Adolescent Substance Use Disorders, An Issue of Child and Adolescent Psychiatric Clinics of North America

Yifrah Kaminer

Description

This comprehensive issue on Substance Abuse in youth begins with articles on epidemiological trends, genetic risk factors, neurobiology of substance use disorders, and race and gender associations, and then provides detailed reviews on prevention and various treatment methodologies. Treatments discussed include individual and group interventions (motivational interviewing and cognitive behavioral therapy), contingency reinforcement, multidimentional family therapy, pharmacotherapy, and post-treatment aftercare. Also reviewed in detail are substance use disorders and psychiatric comorbidity. The issue then takes a close look at two emerging areas of concern in youth: gambling and internet occupation, and energy drink use. By all accounts, a must-read issue for psychiatrists everywhere.

Sujets

• Medical
• Médecine
• Psychiatry

Informations

• Publié par: Saunders
• Date de parution: 29 juin 2010
• Nombre de lectures: 1
• EAN13: 9781455700202
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Child and Adolescent Psychiatry Clinics of North America , Vol. 19, No. 3, July 2010
ISSN: 1056-4993
doi: 10.1016/S1056-4993(10)00048-9

Contributors
Child and Adolescent Psychiatry Clinics of North America
Adolescent Substance Use Disorders
Yifrah Kaminer
Alcohol Research Center, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-2103, USA
ISSN  1056-4993
Volume 19 • Number 3 • July 2010

Contents
Cover
Contributors
Forthcoming issues
Foreword
Preface
Epidemiologic Trends of Adolescent Use of Alcohol, Tobacco, and Other Drugs
Genetic and Environmental Risk Factors for Adolescent-Onset Substance Use Disorders
Neurobiology of Adolescent Substance Use Disorders: Implications for Prevention and Treatment
Development and Vulnerability Factors in Adolescent Alcohol Use
Evidence-Based Interventions for Preventing Substance Use Disorders in Adolescents
Evidence for Optimism: Behavior Therapies and Motivational Interviewing in Adolescent Substance Abuse Treatment
Contingency Management Approaches for Adolescent Substance Use Disorders
Multidimensional Family Therapy: Addressing Co-occurring Substance Abuse and Other Problems Among Adolescents with Comprehensive Family-based Treatment
From Assessment Reactivity to Aftercare for Adolescent Substance Abuse: Are We There Yet?
Pharmacotherapies for Adolescent Substance Use Disorders
Management of the Adolescent with Substance Use Disorders and Comorbid Psychopathology
Non–Substance-Addictive Behaviors in Youth: Pathological Gambling and Problematic Internet Use
Problematic Use of Energy Drinks by Adolescents
Index
Child and Adolescent Psychiatry Clinics of North America , Vol. 19, No. 3, July 2010
ISSN: 1056-4993
doi: 10.1016/S1056-4993(10)00050-7

Forthcoming issues
Child and Adolescent Psychiatry Clinics of North America , Vol. 19, No. 3, July 2010
ISSN: 1056-4993
doi: 10.1016/j.chc.2010.04.001

Foreword
The Elephant in the Room

Harsh K. Trivedi, MD
Vanderbilt Psychiatric Hospital, 1601 23rd Avenue South, Suite 1157, Nashville, TN 37212, USA
E-mail address: [e-mail]


Harsh K. Trivedi, MD Consulting Editor
The National Institute on Drug Abuse has found that 46.7% of 12th graders have already used an illicit substance and 72.3% have used alcohol. Unfortunately, we are not talking exclusively about kids “testing the waters” or “getting high on some dope” or “experimenting with alcohol.” When asked about the nonmedical use of prescription painkillers, nearly 1 in 10 high school seniors reported using Vicodin and 1 in 20 reported abuse of OxyContin within the past year. Add to that nearly 45% of 12th graders having used cigarettes, 10% having used inhalants, 9% having used tranquilizers, 7% having used ecstasy, 7% having used hallucinogens, 6% having used nonprescription cough medicine, and 6% having used crack cocaine…and the numbers seem quite staggering. 1
What is most amazing about the issue of substance abuse in kids is how little is done, at the level of training programs as well as in treatment programs, to help diagnose and treat this population. Most training programs (pediatrics, child and adolescent psychiatry, psychology, social work, nursing, and others) gloss over this topic by providing a few reference articles to their respective students or muddling through it in a few lectures over the course of an entire training program. Where this starts to get scary is when there is an identified youth who needs help. The remarkable lack of appropriate treatment programs (across the board in most parts of the country) is shocking. For the ones that do exist, finding ones that provide high-quality and competent care with pediatric-trained providers (ie, not using adult providers to treat youth) can prove even more difficult. Even inpatient adolescent psychiatric units that admit patients with comorbid substance abuse problems often choose to treat the psychiatric condition and refer out for the substance abuse treatment.
I thank Yifrah Kaminer for taking on this extremely important topic. Anyone treating youth likely encounters patients who have substance abuse problems. Due to the paucity of services, the responsibility of identifying (and often treating) these youth also falls to these same providers. I thank Dr Kaminer for being a leader in this field and contributing substantially to our understanding of this issue. Likewise, I thank him for being able to produce an excellent volume that brings forth practical knowledge to help each of us do a better job in caring for these youth. I am also grateful to all of the respected contributors, who have each shared their expertise on this topic. Let us hope that, through the efforts of our youth, concerned loved ones, researchers, clinical treatment providers, the media, scientific publications, and advocacy efforts; that we can begin talking more comprehensively about the elephant in room (and potentially have an intervention to get him some necessary help).

Reference

   1. National Institute on Drug Abuse (NIDA) InfoFacts. High school and youth trends. Available at: http://www.drugabuse.gov/infofacts/HSYouthtrends.html Accessed April 17, 2010
Child and Adolescent Psychiatry Clinics of North America , Vol. 19, No. 3, July 2010
ISSN: 1056-4993
doi: 10.1016/j.chc.2010.03.014

Preface
Been There, Done That, and Now What? Adolescent Addictive Behaviors from Etiology to Postvention

Yifrah Kaminer, MD, MBA
Alcohol Research Center, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-2103, USA
E-mail address: [e-mail]


Yifrah Kaminer, MD, MBA Guest Editor
Childhood and adolescence are not only critical phases for normal development but also periods when various pathological behaviors or disorders, including substance use disorders (SUD), are first recognized. Substance use and SUD among American youth continues to present a challenging public health problem because of concerns regarding the short- and long-term physical and mental health outcomes of adolescents who use psychoactive drugs. The use of alcohol and other drugs is a leading cause of morbidity and mortality among adolescents from motor vehicle accidents, suicidal behavior, violence, drowning, and unprotected sexual activity, including unplanned pregnancy and sexually transmitted diseases. 1 Lifetime diagnoses of alcohol and drug abuse among adolescents in the United States range from 3% to 10%. Six percent and 5.4% of youths ages 12 to 17 were classified as needing treatment for alcohol use and illicit drug use, respectively. 2 Only a small segment of adolescents in need of treatment (10% –15%) end up receiving services because of lack of motivation for treatment among youth, poor screening and assessment skills of providers, limited resources, inadequate age-appropriate quality programs, and lack of a broad consensus on preferred treatment strategies. Nevertheless, the number of published treatment studies has grown dramatically during the last decade. 3
The main objective of this compilation of thirteen articles is to provide updated contributions on important topics pertaining to better understanding the development of SUD in youth and responding to their treatment needs. Additional information is provided on new emerging issues in the study of newer addictive behaviors in youth.
One article reviews the epidemiologic trends of adolescent substance use. Another two articles look at risk factors for the development of substance use disorders and the interphase between genetic 4 and environmental influences. The authors address the implications for prevention and treatment. Two other articles address the development and transitions of substance abuse from adolescence into early adulthood and prevention approaches.
Six articles examine treatment approaches. The four psychotherapy articles address motivational interviewing and cognitive behavioral therapy with special attention to the difference between individual and group interventions. Also included are two articles on contingency reinforcement approaches and on multidimensional family therapy. The psychotherapy section is concluded with a synthesis on the process of treatment from the assessment phase through treatment and aftercare (known also as continued care). Two articles address pharmacotherapy and the management of youth substance abuse with psychiatric comorbidity.
Finally, there is still an ongoing debate whether nonsubstance-related addictions are actually addictions. 5 A clever article on the use of butterbeer by Harry Potter and his friends indirectly addresses the question of youth habit formation and exposure to addictive drinks even though it occurs in a fantasy world. 6 Internet addiction and the availability of gambling online are relatively new developments in the study of addictive behaviors in youth. Associations with predictive psychiatric symptoms that might serve as markers for the identification of adolescents at high-risk for these behaviors are intriguing. 7 Unique and relevant contributions are two articles addressing emerging addictive disorders, which include gambling, Internet preoccupation, the use of “energy” drinks, and, perhaps, the next vogue of “antienergy drinks.”
I am grateful to the experts who have contributed scholarly articles for this special issue.

References <