Substance use among adolescents is pervasive and commonly encountered in primary care pediatrics. According to the most recent Monitoring the Future Study published in 2018, opioid misuse among teens and marijuana use remains stable while vaping device use is climbing to record numbers. The general approach to the assessment and treatment of adolescents with substance use disorders is similar in some respects to adults; however, developmental considerations require an approach tailored to the cognitive, social, and legal status of adolescents.

In this episode we discuss the epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis of substance use and substance use disorder in adolescents with Christian Thurstone, MD.

Dr. Thurstone is the Director of Behavioral and Health Sciences at Denver Health and Professor of Psychiatry at the University of Colorado Denver.

Discussed in this episode:

• HEADSS Screening Tool
• Motivational Interviewing
• Apply for a practitioner waiver to prescribe or dispense buprenorphine under the Drug Addiction Treatment Act of 2000 (DATA 2000) - Office-based treatment for opioid use in patients aged 16 years and above
• How to diffuse tense family situations in the office
  • Show empathy
  • Slow the conversation down
  • Maintain confidentiality
  • Meet with teens and parents separately
  • EPE - Elicit Permission; Provide Advice; Elicit Feedback "What do you think about what I just said?"
• Another good question to ask teens, "What do you already know about....."

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