Pediatric Subspecialist Alcohol Screening Rates and Concerns About Alcohol and Cannabis Use Among Their Adolescent Patients.

Purpose: Pediatric specialty care provides an opportunity to screen for and address patient substance use; however, little is known about providers' screening rates, their opinions regarding substance use harms, or the potential marijuana to be used as a medication.

Methods: We surveyed national convenience samples of pediatric endocrinologists (N = 142) and rheumatologists (N = 83) and used descriptive statistics and multivariate logistic regression to examine alcohol screening rates, barriers, and for medical use of marijuana, differences between subspecialist concerns.

Results: In all, 36.4% of providers reported screening adolescent patients annually or more, and a majority expressed concerns about impacts on disease management (80.0%/80.0%) and symptom management (69.3%/53.3%) from alcohol and marijuana, respectively. Nearly equal proportions disagreed (30.2%), were neutral (34.7%), or agreed (35.1%) that some patients would benefit from medical marijuana, although majorities were not comfortable recommending marijuana (62.7%) and did not believe marijuana is standardized enough to be used as medication (57.8%).

Discussion: Fewer than half of the subspecialists in our study routinely screen their adolescent patients for substance use, although many have concerns regarding the impacts of alcohol and marijuana use on their patients. Education and training on best practice could help to increase screening rates. There is agreement that marijuana is not standardized enough to be used as a medication. There is also a broad range of opinions regarding the pharmaceutical potential of marijuana and concerns about the impact of marijuana on underlying chronic medical conditions, which should be considered as marijuana policy continues to evolve.