and older were diagnosed with some type of illicit drug dependency or abuse. As well, the experts said illicit drugs caused over 70,000 deadly overdoses in 2017; other non-fatal serious outcomes can include heart attack, seizures, arrhythmias, and more.

Moderate benefit

Based on the data it currently has, the USPSTF has determined that there is a 'moderate net benefit' for screening all adults ages 18 years and older for illicit drug use. The screening is recommended to health care professionals and would apply even in cases in which doctors do not suspect that drug abuse is taking place. Alcohol and tobacco would not be included in the screening.

The panel points toward multiple potential screening tools doctors could use, including one called BSTAD that involves asking the patient six questions. 'Screening tools are not meant to diagnose drug dependence, abuse, addiction, or use disorders,' the USPSTF notes.

Barriers to screening

The experts also point out, 'Providers should be aware of any state requirements for mandatory screening or reporting of screening results to medicolegal authorities and understand the positive and negative implications of reporting.' In some states, for example, doctors are required to report cases of drug use by women if the use takes place during pregnancy.

Though experts hope that screening may curb the concerning increase in opioid-related addiction and deaths, there are limitations to the plan. Such screenings depend on honesty from patients who may be reluctant to disclose drug use out of fear of legal consequences or being judged, for example.

This screening recommendation would join existing USPSTF recommendations related to public health, which include offering smoking cessation interventions to smokers, screening for depression and suicide risk, and offering behavioral counseling in cases of excessive alcohol consumption.