March 4, 2022

Online quiz helps predict likelihood of teen substance use

Assessment helps parents and caregivers intervene early when kids are at risk for drug and alcohol use.

Parents are sometimes shocked to learn that their teenager has a problem with drugs or alcohol. But new Kaiser Permanente research suggests there may be clues in a child’s medical history.

Based on these findings, our researchers worked with the Partnership to End Addiction to develop a free online quiz that anyone can use to predict a young person’s risk of substance use.

“This tool is meant to help parents and clinicians more reliably predict when a child is at risk for a future substance use problem, so they can intervene with preventive measures and early treatment,” said Stacy Sterling, DrPH, MSW, an investigator at the Kaiser Permanente Division of Research in Northern California and co-director of its Center for Addiction and Mental Health Research.

“Our ability to make predictions has been limited to anecdotal evidence and best guesses, and research has shown those methods don’t work well,” she added. “We’re hoping this tool can be a step toward a more evidence-based approach.”

Experimentation or something more?

Our researchers began by analyzing the medical records of 41,000 adolescents born between 1997 and 2000. Using a sophisticated data technique known as machine learning, they worked to identify health issues related to the use of drugs or alcohol in the teen years.

Their study, published in the Journal of Substance Abuse Treatment, found several childhood-based health issues that are risk factors, including oppositional defiance disorder, trauma- or stress-related disorder, attention deficit hyperactivity disorder, and self-injury.

Young people who went on to develop bipolar disorder, depression, eating disorders, and self-harm as teens were also found to be at higher risk for substance use.

“Parents told us they were suddenly finding out their teen was getting high on weekends — something the parents themselves may have done when they were younger without suffering severe negative consequences,” said Sean Clarkin, senior advisor at the Partnership to End Addiction. “So they want to know how worried they should be about their kid’s experimentation. There are answers to that question because of this study.”

Helping parents take action

The online quiz allows insights from the study to be shared in a parent-friendly format. Focus groups of parents and pediatricians provided feedback on the quiz to make sure it was useful and easy to understand.

After completing the quiz, the user gets an assessment of a young person’s risk of a substance use disorder, along with resources for next steps and tips on how to get help. Jointly developed by Sterling’s research team and the partnership, resources include playbooks of educational materials for the parents of teens and preteens.

An online e-learning program “explains why kids use substances in the first place and offers skills parents can use to have conversations about difficult subjects and encourage healthier behaviors,” said Pat Aussem, associate vice president of consumer clinical content development at the Partnership to End Addiction.

Sterling likens this effort to other health education campaigns meant to help people identify risks early, such as monitoring a child’s skin for sun damage to avoid skin cancer later in life.

“Substance use remains stigmatized, and there’s an idea that these are ‘bad kids,’” she said. “We are trying to change that and normalize prevention of substance use problems like any other health concern. We want to arm all of us — parents, patients, clinicians — with some additional information to protect our kids and nurture healthy development.”

Find resources and support for people with substance use disorders.

Take the free online quiz to learn if a child you know may be at risk of substance use.