The recommendation is the first time the panel has concluded there is enough evidence to support screening all adults. In 2008, it declined to do so.
The guidance is important because the Affordable Care Act requires that services recommended by the task force be covered free or with very small co-payments. The proposed recommendations are open for public comment until Sept. 9, after which the task force will consider them for final approval.
The panel concluded screening is effective when “services for accurate diagnosis of unhealthy drug use or drug use disorders, effective treatment, and appropriate care can be offered or referred.”
It cited the findings of a 2017 national survey that 11.5 percent of Americans 18 or older were using illegal drugs at the time and data that showed that 8.5 percent of pregnant women aged 18 to 44 had used drugs in the past month.
Among drug users aged 12 and over, 85.3 percent said they used cannabis and 19.5 percent used “psychotherapeutic drugs,” including opioids and other pain relievers.
The panel suggested several questionnaires, administered by health care providers or taken by patients on their own, that it said were effective in picking up illicit drug use. It warned primary care providers that “screening tools are not meant to diagnose drug dependence, abuse, addiction, or use disorders. Patients with positive screening results may therefore need to be offered or referred for diagnostic assessment.”
It said providers also would have to be aware of state requirements for reporting results to legal authorities.