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Two-question screen for alcohol use in children and adolescents

Age group	Screening questions	Risk assessment*
9 to 11 years	"Do you have any friends who drank beer, wine, or any drink containing alcohol in the past year?"	Any drinking by friends heightens concern^¶
9 to 11 years	"How about you – have you ever had more than a few sips of beer, wine, or any drink containing alcohol?"	Any drinking indicates highest risk^Δ
11 to 14 years	"Do you have any friends who drank beer, wine, or any drink containing alcohol in the past year?"	Any drinking by friends heightens concern^¶
	"How about you – in the past year, on how many days have you had more than a few sips of beer, wine, or any drink containing alcohol?"	11 years: Any drinking: Highest risk^Δ
		12 to 14 years: 1 to 5 days: Moderate risk^Δ >5 days: Highest risk^Δ
14 to 18 years	"In the past year, on how many days have you had more than a few sips of beer, wine, or any drink containing alcohol?"	14 through 15: 1 to 5 days: Moderate risk^Δ >5 days: Highest risk^Δ
		16 years: 1 to 5 days: Lower risk 6 to 11 days: Moderate risk^Δ >11 days: Highest risk^Δ
		17 years: 1 to 5 days: Lower risk 6 to 23 days: Moderate risk^Δ >23 days: Highest risk^Δ
		18 years: 1 to 11 days: Lower risk 12 to 51 days: Moderate risk^Δ >51 days: Highest risk^Δ
	"If your friends drink, how many drinks do they usually drink on an occasion?"	Binge drinking^◊ by friends heightens concern^¶

* Use in conjunction with what you already know about the patient's physical and psychosocial development, level of family support, drinking and smoking habits of parents and siblings, school functioning, or trouble with authority figures to provide advice and assistance. Refer to the practitioner's guide for details.
¶ If the patient does not drink, but friends do, explore the patient's views about friends' drinking and ask about his or her plans to stay alcohol free.
Δ For patients at moderate or higher risk, obtain additional information about drinking pattern, drinking-related problems or risk-taking, and other substance use.
◊ Binge drinking: ≥3 drinks for girls (all ages) and boys ages 9 to 13 years; ≥4 drinks for boys 14 through 15 years; ≥5 drinks for boys age ≥16 years.

Adapted from: National Institute on Alcohol Abuse and Alcoholism. Alcohol screening and brief intervention for youth: A practitioner's guide. Available at: https://www.niaaa.nih.gov/publications/clinical-guides-and-manuals/alcohol-screening-and-brief-intervention-youth (Accessed on June 20, 2017).

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