Adolescent substance abuse

Substance use and experimentation are common in adolescents. It is important for the pediatrician to educate children and their parents about the dangers of such use and potential abuse, starting at an early age. The best way to assess if an adolescent is abusing alcohol or drugs is by a careful, confidential interview. Most adolescents simply need to be warned of the consequences of experimentation, the risks of driving while intoxicated, unsafe sex, and violent situations that may arise when they are under the influence of alcohol or drugs. For the adolescent with problematic alcohol or substance abuse, the pediatrician must decide whether to treat the patient and family alone or in coordination with a mental health professional or to refer the patient to a physician with greater expertise in substance abuse. If the adolescent is displaying self-destructive behavior, signs of withdrawal, has run away, lives in a nonsupportive family situation, has a serious psychiatric illness, or has failed outpatient treatment, inpatient care is warranted in either a hospital-based or a residential treatment program.