Practice parameter for the assessment and treatment of children and adolescents with substance use disorders.

Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 6.35). 07/2005; 44(6):609-21.
Source: PubMed

ABSTRACT This practice parameter describes the assessment and treatment of children and adolescents with substance use disorders and is based on scientific evidence and clinical consensus regarding diagnosis and effective treatment as well as on the current state of clinical practice. This parameter considers risk factors for substance use and related problems, normative use of substances by adolescents, the comorbidity of substance use disorders with other psychiatric disorders, and treatment settings and modalities.

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Available from: William Bernet, Aug 09, 2015
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    • "Substance abuse requires evidence of a maladaptive pattern of substance use with clinically significant levels of impairment or distress (e.g., significant problems in life's major domains, including school, family, or the community) (Bukstein et al., 2005). Substance dependence is more serious in that it requires ''a substantial degree of involvement with a substance as evidenced by the adolescent's meeting at least three criteria from a group of seven criteria'' (Bukstein et al., 2005, p. 3) which include withdrawal, tolerance, loss of control, repeated unsuccessful attempts to quit, much time spent obtaining, using, and recovering, giving up important activities to use, and continued use despite knowledge of adverse consequences (American Psychiatric Association, 2000). "
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    • "Moreover, within the adolescent drug treatment literature, different treatment approaches have shown some positive results (including cognitive behavior therapies, contingency management, multidimensional family therapy, multisystemic therapy, residential treatment and 12-step methods), but no one treatment modality has proved to be consistently superior (Dennis et al., 2005; Morral et al., 2006). Accordingly, rather than advocate for one particular treatment modality, several groups, including the National Institute on Drug Abuse (2006) and the American Academy of Child and Adolescent Psychiatry (Bukstein et al., 2005), have described a set of elements that are thought to define high quality treatment and thus constitute " best practices " or " quality elements " (Drug Strategies, 2005). For example, the NIDA (2006) principles of drug treatment for criminal justice populations note that treatment must last long enough to produce stable changes, and that those with severe drug problems or cooccurring disorders usually require treatment that lasts at least three months. "
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    • "The clinical challenge is to slow or halt the progression of early stage problems before these destructive behavioral patterns become ingrained and highly resistant to change (Loeber & Farrington 1998). This is best accomplished by intervening at the earliest stages of prob­ lems to reduce risk and promote protective factors in as many fu nctional domains as possible (Bukstein 1998). For these reasons, policymakers, researchers, and clinicians agree that early adolescence is a critical period for inter­ ventions to reduce early-stage drug use and delinquency (Lynam 1996; Lerner 1993). "
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