{"title":"Adolescent use and misuse of marijuana.","authors":"John D Foley","doi":"10.1016/j.admecli.2006.03.008","DOIUrl":"https://doi.org/10.1016/j.admecli.2006.03.008","url":null,"abstract":"<p><p>Substance use by adolescents and young adults continues to be a serious problem. Marijuana remains the most commonly used illicit substance with close to 50% of high school seniors admitting use at some time. Each year 2.6 million individuals in this country become new users and most are under 19 years old. Individuals who provide health care services to this age group must have an understanding of the drug, its pharmacokinetics, and the many short- and long-term adverse effects. Familiarity with risk factors associated with initiating use can be helpful in screening older children and targeting anticipatory guidance toward those most likely to benefit. This article reviews these issues and includes commentary on a recently published review of treatment programs.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"17 2","pages":"319-34"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26123147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medical management of adolescent drug overdoses.","authors":"John F Haynes","doi":"10.1016/j.admecli.2006.03.003","DOIUrl":"https://doi.org/10.1016/j.admecli.2006.03.003","url":null,"abstract":"<p><p>This article outlines the current clinical approach to poisonings in the adolescent age group. Management issues are presented for several specific substances frequently abused by this population. The purpose of such a review is to stimulate self-education in the practitioner. A secondary goal is to promote awareness of the various manifestations of substance abuse problems to facilitate recognition and referral. Adolescence is often a critical point for effective intervention and prevention on the road from use to addiction. Long-term survival may depend more on substance use rehabilitation than on the initial medical management.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"17 2","pages":"353-79"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26123149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeffery P Greene, Dale Ahrendt, Elisabeth M Stafford
{"title":"Adolescent abuse of other drugs.","authors":"Jeffery P Greene, Dale Ahrendt, Elisabeth M Stafford","doi":"10.1016/j.admecli.2006.03.007","DOIUrl":"https://doi.org/10.1016/j.admecli.2006.03.007","url":null,"abstract":"<p><p>This article provides a general overview of other drugs of abuse within the adolescent population. Stimulants, hallucinogens, club drugs, inhalants, sedative-hypnotics, tranquilizers, opiates, and ergogenic drugs are included. Epidemiology, pharmacology, clinical aspects, laboratory, and treatment issues are addressed. Attention is focused on most commonly used drugs or representative drugs within each category. Review of alcohol, marijuana, and tobacco abuse can be found in other articles.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"17 2","pages":"283-318"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26123146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adolescents with co-occurring mental health and substance use disorders in primary care.","authors":"Robert L Gee, Rachele C Espiritu, Larke N Huang","doi":"10.1016/j.admecli.2006.03.010","DOIUrl":"https://doi.org/10.1016/j.admecli.2006.03.010","url":null,"abstract":"<p><p>Co-occurring mental and substance use disorders (COD) among children and adolescents present special challenges for family members and primary care clinicians. A broad understanding of prevalence rates, etiology, risk and protective factors, and intervention strategies is important in promoting evidence-based practices. The authors present a synopsis of important issues in this area and provide support for integrating behavioral health into primary care practice.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"17 2","pages":"427-52"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26123619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Co-occurring disorders of adolescents in primary care: closing the gaps.","authors":"Larke N Huang, Rachel Freed, Rachele C Espiritu","doi":"10.1016/j.admecli.2006.03.004","DOIUrl":"https://doi.org/10.1016/j.admecli.2006.03.004","url":null,"abstract":"<p><p>The increasing prevalence of co-occurring mental health and substance use disorders in adolescents is a serious challenge for the primary care system. The needs of these youth continue to be underrecognized, poorly diagnosed, and inappropriately treated in primary care settings, which are often the first point of contact with the health provider system. This article highlights the need for changes at the clinical, organizational, and policy levels to create a system of care that can effectively identify, refer, treat, and coordinate the care for these adolescents and their families.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"17 2","pages":"453-67"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26123620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Viviana E Horigian, Onelia G Lage, José Szapocznik
{"title":"Cultural differences in adolescent drug abuse.","authors":"Viviana E Horigian, Onelia G Lage, José Szapocznik","doi":"10.1016/j.admecli.2006.03.012","DOIUrl":"https://doi.org/10.1016/j.admecli.2006.03.012","url":null,"abstract":"<p><p>This chapter describes the epidemiology of drug use among adolescents from different racial and ethnic groups. Second, it addresses the cultural variables prevalent in each of these groups and their relevance in the delivery of clinical care. Third, it describes the risks and protective factors for adolescent drug use and their interface with culture and the screening tools available for the pediatrician. Finally, we present the treatment and model programs of prevention that were tested specifically with ethnic groups ranked by the National Registry of Evidence-Based Programs.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"17 2","pages":"469-98"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26123621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kevin M Gray, Himanshu P Upadhyaya, Deborah Deas, Kathleen T Brady
{"title":"Advances in diagnosis of adolescent substance abuse.","authors":"Kevin M Gray, Himanshu P Upadhyaya, Deborah Deas, Kathleen T Brady","doi":"10.1016/j.admecli.2006.03.011","DOIUrl":"https://doi.org/10.1016/j.admecli.2006.03.011","url":null,"abstract":"<p><p>Screening and diagnosis of adolescent substance abuse is a challenging but achievable component of primary care practice. Successful integration of these procedures into office visits requires an understanding of prevalence, risk factors, and strategies for prevention and treatment. The authors provide a synopsis of recent advances and important issues in this area and propose a stepwise, evidence-based approach to evaluation of substance abuse in adolescents.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"17 2","pages":"411-25"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26123618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Individual, family, and group therapy for adolescents.","authors":"Christina M McCann, Pieter le Roux","doi":"10.1016/j.admecli.2005.09.003","DOIUrl":"https://doi.org/10.1016/j.admecli.2005.09.003","url":null,"abstract":"<p><p>The three main psychotherapeutic treatment modalities include individual,family, and group therapies. Many theoretic orientations guide psychotherapists as they try to help adolescents with mental health problems. PCPs play a critical role in initial assessment of mental health symptoms, in addition to coordinating treatment needs. There is a need for increased education regarding mental health treatment for health care providers to help them connect adolescents and their families to appropriate mental health care providers. Integrative approaches that involve more than one treatment modality are often needed to provide the best treatment for adolescents. Better collaborative care not only improves physician understanding of mental health treatment but also improves the mental health provider's understanding of the medical system [30]. This emerging con-text of increased mutual collaborative care builds a better system that serves the adolescent.Web-based resources related to psychotherapy for adolescents American Academy of Child and Adolescent Psychiatry http://www.AACAP.org American Association for Marriage & Family Therapy http://www.AAMFT.org American Psychological Association http://www.APA.org American Psychiatric Association http://www.psych.org National Mental Health Association http://www.NMHA.org National Alliance for the Mentally Ill http://www.NAMI.org</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"17 1","pages":"217-31"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25850613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Consent, competence, and confidentiality related to psychiatric conditions in adolescent medicine practice.","authors":"Amy T Campbell","doi":"10.1016/j.admecli.2005.09.001","DOIUrl":"https://doi.org/10.1016/j.admecli.2005.09.001","url":null,"abstract":"<p><p>Health care for adolescents with psychiatric conditions plays out on a complex stage with considerable state variation, based on a mix of statutory and case law. Added to this are less defined factors such as level of trust in community providers, level of cooperation between generalists and specialists, and local regulatory stances toward adolescent health care and mental health care. And, of course, there is the great diversity in diagnosis and maturity level, as well as family cohesion, from patient to patient (and even within a given patient across time). Finally, this situation resides within a larger environment of stigma vis-a-vis mental health care, most notably evident in the United States in disparate insurance coverage of mental versus physical health treatment. With so complex and varied a picture, clinicians should consult with legal counsel to understand applicable state law and local regulatory guidance (if any)and should also seek out ethical consultation when law does not apply or is not decisive, leaving ongoing concerns. And, as with clinical decision-making, in law and ethics \"facts matter\" [4]. A growing body of law carves out exceptions to general requirements for parental consent, including in mental health care. Ethically informed discussion around capacity determinations, the consent process, and confidentiality can help engage adolescents as \"emerging adults\"while remaining mindful of risky behavior and \"immediate future\" orientation that can be hallmarks of adolescence [30]. Respect for the adolescent, parental responsibility toward their child's best interests, and the family unit generally are paramount. Respect--coupled with caution, greater disclosure and cultural sensitivity, and a participatory approach to decision-making that seeks out the least restrictive and coercive options-can help avoid potential legal traps. How best to proceed? It truly depends-with law and ethics the start (not end) of the discussion and analysis.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"17 1","pages":"25-47"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25851182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Psychopharmacology in adolescent medicine.","authors":"Michael A Scharf, Thomas P Williams","doi":"10.1016/j.admecli.2005.10.004","DOIUrl":"https://doi.org/10.1016/j.admecli.2005.10.004","url":null,"abstract":"<p><p>Psychopharmacology is a challenge for health care providers treating adolescents. A detailed and accurate assessment, including developmental issues relevant to adolescence in general and to the individual adolescent, guides clinicians in formulating thoughtful and effective treatment plans to meet the needs of each patient. Parents play an important role in providing family history regarding psychiatric diagnoses and the response to various drugs, in making decisions to initiate medication and to change a medication regimen, and in monitoring an adolescent's adherence to a prescribed regimen. The role of parents is especially important for younger patients. Following the biopsychosocial model, rarely should psychopharmacologic agents be used as the sole means to treat a psychiatric condition in adolescents. Pharmacologic agents described in this article are tools that have their effect in the biological domain of central neurotransmitters, but psychosocial interventions addressing the emotional and behavioral issues that are the indications for such medication are generally also required. The development of newer medications holds promise for more effective treatment of target symptoms with minimal side effects.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"17 1","pages":"165-81"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25850610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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