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8 Core Principles When Treating Addiction in Adolescents

8 Core Principles When Treating Addiction in Adolescents


  • The principal goal of treatment of substance abuse disorders (SUDs) in adolescents is achieving and maintaining abstinence and improving functioning. This slideshow presents 8 core principles for the clinical management of adolescents with SUDs.


  • SUDs in adolescents have multifactorial etiologies and treatment requires integrated and concurrent approaches for both substance use and any co-occurring psychiatric disorders. Be aware of stages of development and use developmentally-informed approaches (ie, meeting adolescents “where they are”).


  • Know the level of care you as a provider are comfortable managing and the referral sources in your community for higher levels of care (ie, residential/inpatient, intensive outpatient services).


  • One behavioral intervention is to involve parents and family in the treatment process. This will help to improve family functioning and parent-teen relationships. Changing parental monitoring, limit setting, and substance use beliefs can improve outcomes. A comprehensive diagnostic evaluation that includes the patient and his or her parents is used to characterize developmental history, risk and protective factors, current and lifetime psychiatric symptoms and disorders, and substance use and related disorders.


  • Use evidence-based behavioral interventions as your treatment backbone. There is strong evidence for the efficacy of psychosocial or behavioral interventions in the treatment of adolescent SUDs. This will help to fine-tune and solidify approaches to treatment.


  • Evaluate patients for co-occurring psychiatric disorders (eg, ADHD, conduct disorder, depression, PTSD) and provide integrated and concurrent treatment if necessary. Evidence-based psychosocial and pharmacotherapy approaches are used concurrently to treat psychiatric disorders when present.


  • Adjunctive pharmacotherapy may be used for the treatment of withdrawal symptoms and craving in youth that have failed behavioral interventions.


  • Incorporate urine drug screening, in a systematic way, as part of the initial screening and maintenance phases of treatment. Using a contingency management approach that provides awards for negative UDSs can improve outcomes.


  • Twelve step programs, such as Alcoholics or Narcotics Anonymous (AA/NA), especially those with a teen focus, may be helpful when added to (but not in place of) the above described integrated treatment approaches.


  • For more on this topic, see Treatment Strategies for Substance Use Disorders in Adolescents, by Christopher J. Hammond, MD, PhD and Pravesh Sharma, MD, on which this slideshow is based.

 

View the slides in PDF format.

Comments

more responses to the question - Is it necessary for those treating addicted adolescents to have training in FASD?

Absolutely and they MUST understand receptive processing disorders

‪ Most definitely‬

‪ I agree 100%. I have a 35 year old FASD son who has battled addictions since 13. Over the years the heartache, pain, bigger and stronger addictions, the abuse, the self harm, the suicide attempts, theft and the list goes on. Each time we went to the hospital they said he had bipolar or schizophrenia and pushed us back out. His life has been very difficult and so has ours. After being on life support in February and in a coma for 11 days I found a doctor who listened when I said he had FASD. They started him on respiratone and from the time he came out of his coma till now the change has been outstanding. Just someone who listened who helped and gave him/ us the time has changed all our lives. The other doctors and physcs over the years did nothing‬

barry @

Is it necessary for those treating addicted adolescents to have training in FASD?
I posted the above question on two FASD Facebook groups. The following were the responses.
Keeping mind that 98% of individuals diagnosed with FASD will subsequently receive diagnoses from the DSM. 20% of those diagnosed with FASD will have alcohol and drug problems. The great majority of those with FASD are undiagnosed.

From the facebook group Flying with broken wings

Actually we need to up the ante on this one.. ALL persons dealing with people in crisis need to have the training to recognize the signs of possible FASD, know what questions to then ask, and then provide proper resources.
This has to be across the board... and one day, we will make it happen.

YES!!!!!! What a difference that could make in people's lives!

We need this in Australia to

I asked our local crisis intervention if they had ANY trading at all on this & it was a terrible, NO. Needless to say I printed up bunches of stuff & links to go to. I hope they used it to educate themselves.

I think everyone in the government systems should have mandatory training for all disabilities so they can spot it better and not beat down a non verbal persons with disabilities or restrain disabled people who just need a hug to feel better

Yes, definitely

ABSOLUTELY!!!! Without a doubt!!

We have the number 1 Special Education training program in the US and fasd is not covered

Yes

Of course.

As much as you would think so, most do not!

Definitely

Absolutely

Most definately

I agree! Knowledge is power.

Yes definitely alcohol addiction is a massive problem in the uk

I'm not even sure all doctors know about FASD

Yes

Absolutely!

Yes. I was just thinking the other day how I'd like to see a therapist, but one that's been through or at least has great knowledge of some of the things we go through. Most therapists I've seen don't know and don't care to know

certainly would be a great idea, too few people are educated in fas...

From the facebook group FASD for everyone

Yes every government worker and agencies should be fully trained in all disabilities. Cops are harming non verbal persons with disabilities just because they can not talk. Hospital staff are restraining patients who only need a hug to feel better. Welfare workers are ripping families apart just because there is members with the families who have disabilities.

I think they should

barry @

Interesting: I can read the slides by clicking on the image and on the PDF format. I use Safari

barry @

I can view the slides on the Google Chrome browser but not on Safari. I can't view the slides in PDF format with either browser. On Google Chrome I received the following message:

This site can’t be reached

http’s server DNS address could not be found.
Search Google for http images ubm medica psychiatric times pdfs 2017 Jul AdolescentSUDs PDF
ERR_NAME_NOT_RESOLVED

Peter @

I had the exact same error message. July 9

Haydn @

How do these apply to adolescents who have fetal alcohol spectrum disorder? Is it necessary for those treating addicted adolescents to have training in FASD?

barry @

Prevention strategies by our social "networks". (And I use that term loosely), are lacking. We should be bombardimg them at every opportunity, in the schools, on television , video games and apps, on the internet. By the time they enter treatment, the damage is already done.

Brenda E @

Pax GBG used in elementary schools reduced substance abuse by 50% in one study and reduced heroin use by 69% in another. For true prevention, research Pax GBG. For starters see:

NIDA Notes. “Behavior Game Played in Primary Grades Reduces Later Drug-Related Problems.” Volume 23, Number 1, April 2010. National Institute on Drug Abuse.
http://www.drugabuse.gov/news-events/nida-notes/2010/04/behavior-game-pl...

NIDA Notes. “Good Behavior Game Wins 2012 Mentor International Best Practice Award.” November 2012. National Institute on Drug Abuse.
http://www.drugabuse.gov/news-events/nida-notes/2012/11/good-behavior-ga...

Bates, Mary. “Calm Down Boys, Adolescent Girls have ADHD, too.” Psychology Today, June 2012. http://www.psychologytoday.com/articles/201206/diagnosis-calm-down-boys

SAMHSA National Registry of Evidence-based programs and Practices (NREPP) Good Behavior Game.
http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=201

SAMHSA National Registry of Evidence-based programs and Practices (NREPP) Pax Good Behavior Game.
http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=351

David-Ferdon C, Simon TR. Preventing Youth Violence: Opportunities for Action. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 2014. p. 27
http://www.cdc.gov/violenceprevention/youthviolence/pdf/opportunities-fo...

Washington State Institute for Public Policy
http://www.wsipp.wa.gov/BenefitCost

or go to www.goodbehaviorgame.org

also reduces many other negatives e.g. smoking, depression, suicide, delinquency, conduct disorders, truancy, drop outs...

Richard @

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