Addressing Substance Use in Childhood, Adolescence, and Young Adulthood

Abstract

Substance use and substance use disorder (SUD) are typically developmental problems of pediatric onset. Earlier initiation of substance use predicts a greater likelihood of the progression to a SUD, the severity of the SUD, persistence into adulthood, and a poorer prognosis. Conversely, early intervention predicts an earlier and more favorable response and a better prognosis. Addressing substance use in young persons with developmentally informed approaches should be a core competency for youth-serving providers. Education and prevention for those who have not yet used can prevent initiation, and screening for use, case identification, referral, and treatment can all prevent progression to more advanced stages of substance use. This is analogous to practice in other potentially chronic health conditions. There are core approaches that are applicable for addressing substance use in youth in general across childhood, adolescence, and young adulthood, as well as other approaches that have more specific salience at each of these developmental stages. Fostering open communication and promoting ongoing engagement are especially important. Understanding confidentiality, and also its limitations, is essential for providers. There is also great benefit to providing guidance for parents and caregivers around attitudes, modeling, monitoring, and supervision.