Recent trends in adolescent substance use, primary care screening, and updates in treatment options.
OBJECTIVE
To provide a brief overview on trends in common substances of abuse in adolescents, a summary of tools to evaluate adolescent substance abuse in an outpatient setting, and an update of outpatient and inpatient treatment options.


RESULTS
Recent national data suggest an overall slight decline in the use of tobacco, crystal methamphetamine, heroin, and club drugs. No significant change was noted in the use of alcohol, marijuana, and cocaine. Yearly screening of all adolescents for substance use is recommended. This can be accomplished in an office setting using mnemonics, structured interview techniques, and brief screens for substance abuse. If a problem is identified, various outpatient and inpatient treatments are available. Individual, family, and group therapy methods are available. Other options include acute detoxification programs, partial hospitalization, acute residential treatment, residential treatment centers and wilderness programs. Pharmacological treatments are available for nicotine, alcohol, and opioid addiction.


CONCLUSIONS
Tobacco, alcohol, marijuana, and other drugs remain a significant problem among adolescents in the United States. Pediatricians should screen and assess all adolescents on a yearly basis. If a problem is identified, there are many options for treatment, including pharmacologic treatment as well as individual, family, or group therapy in an inpatient or outpatient setting.
Fournier
Mary E
ME
Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, Boston, Massachusetts 02115, USA. Mary.Fournier@childrens.harvard.edu
Levy
Sharon
S
D000293:Adolescent; D000553:Ambulatory Care / Q000639:trends; D016739:Behavior, Addictive / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D003376:Counseling / Q000639:trends; D006801:Humans; D011320:Primary Health Care / Q000639:trends*; D015813:Substance Abuse Detection / Q000639:trends*; D016320:Substance Abuse Treatment Centers / Q000639:trends; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D014481:United States / Q000453:epidemiology