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Substance Use Disorders: Part I, An Issue of Child and Adolescent Psychiatric Clinics of North America, E-Book

Substance Use Disorders: Part I, An Issue of Child and Adolescent Psychiatric Clinics of North America, E-Book

Ray Chih-Jui Hsiao | Leslie Renee Walker

(2016)

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Book Details

Abstract

This issue of the Child and Adolescent Psychiatric Clinics will be Part I of II on Substance Use Disorders. Part I will be edited by Drs. Ray Hsiao and Leslie Walker. They present an overview of prevalence and patterns, the neurobiology of adolescent abuse, and evidence-based prevention. This volume will cover a wide array of substances including, alcohol, cannabis, tobacco, stimulant, opioid, hallucinogens, inhalants, and even internet addiction or abuse, among other topics.


Table of Contents

Section Title Page Action Price
Front Cover Cover
Substance UseDisorders, Part I i
Copyright ii
Contributors iii
CONSULTING EDITOR iii
CONSULTING EDITOR EMERITUS iii
FOUNDING CONSULTING EDITOR iii
EDITORS iii
AUTHORS iii
Contents vii
Preface: Understanding Adolescent Substance Use Disorders in the Era of Marijuana Legalization, Opioid Epidemic, and Social ... vii
Overview on Prevalence and Recent Trends in Adolescent Substance Use and Abuse vii
Neurobiology of Adolescent Substance Use Disorders vii
Genetics of Substance Use Disorders vii
Evidence-Based Prevention for Adolescent Substance Use viii
Assessment and Treatment of Adolescent Substance Use Disorders: Alcohol Use Disorders viii
Cannabis Use Disorder in Adolescence viii
Tobacco Use Disorders viii
Stimulant Use Disorders ix
Opioid Use Disorders ix
Hallucinogen Use Disorders ix
Inhalant Abuse and Dextromethorphan ix
Internet Addiction and Other Behavioral Addictions x
Psychiatric Comorbidity and Complications x
Medical Comorbidity and Complications x
Objective Testing: Urine and Other Drug Tests x
CHILD AND ADOLESCENT\rPSYCHIATRIC CLINICS xii
FORTHCOMING ISSUES xii
October 2016 xii
January 2017 xii
RECENT ISSUES xii
April 2016 xii
January 2016 xii
October 2015 xii
Preface:\rUnderstanding Adolescent Substance Use Disorders in the Era of Marijuana Legalization, Opioid Epidemic, and Social Media xiii
Overview on Prevalence and Recent Trends in Adolescent Substance Use and Abuse 349
Key points 349
PREVALENCE OF ADOLESCENT SUBSTANCE USE 350
ALCOHOL USE 350
TOBACCO USE 350
MARIJUANA USE 352
ILLICIT DRUG USE 352
NONMEDICAL PRESCRIPTION DRUG USE 352
SOCIAL AND DEMOGRAPHIC DIFFERENCES IN SUBSTANCE USE 352
Neurobiology of Adolescent Substance Use Disorders 367
Key points 367
INTRODUCTION 367
REVIEW OF NEUROBIOLOGY OF SUBSTANCE USE 368
ROLE OF NUCLEUS ACCUMBENS 368
BRAIN CHANGES OCCURRING IN ADOLESCENCE 369
FUNCTIONAL IMPLICATIONS OF MATURATION PATTERN 369
NEUROBIOLOGY OF PEER INFLUENCE 370
UNIQUE VULNERABILITY TO STRESS 370
UNIQUE SENSITIVITIES TO THE EFFECTS OF SUBSTANCES OF ABUSE 371
NEUROBIOLOGICAL EFFECTS OF SUBSTANCE USE 371
SUMMARY 372
REFERENCES 372
Genetics of Substance Use Disorders 377
Key points 377
INTRODUCTION 377
FAMILY, TWIN, AND ADOPTION STUDIES 378
GENETIC ARCHITECTURE OF COMPLEX DISEASE 378
METHODS OF GENE DISCOVERY 379
ALCOHOL USE DISORDERS 379
Alcohol Metabolizing Gene Pathways 379
GABAergic System 380
Linkage Studies 380
Genome-wide Association Studies 380
NICOTINE USE DISORDERS 381
Nicotinic Acetylcholine Receptors 381
Cytochrome Enzyme CYP2A6 381
Linkage Studies 381
Genome-wide Association Studies 382
ILLICIT SUBSTANCE USE DISORDERS 382
SUMMARY 382
REFERENCES 383
Evidence-Based Prevention for Adolescent Substance Use 387
Key points 387
THE SCIENCE OF PREVENTING PROBLEMATIC BEHAVIORS 388
RISK FACTORS FOR SUBSTANCE USE 390
Risk Factors for Substance Use in Adolescence 390
Risk Factors for Substance Use in Emerging Adulthood 391
PROTECTIVE FACTORS FOR SUBSTANCE USE IN ADOLESCENCE AND EMERGING ADULTHOOD 395
EVIDENCE-BASED PREVENTION PROGRAMS WITH IMPACT ON SUBSTANCE USE 395
Overview of Prevention Program Development 395
Key Factors in Developing and Implementing Prevention Interventions 396
Effective and Efficacious Prevention Programs 396
Challenges in Prevention 403
FUTURE DIRECTIONS FOR PREVENTION SCIENCE 404
REFERENCES 404
Assessment and Treatment of Adolescent Substance Use Disorders 411
Key points 411
INTRODUCTION 411
EPIDEMIOLOGY 412
Prevalence 412
Risk Factors 413
Biological substrates 413
Neurobiological substrate 413
Temperament risks 413
Genetic factors 413
Gene–environmental interactions 413
Psychiatric disorders and drug use related comorbidities 414
Environmental influences 414
Alcohol expectancies 414
Influence of peer and family 414
Influence of school and work 415
Influence of religion and sports 415
Developmental determinants 415
CLINICAL CONSIDERATIONS 415
Primary Care 415
Critical Care Issues 416
Overdosing 416
Impaired decision making 416
Psychiatric Care 416
Inpatient Care 416
SCREENING AND ASSESSMENT 417
Screening Tools 417
Biomarkers 417
Assessment 418
Diagnostic nosology 419
Confidentiality 419
SUMMARY OF CLINICAL MANAGEMENT 419
Psychotherapy 419
Brief motivational interviewing 420
Twelve steps 420
Cognitive–behavioral therapy 420
Family therapy 420
Integrated care and other therapies 421
Relapse prevention 421
Pharmacotherapy 421
Alcohol withdrawal and detoxification 422
Pharmacologic agents for medication-assisted addiction treatment 422
Aversive therapy 422
Treatment of comorbid conditions 422
Levels of Care 423
Prevention 424
REFERENCES 424
Cannabis Use Disorder in Adolescence 431
Key points 431
INTRODUCTION 431
CLINICAL PRESENTATION AND DIAGNOSIS 432
ADVERSE EFFECTS ASSOCIATED WITH USAGE OF CANNABIS 433
CANNABIS WITHDRAWAL SYNDROME 433
EPIDEMIOLOGY 434
EPIDEMIOLOGY: TRANSITIONAL AGE POPULATION 435
CLINICAL MANAGEMENT: PHARMACOTHERAPY AND BEHAVIORAL MANAGEMENT 436
EPIDEMIOLOGY OF CLINICAL MANAGEMENT 436
BEHAVIORAL MANAGEMENT OF CANNABIS USE DISORDER 437
PHARMACOTHERAPY OF CANNABIS USE DISORDER 439
SYNTHETIC CANNABINOIDS (HERBAL MARIJUANA ALTERNATIVES) 440
MEDICINAL BENEFITS 441
DISCUSSION 441
REFERENCES 442
Tobacco Use Disorders 445
Key points 445
INTRODUCTION/BACKGROUND 445
EPIDEMIOLOGY 446
Cigarette Use 446
Electronic Cigarettes 447
Cigars, Cigarillos, and Little Cigars 449
Smokeless Tobacco 449
Hookah 450
Dual Use and Polytobacco Use 450
Comorbidity with Mental Health or Developmental Disorders 450
Comorbidity with Substance Use Disorders 452
CLINICAL PRESENTATION 452
DIAGNOSIS 452
BRIEF SUMMARY OF CLINICAL MANAGEMENT 453
Behavioral Interventions for Tobacco Use Disorders 454
Pharmacotherapy 454
CONSIDERATIONS WITH CO-OCCURING PSYCHIATRIC DISEASE OR SUBSTANCE USE DISORDERS 456
SUMMARY 457
REFERENCES 457
Stimulant Use Disorders 461
Key points 461
INTRODUCTION AND EPIDEMIOLOGY 461
BRIEF PHARMACOLOGY OF AMPHETAMINE, METHAMPHETAMINE, PRESCRIPTION STIMULANTS, AND COCAINE 462
Amphetamine 462
Methamphetamine 462
Prescription Stimulants 463
Cocaine 463
RISK FACTORS AND ASSOCIATED OUTCOMES 463
BRAIN CHANGES: STRUCTURAL AND NEUROTRANSMISSION 464
CLINICAL PRESENTATION 465
Physiological Symptoms 465
Psychiatric and Neurocognitive Symptoms 465
Cocaine 466
DIAGNOSIS 466
CLINICAL MANAGEMENT 466
Acute Management 466
Long-Term Treatment 467
TREATMENT ISSUES SPECIFIC TO ADOLESCENTS 467
Demographic Features 467
History of in Utero Exposure 467
Misuse and Diversion of Prescription Stimulants 468
SUMMARY 468
REFERENCES 468
Opioid Use Disorders 473
Key points 473
INTRODUCTION/BACKGROUND 473
Etiologic Factors 474
EPIDEMIOLOGY 476
Age 476
Gender and Race 477
Injection Use 478
Morbidity and Mortality 478
CLINICAL PRESENTATION AND COURSE 478
ASSESSMENT AND DIAGNOSIS 479
Overdose 480
Withdrawal 480
TREATMENT 481
Detoxification (Withdrawal Management) 481
Emergency Treatment of Overdose 482
Relapse Prevention Medications 482
CLINICAL CASES 482
Case 1 482
Case 2 483
REFERENCES 483
Hallucinogen Use Disorders 489
Key points 489
INTRODUCTION/BACKGROUND 489
EPIDEMIOLOGY 490
CLINICAL PRESENTATION 491
DIAGNOSIS 492
BRIEF SUMMARY OF CLINICAL MANAGEMENT 493
Hallucinogen Intoxication 493
Hallucinogen Persisting Perception Disorder 494
Hallucinogen Use and Related Disorders 495
REFERENCES 495
Inhalant Abuse and Dextromethorphan 497
Key points 497
INTRODUCTION 497
TYPES OF SUBSTANCES AND PRODUCTS ABUSED 498
Epidemiology 499
CLINICAL PRESENTATION 501
Methods of Inhalation and Absorption and Mechanisms of Action 501
Warning signs and adverse effects 502
SUMMARY: PROVIDER AND PARENT/CLINICIAN GUIDANCE 505
REFERENCES 505
Internet Addiction and Other Behavioral Addictions 509
Key points 509
INTRODUCTION 509
Behavioral Addiction 509
Increasing Use and Misuse of the Internet 510
Aims 510
NEUROBIOLOGY 510
PREVALENCE 511
Risk Factors 512
Comorbidity 512
CLINICAL PRESENTATION 512
ASSESSMENT 513
DIAGNOSIS 513
CLINICAL MANAGEMENT 514
Comorbidity 514
Prevention 514
Psychosocial Interventions 515
Pharmacotherapy 515
SUMMARY 516
REFERENCES 516
Psychiatric Comorbidity and Complications 521
Key points 521
INTRODUCTION 521
COMORBID SUBSTANCE ABUSE AND MENTAL HEALTH DISORDERS 522
Adolescents with Substance Use Disorders 522
Adolescents with Mental Health Disorders 522
Developmental Psychopathology 522
COMORBIDITY AND SUICIDE 523
Assessment 523
Recommendations for assessment 523
Brief clinical interview 523
Brief screening measures 524
Comprehensive assessment 524
Privacy and confidentiality 524
Utilizing assessment results 524
Approaches to Treatment 524
Psychosocial treatments 524
Community and cognitive-behavioral treatments 525
Family-based interventions 525
Pharmacotherapy 526
Medication considerations 526
Recommendations 526
Barriers/obstacles to treatment 527
Treatment integration 527
Patient characteristics 527
Differing outcomes by diagnoses 527
Safety and diversion issues 528
Safety issues 528
Diversion issues 528
PREVENTION 528
SUMMARY 529
REFERENCES 529
Medical Comorbidity and Complications 533
Key points 533
EPIDEMIOLOGY OF SUBSTANCE USE AMONG YOUTH WITH CHRONIC MEDICAL CONDITIONS 534
Asthma 534
Conclusion 535
Conclusion 536
Conclusion 537
Type I Diabetes Mellitus 538
Other Chronic Medical Conditions 538
HOW SUBSTANCES MAY ALTER THE COURSE OF ILLNESS AMONG YOUTH WITH CHRONIC MEDICAL CONDITIONS 538
ROUTINE HEALTH CARE AND SCREENING 541
SUMMARY 542
REFERENCES 542
Objective Testing 549
Key points 549
DRUGS TESTED 550
SOURCES FOR TESTING 550
Urine 551
Blood 554
Oral (Saliva) 554
Hair 555
Breath 555
Sweat 555
Meconium 556
INDICATIONS FOR DRUG TESTING 556
Emergent Care 556
Assessment of Behavioral or Other Mental Health Concerns 556
Substance Use Treatment 557
Other Settings 557
PRACTICAL CONCERNS IN ADOLESCENT DRUG TESTING 558
Adolescent Assent/Parental Consent and Confidentiality 558
Test Selection and Timing 558
Specimen Collection 559
Specimen Validation 560
Interpretation of Results 560
Interpretation of immunoassay tests 561
Interpretation of confirmatory chromatography tests 561
Interpretation of negative tests 561
Presenting drug test results to adolescents 562
SUMMARY 562
REFERENCES 563
Index 567