title: Addressing adolescent substance use in a paediatric health-care setting.
abstract: OBJECTIVE
  The aim of this study is to review the operation of a specialist adolescent drug and alcohol consultation liaison service in a tertiary paediatric hospital.
  
  
  METHODS
  A retrospective review of patient records was conducted to identify patient characteristics and assess service utilisation.
  
  
  RESULTS
  Two hundred adolescents were referred over 4 years. Most presented during mid-adolescence (14-16 years). Alcohol, cannabis and nicotine were the most frequently reported substances, and almost half of referrals involved polysubstance use. Mental health diagnoses and behavioural problems were commonly reported. Almost two-thirds (63.5%) attended an appointment for drug and alcohol assessment and intervention (n = 92) or were referred to appropriate services (n = 35). Adolescents more likely to engage and attend an appointment with the specialist adolescent addiction medicine service included those with amphetamine use, polysubstance use, chronic illness, any mental health diagnosis and mood disorder. Indigenous Australians and those with a history of aggression were more difficult to engage.
  
  
  CONCLUSIONS
  Adolescents present to paediatric health settings with drug- and alcohol-related issues, including associated harms. These comprise, but are not limited to, physical and sexual assault, family conflict, mood and behavioural concerns (including psychosis), and forensic issues. Early intervention aims to reduce long-term risks such as dependence in adulthood. Specialist adolescent drug and alcohol services may assist in identifying and engaging these high-risk and often complex young people in developmentally appropriate treatment.
authors.affiliation: The Department of Adolescent Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
authors.forename: Natalie Lynette
authors.initials: NL
authors.lastname: Phillips
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Milne
authors.forename: Catherine
authors.initials: C
authors.lastname: Silsbury
authors.forename: Popi
authors.initials: P
authors.lastname: Zappia
authors.forename: Anthony
authors.initials: A
authors.lastname: Zehetner
authors.forename: Emily
authors.initials: E
authors.lastname: Klineberg
authors.forename: Susan
authors.initials: S
authors.lastname: Towns
authors.forename: Katharine
authors.initials: K
authors.lastname: Steinbeck
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D001315:Australia / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000379:methods; D012189:Retrospective Studies; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy
keywords: adolescent; alcohol; cannabis; drug abuse; early intervention; treatment