A Practical Clinical Approach to the Treatment of Nicotine Dependence in Adolescents

Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 10/2005; 44(9):942-6. DOI: 10.1097/01.chi.0000170881.94451.14
Source: PubMed
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    ABSTRACT: 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. 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. 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.
    Current Opinion in Pediatrics 09/2006; 18(4):352-8. DOI:10.1097/01.mop.0000236381.33907.9d · 2.53 Impact Factor
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    ABSTRACT: A major proportion of the disease burden and deaths for young people in developed nations is attributable to misuse of alcohol and illicit drugs. Patterns of substance use established in adolescence are quite stable and predict chronic patterns of use, mortality, and morbidity later in life. We integrated findings of systematic reviews to summarise evidence for interventions aimed at prevention and reduction of harms related to adolescent substance use. Evidence of efficacy was available for developmental prevention interventions that aim to prevent onset of harmful patterns in settings such as vulnerable families, schools, and communities, and universal strategies to reduce attractiveness of substance use. Regulatory interventions aim to increase perceived costs and reduce availability and accessibility of substances. Increasing price, restricting settings of use, and raising legal purchase age are effective in reducing use of alcohol and tobacco and related harms. Screening and brief intervention are efficacious, but efficacy of a range of treatment approaches has not been reliably established. Harm-reduction interventions are effective in young people involved in risky and injecting substance use.
    The Lancet 05/2007; 369(9570-9570). DOI:10.1016/S0140-6736(07)60369-9 · 45.22 Impact Factor
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