Screening for alcohol abuse and illicit drug use needs to be a standard procedure in any practice that cares for adolescents and young adults. Recent national surveys indicate that prescription pain relievers have replaced marijuana as the most common entry drugs for adolescents beginning to experiment with drugs. In this chapter, we review appropriate screening tools and management approaches for use in this population. We cover standard treatment options with a focus on the treatment of adolescents dependent on heroin or opioid pharmaceuticals and the promising role of buprenorphine in the treatment of this high-risk population. A case is presented at the end of this chapter, including related questions for additional consideration. Epidemiology Opioid abuse among adolescents is a growing problem in the United States. According to data from the National Institute on Drug Abuse’s Monitoring the Future study, use of “narcotics other than heroin” has doubled among high school students since the year 2000, with marked increases in the use of long-acting oxycodone tablets and hydrocodone-acetaminophen combination tablets. In 2007, the annual prevalence for oxycodone and hydrocodone use reached its highest level Read more […]
Archive for category Buprenorphine'
Non-Opioid-Dependent Teens Primary Prevention When prescribing opioid medications, clinicians should provide anticipatory guidance. Teens and parents should be advised that although pain medications are highly effective and safe when used as prescribed, they are also highly addictive and can be dangerous when misused. Parents should monitor use to ensure that medications are always used as directed. Any leftover medication should be discarded by returning it to the pharmacy. Medications should never be shared or given to anyone other than the patient for whom the prescription was written. Pain medication can be safe for use even in patients with substance use disorders, and pain should not be left untreated because of a history of substance abuse or dependence. However, in these situations clinicians should require increased supervision and monitoring to avoid misuse. Parents should be asked to hold, dispense, and observe all medication doses. When treating chronic pain the clinician should insist on the patient receiving all prescriptions from a single prescriber, open communication among all treating physicians, and use of a single pharmacy to fill all prescriptions. A parent should bring in remaining medication Read more […]