title: Adolescent substance use and abuse: recognition and management.
abstract: Substance abuse in adolescents is undertreated in the United States. Family physicians are well positioned to recognize substance use in their patients and to take steps to address the issue before use escalates. Comorbid mental disorders among adolescents with substance abuse include depression, anxiety, conduct disorder, and attention-deficit/ hyperactivity disorder. Office-, home-, and school-based drug testing is not routinely recommended. Screening tools for adolescent substance abuse include the CRAFFT questionnaire. Family therapy is crucial in the management of adolescent substance use disorders. Although family physicians may be able to treat adolescents with substance use disorders in the office setting, it is often necessary and prudent to refer patients to one or more appropriate consultants who specialize specifically in substance use disorders, psychology, or psychiatry. Treatment options include anticipatory guidance, brief therapeutic counseling, school-based drug-counseling programs, outpatient substance abuse clinics, day treatment programs, and inpatient and residential programs. Working within community and family contexts, family physicians can activate and oversee the system of professionals and treatment components necessary for optimal management of substance misuse in adolescents.
authors.affiliation: State University of New York at Buffalo School of Medicine and Biomedical Sciences, Department of Family Medicine, Buffalo, New York 14215, USA. griswol@buffalo.edu
authors.forename: Kim S
authors.initials: KS
authors.lastname: Griswold
authors.forename: Helen
authors.initials: H
authors.lastname: Aronoff
authors.forename: Joan B
authors.initials: JB
authors.lastname: Kernan
authors.forename: Linda S
authors.initials: LS
authors.lastname: Kahn
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000553:Ambulatory Care; D001007:Anxiety / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D015897:Comorbidity; D019955:Conduct Disorder / Q000453:epidemiology; D003219:Confidentiality; D003376:Counseling; D003863:Depression / Q000453:epidemiology; D003937:Diagnosis, Differential; D005194:Family Practice; D005196:Family Therapy; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D012017:Referral and Consultation; D012114:Residential Treatment; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D013406:Suicide, Attempted / Q000517:prevention & control; D011795:Surveys and Questionnaires