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Narrative Review: Revised Principles and Practice Recommendations for Adolescent Substance Use Treatment and Policy - 29/01/25

Doi : 10.1016/j.jaac.2024.03.010 
Justine W. Welsh, MD a, , Alex R. Dopp, PhD b, Rebecca M. Durham, BS c, Siara I. Sitar, MS d, Lora L. Passetti, MS e, Sarah B. Hunter, PhD f, Mark D. Godley, PhD g, Ken C. Winters, PhD h
a Emory University, Atlanta, Georgia 
b RAND Corporation Santa Monica, California 
c Emory University, Atlanta, Georgia 
d Emory University, Atlanta, Georgia 
e Chestnut Health Systems, Normal, Illinois 
f RAND, Santa Monica, California 
g Chestnut Health Systems, Normal, Illinois 
h Oregon Research Institute, Minnesota 

Correspondence to Justine W. Welsh, MD, 1821 Clifton Road NE, Suite 1200, Atlanta, GA 303291821 Clifton Road NESuite 1200AtlantaGA30329

Abstract

Objective

In 2014, the US National Institute on Drug Abuse released the “Principles of Adolescent Substance Use Disorder Treatment,” summarizing previously established evidence and outlining principles of effective assessment, treatment, and aftercare for substance use disorders (SUD). Winters et al. (2018)1 updated these principles to be developmentally appropriate for adolescents. This review builds on that formative work and recommends updated adolescent assessment, treatment, and aftercare principles and practices.

Method

The Cochrane, MEDLINE-PubMed, and PsychInfo databases were searched for relevant studies with new data about adolescent substance use services. This article updates the 13 original principles; condenses the 8 original modalities into 5 practices; and highlights implications for public policy approaches, future funding, and research.

Results

Key recommendations from the principles include integrating care for co-occurring mental health disorders and SUDs, improving service accessibility including through the educational system, maintaining engagement, and addressing tension between agencies when collaborating with other youth service systems. Updates to the treatment practices include adoption of Screening, Brief Intervention and Referral to Treatment (SBIRT), investment in social programs and family involvement in treatment, expanding access to behavioral therapies and medications, increasing funding to harm reduction services, supporting reimbursement for continuing care services, and increasing investment in research.

Conclusion

These revised principles of adolescent assessment, treatment, and aftercare approaches and practices aim to establish guidance and evidence-based practices for treatment providers, while encouraging necessary support from policymakers and funding agencies to improve the standard of care for adolescent SUD services.

Plain language summary

In this review article and building upon previous work in this area, the authors describe principles and practices for adolescent substance use treatment and identified areas of treatment in need of further research. The authors also outline recommendations for policy changes and support for funding to implement these principles and practices to further improve the standard of care for adolescent substance use disorders services.

Il testo completo di questo articolo è disponibile in PDF.

Key words : substance use disorders, adolescents, addiction, pharmacology, public policy


Mappa


 Dr. Winters is supported by awards from the National Institute on Drug Abuse (R34DA049070 & R34DA53660, Waldron and Winters, MPI). Dr. Dopp, Ms. Passetti, Dr. Hunter, and Dr. Godley’s contributions were supported by an award from the National Institute on Drug Abuse (R01DA051545; Dopp, PI).
 This article is part of a special series devoted to the subject of substance use, featuring topics relevant to child and adolescent behavioral health, including genetics, neuroscience, epidemiology, measurement, prevention, and treatment. This special series is edited by Guest Editor Kevin M. Gray, MD, JAACAP Open Deputy Editor Kara S. Bagot, MD, JAACAP Deputy Editor Mary Fristad, PhD, ABPP, JAACAP and JAACAP Open Associate Editor Robert R. Althoff, MD, PhD, JAACAP Open Editor Manpreet K. Singh, MD, MS, and Editor-in-Chief Douglas K. Novins, MD.
 Disclosure: Dr. Welsh has received consulting fees received from Applied Clinical Intelligence LLC (ACI Clinical). Drs. Dopp, Hunter, Godley, and Winters and Ms. Durham, Sitar, and Passetti have reported no biomedical financial interests or potential conflicts of interest.


© 2024  American Academy of Child and Adolescent Psychiatry. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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