substance use in children & adolescents

8/2/2019 Substance Use in Children & Adolescents

1/27


2/27

Case presentation

Prevalence rates of substance use for

pediatric population in Utah Substance Use as a Spectrum

Screening Methods & Techniques

Basic Motivation Interviewing Techniques Substance Abuse Referral Sources in

Utah


3/27

15 year old Caucasian male

CC: I wanna stop using.

HPI: Brought for residential CD treatmentwith his bio father. Not court committedto treatment, but DCFS involvement fortruancy.

No history of mental health treatment,but reports depression symptoms thepast year.


4/27

Started drinking beer and smoking at 13-binge drinking pattern at parties-last use

2 mos ago Marijuana-14 yo- twice/wk then daily use

Experimentation- ecstasy, Oxycontin (up

to 60mg/day) Heroin- 15 yo- smoking once/wk with

friends, then IV use started 6 mos ago

Using IV heroin daily prior to admission.


5/27

Nonspecific vague complaints ofheadaches, insomnia,& abdominalpain/vomiting

EGD- Mild chronic gastritis-Prilosec/Reglan Lap cholecystectomy/cholangiogram-no calculi

noted on path report-chronic cholecyctitis Brain MRI with contrast-normal-

Depakote/Topamax for migraines

2D Bubble echo- normal Sleep study eval No UDS or documented substance use history in

chart


6/27

Experimentation with substances iscommon in teens and young adults!

Use of alcohol and other drugs is a

leading cause of morbidity & mortailityfor youth in the US.

All substance use involves health risksthat can occur long before there is a

true drug addiction. Adolescence is a period of

neurodevelopmental vulnerability.


7/27

Utah Dept of Human Services Substance Abuse and Mental Healthhttp://dsamh.utah.gov/


8/27


9/27

Abstinence

Experimentation

Limited Use

Problematic Use

Abuse

Addiction


10/27


11/27


12/27

In the past 12 months, did you:

1) Drink any alcohol (more than a few sips)?2) Smoke any marijuana or hashish?

3) Use anything else to get high? (Anythingelse includes illegal drugs, OTC and

prescription drugs, and things that you sniffor huff.


13/27

0 or 1 on CRAFFT= Brief Advice

2 or more on CRAFFT= Brief Assessment

Tell me more about your alcohol/substance

use. Has it caused you any problems? Haveyou tried to quit? Why?


14/27

Express Empathy with a warm,nonjudgmental stance, active listening,and reflecting back what is said.

Develop Discrepancy between thepatients choice to drink and his or hergoals, values, or beliefs.

Roll with Resistance by acknowledging the

patients viewpoint, avoiding a debate,and affirming autonomy.

Support Self-efficacy by expressingconfidence and pointing to strengths andpast successes.


15/27


16/27


17/27


18/27


19/27


20/27

People who drink by age 15 are 4 timesmore likely to develop alcoholism thanthose who began at 21.

Average age of first use 13 years old

More than 1/3 of high school seniors seeno great risk in consuming 4-5 alcoholic

drinks in a day, despite having blackouts. Drinking is often perceived as normal

behavior


21/27


22/27


23/27


24/27

1. Odyssey House - 801.322.3222offers residential,outpatient, and an in-home program

2. Wasatch Canyons801.313.7711offers residential andday treatment programs

3. Cornerstone Counseling801.355.2846offers outpatienttreatment

4. ARTEC through Valley Mental Healthresidential with adual diagnosis track801.963.4200

5. Youth Careresidential programs801.657.7095

6. Salt Lake County Substance Abuse Services801.468.2009offers substance abuse assessments and referrals

7. ACESAssessment, Counseling, and Educational Servicesoffers outpatient therapy for 16 year olds and older

8. UNI- Acute inpatient hospitalization for detox and

Teenscope Day Treatment Program


25/27
http://hsemployee.utah.gov/dsamh/atr/


26/27

Pediatricians play a crucial role in early detectionof substance use problems.

It is important to relay a message of NONUSEthrough clear and consistent information topatients, parents, & family while maintaining atrusting patient care relationship.

Motivational interviewing is helpful to assessreadiness for change in a non-judgmentalmanner.

SAMSA/AAP recommend universal screening forsubstance use, brief intervention, and/ortreatment referral become a part of routinehealth care.

Dont hesitate to refer when appropriate.


27/27

Alcohol Screening & Brief Intervention for Youth: APractitioners Guide. NIAAA. NIH Publication No. 11-7805

Committee on Substance Abuse. Substance UseScreening, Brief Intervention, and Referral to Treatment for

Pediatricians. Pediatrics Vol. 128; 2011. pp.1330-43. Committee on Substance Abuse. Alcohol Use and Abuse:A Pediatric Concern. Pediatrics Vol. 108 No. 1 July 1, 2001pp. 185 -189

Griswold, K.S. et al. Adolescent substance use and abuse:recognition and management.Am Fam Physician. 2008

Feb 1; 77 (3):331-6. Shrier, L.A. et al. Substance Use Problems and Associated

Psychiatric Symptoms Among Adolescents in Primary Care.Pediatrics Vol 111 No. 6; 2003. pp. 699-705.

www.erowid.comCannabis images
http://www.erowid.com/http://www.erowid.com/

substance use in children & adolescents

Documents