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

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

Ray Chih-Jui Hsiao | Paula D. Riggs

(2016)

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Book Details

Abstract

This issue of the Child and Adolescent Psychiatric Clinics will be Part II of II on Substance Use Disorders. Part II will be edited by Drs. Ray Hsiao and Paula Riggs. This portion will focus more on treatments, recovery, and support considerations for adolescents with substance abuse issues. Topics covered include, but are not limited to: screening brief intervention referral treatment in primary care, family-based interventions, motivational enhancement therapy, school-based interventions, contingency management, pharmacotherapy, treatment for children with co-morbid psychiatric issues, special populations, and integration of system of care.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Substance UseDisorders, Part II i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
CONSULTING EDITOR EMERITUS iii
FOUNDING CONSULTING EDITOR iii
EDITORS iii
AUTHORS iii
Contents vii
Preface: The Changing Landscape of Adolescent Substance Treatment\r vii
Screening, Brief Intervention, and Referral to Treatment\r vii
Family-Based Treatments for Adolescent Substance Use\r vii
Cognitive Behavioral Therapy and Motivational Enhancement Therapy\r vii
Advances in Research on Contingency Management for Adolescent Substance Use\r viii
Meeting Youth Where They Are: Substance Use Disorder Treatment in Schools\r viii
Continuing Care for Adolescents in Treatment for Substance Use Disorders\r viii
The Role of Pharmacotherapy in the Treatment of Adolescent Substance Use Disorders\r viii
Cooccurring Psychiatric and Substance Use Disorders\r ix
Substance Abuse and Trauma\r ix
Substance Use Among College Students\r ix
Technology-based Interventions for Preventing and Treating Substance Use Among Youth\r ix
Integrated Care for Pediatric Substance Abuse\r x
CHILD AND ADOLESCENT\rPSYCHIATRIC CLINICS xi
FORTHCOMING ISSUES xi
January 2017 xi
April 2017 xi
July 2017 xi
RECENT ISSUES xi
July 2016 xi
April 2016 xi
January 2016 xi
Erratum xiii
Preface:\rThe Changing Landscape of Adolescent Substance Treatment xv
Screening, Brief Intervention, and Referral to Treatment 579
Key points 579
INTRODUCTION 579
SCREENING, BRIEF INTERVENTION, REFERRAL TO TREATMENT IN CHILD AND ADOLESCENT PSYCHIATRY 581
SCREENING 582
SCREENING TOOLS 582
BRIEF INTERVENTION 587
No Use: Positive Reinforcement 587
Lower Risk: Brief Advice 588
Moderate Risk: Brief Intervention 588
Severe Risk: Referral to Treatment 589
CHALLENGES TO SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT IMPLEMENTATION 592
SUMMARY 593
REFERENCES 593
Family-Based Treatments for Adolescent Substance Use 603
Key points 603
INTRODUCTION 603
WHY FAMILY-BASED APPROACHES? 604
MULTISYSTEMIC THERAPY 606
Phases of Treatment 606
FUNCTIONAL FAMILY THERAPY 607
Phases of Treatment 607
MULTIDIMENSIONAL FAMILY THERAPY 608
Phases of Treatment 609
BRIEF STRATEGIC FAMILY THERAPY 610
Phases of Treatment 621
OTHER FAMILY THERAPY TREATMENTS 621
SELECTING A TREATMENT 622
SUMMARY 622
REFERENCES 623
Cognitive Behavioral Therapy and Motivational Enhancement Therapy 629
Key points 629
OVERVIEW OF COGNITIVE BEHAVIORAL THERAPY 629
COGNITIVE BEHAVIORAL THERAPY AND SUBSTANCE ABUSE DISORDERS 630
COGNITIVE BEHAVIORAL THERAPY WITH MOTIVATIONAL ENHANCEMENT THERAPY 635
COGNITIVE BEHAVIORAL THERAPY EFFICACY IN ADULTS WITH SUBSTANCE USE 635
COGNITIVE BEHAVIORAL THERAPY EFFICACY IN ADOLESCENTS WITH SUBSTANCE USE DISORDERS 636
ISSUES RELATED TO IMPLEMENTATION 638
Comorbid Diagnoses 638
LIMITATIONS IN TREATMENT 639
IMPLICATIONS FOR CLINICIANS 640
REFERENCES 640
Advances in Research on Contingency Management for Adolescent Substance Use 645
Key points 645
CLINICAL TRIALS TESTING CONTINGENCY MANAGEMENT FOR SUBSTANCE USE DISORDERS 646
Moderators and Mediators 652
Applying Contingency Management to Tobacco Cessation 652
DISSEMINATION AND IMPLEMENTATION OF CONTINGENCY MANAGEMENT FOR ADOLESCENT SUBSTANCE USE 653
Other Indicators of Acceptance of Contingency Management Models 654
CONTINGENCY MANAGEMENT TARGETING OTHER HEALTH BEHAVIORS IN ADOLESCENTS 655
FUTURE DIRECTIONS 655
SUMMARY 656
REFERENCES 657
Meeting Youth Where They Are 661
Key points 661
SCHOOL AS AN IDEAL SETTING FOR MENTAL HEALTH INTERVENTION 661
SCHOOLS OFFER AN OPPORTUNITY TO ADDRESS SIGNIFICANT UNMET NEED FOR TREATMENT 662
SCREENING FOR SUBSTANCE USE DISORDERS IN SCHOOLS 662
INTERVENTIONS: FROM BRIEF INTERVENTION TO INTEGRATED TREATMENT 663
Brief Interventions 663
Randomized, Controlled Trials of Brief Interventions 664
THE NEED FOR MORE ROBUST TREATMENT OF SUBSTANCE USE DISORDERS IN SCHOOLS 664
POTENTIAL BARRIERS TO THE IMPLEMENTATION OF SUBSTANCE ABUSE SERVICES IN SCHOOLS 665
SUMMARY 666
REFERENCES 666
Continuing Care for Adolescents in Treatment for Substance Use Disorders 669
Key points 669
INTRODUCTION 669
RESEARCH ON ADOLESCENT LINKAGE TO CONTINUING CARE SERVICES 671
RESEARCH ON CONTINUING CARE FOR ADOLESCENTS AFTER RESIDENTIAL TREATMENT FOR SUBSTANCE USE DISORDERS 672
Early Studies of Continuing Care 672
Studies of Standard Continuing Care 672
Assertive Continuing Care 673
Research on Continuing Care for Adolescents after Outpatient Treatment for Substance Use Disorders 674
Active Aftercare 674
Assertive Continuing Care 675
ADAPTIVE APPROACHES TO CONTINUING CARE 675
RESEARCH ON OTHER RECOVERY SUPPORTS FOR ADOLESCENTS 676
Volunteer Telephone Continuing Care 676
Mutual Support Groups 677
WHICH ADOLESCENTS BENEFIT MOST FROM CONTINUING CARE? 677
SUMMARY 678
REFERENCES 679
The Role of Pharmacotherapy in the Treatment of Adolescent Substance Use Disorders 685
Key points 685
INTRODUCTION 685
The Role of Pharmacotherapy in the Treatment of Substance Use Disorders 686
Treatment of Adolescents Versus Adults: Developing Brains and Different Pharmacokinetics and Pharmacodynamics 693
PHARMACOTHERAPY FOR ALCOHOL USE DISORDERS 693
Pharmacotherapy for Alcohol Withdrawal Syndrome 694
Benzodiazepines 694
Pharmacotherapy for Maintenance Treatment of Alcohol Use Disorders 694
Naltrexone 694
Disulfiram 695
Ondansetron 695
Topiramate 695
Summary of evidence for alcohol use disorders 696
PHARMACOTHERAPY FOR TOBACCO USE DISORDERS 696
Nicotine Replacement Therapy 696
Bupropion 697
Varenicline 698
Summary of Evidence for Tobacco Use Disorders 699
PHARMACOTHERAPY FOR CANNABIS USE DISORDERS 699
N-Acetylcysteine 699
Topiramate 700
Summary of Evidence for Cannabis Use Disorders 700
PHARMACOTHERAPY FOR OPIOID USE DISORDERS 700
Pharmacotherapy for Opioid Withdrawal Syndrome 701
Clonidine and buprenorphine 701
Pharmacotherapy for Maintenance Treatment of Opioid Use Disorders 701
Methadone 701
Buprenorphine 702
Naltrexone 702
Pharmacotherapy for Opiate Overdose 703
Intranasal naloxone 703
Summary of evidence for Opioid Use Disorders 703
SUMMARY 703
REFERENCES 705
Cooccurring Psychiatric and Substance Use Disorders 713
Key points 713
INTRODUCTION 713
Evidence-Based Adolescent Substance Treatment Interventions 715
PROGRESS TOWARD INTEGRATION OF MENTAL HEALTH AND SUBSTANCE TREATMENT 715
TREATMENT OF DEPRESSION IN ADOLESCENTS WITH SUBSTANCE USE DISORDERS 716
TREATMENT OF ATTENTION DEFICIT HYPERACTIVITY DISORDER IN ADOLESCENTS WITH SUBSTANCE USE DISORDERS 716
IMPLICATIONS FOR CLINICAL PRACTICE, INTEGRATED TREATMENT, AND FUTURE RESEARCH 717
SUMMARY 718
REFERENCES 719
Substance Abuse and Trauma 723
Key points 723
INTRODUCTION 723
EPIDEMIOLOGY 723
CLINICAL PRESENTATION 724
Posttraumatic Stress Disorder 724
Substance Use Disorder 724
POSTTRAUMATIC STRESS DISORDER AND SUBSTANCE USE DISORDER: A BIDIRECTIONAL RELATIONSHIP 725
NEUROBIOLOGY 726
DIAGNOSTIC CONSIDERATIONS 726
TREATMENT OVERVIEW 727
Treatment of Posttraumatic Stress Disorder 727
Treatment of Substance Use Disorder 728
INTEGRATED TREATMENT 728
Barriers to Implementation 729
Treatment Components 729
Integration of Systems 729
Cultural Competence 730
CASE DISCUSSIONS 730
Sebastian 730
Case summary 730
Substance Use Among College Students 735
Key points 735
INTRODUCTION 735
EPIDEMIOLOGY OF SPECIFIC DRUGS IN COLLEGE STUDENTS 736
Alcohol 736
Tobacco 738
Marijuana 738
Illicit Drugs Other than Marijuana 738
Prescription Drugs 738
COMPARING COLLEGE STUDENTS WITH PEERS NOT IN COLLEGE 739
DEVELOPMENTAL AND INDIVIDUAL CORRELATES OF SUBSTANCE USE 739
Transition from High School to College 739
Initiation of Drug Use in College 740
First-year College Students 740
Gender 740
Peer Influence 741
Personality Characteristics 741
Interactions Between Other Psychiatric Conditions and Substance Use 742
Engagement in Other Risky Behaviors 742
SPECIAL POPULATIONS 743
Athletes 743
Fraternity or Sorority Involvement 743
Sexual Minorities 743
Racial and Ethnic Minorities 743
PROTECTIVE FACTORS FOR SUBSTANCE USE IN COLLEGE STUDENTS 744
PREVENTION AND INTERVENTION 744
SUMMARY 746
REFERENCES 746
Technology-based Interventions for Preventing and Treating Substance Use Among Youth 755
Key points 755
INTRODUCTION 755
TECHNOLOGY-BASED UNIVERSAL PREVENTION 756
Primary Care Settings 757
School Settings 758
CLIMATE 758
HeadOn 758
Home Setting 758
TECHNOLOGY-BASED SELECTIVE PREVENTION 759
Medical Settings 759
Primary care 759
Emergency room 759
University Setting 760
Personalized normative feedback and technology 760
Other drugs in university settings 760
TECHNOLOGY-BASED TREATMENT 761
Therapeutic Education System 761
Step Up 761
Identifying Therapeutic Opportunities: Ecological Momentary Assessment 762
Educating and Supporting Inquisitive Youth in Recovery 762
Momentary Self-Monitoring and Feedback Motivational Enhancement 762
SUMMARY AND FUTURE DIRECTIONS 763
REFERENCES 763
Integrated Care for Pediatric Substance Abuse 769
Key points 769
INTRODUCTION: INTEGRATED CARE FOR PEDIATRIC SUBSTANCE ABUSE—TIMELY AND DEFINED 769
THE ROLE OF PEDIATRIC PRIMARY CARE 770
PUTTING INTEGRATION INTO PRACTICE: SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT 771
Screening 772
Brief Intervention 772
Referral to Treatment 772
CHALLENGES AND OPPORTUNITIES 773
Information Exchange 773
Financial Challenges 774
Role Challenges 774
Evidence Base Challenges 774
SUMMARY 775
REFERENCES 775
Index 779