Addiction Prevention in Primary Care (S2:E15)

In the United States, drug overdose deaths exceed 72,000 annually, and some of these substance abuse issues begin with the young adult population. These patients are particularly vulnerable. When compared to an older adult, it is four times easier for an adolescent with a developing brain to become addicted or develop a substance use disorder.

It's clear that addiction prevention in children and teens is an important component of adolescent primary care, but how can physicians most effectively approach substance abuse in young patients? We explore that in today's episode of Charting Pediatrics.

Listen to an adolescent medicine expert discuss addiction prevention in children and teenagers

This episode was recorded live from the 2018 American Academy of Pediatrics (AAP) National Conference and Exhibition in Orlando, Fla. with Leslie R. Walker-Harding, MD, discussing addiction prevention in primary care. Dr. Walker-Harding is the Medical Director of Penn State Children's Hospital.

In this episode, we discuss:

• Why the home is usually the first place that children get exposure to drugs
• The importance of recognizing that the path to addiction is much faster for children and adolescents than adults
• Risk factors that may lead to addiction in children
• How to use the primary care office as a tool for youth addiction prevention
• Why it's so important to talk to parents and children separately
• The effectiveness of asking parents directly about substance abuse
• The impact of the normalization of marijuana on young adolescents
• How to proceed with children and teens who disclose using drugs or alcohol
• The importance of giving parents the right language to talk to their children about topics like drugs and alcohol
• Strategies for breaking the generational use cycle of drugs
• Why intervention for addiction stems back to understanding the parent's history
• How to approach parents about speaking to their child separately
• Safe opioid prescribing practices and alternate treatment plans
• Opportunities in public policy that will be important for the health of kids going forward

Treating substance abuse and addiction in children

Primary care providers are also tasked with determining when kids need anticipatory guidance versus more intensive interventions. As Dr. Walker-Harding explains, pediatricians must first build a foundation of trust by creating a safe space that promotes discussion with both parents and teens. The child's age, reaction to the use of illicit substances and the intensity of use all guide a provider's approach. If generational substance use is a factor, parent intervention programs are incredibly effective, and evidence supports their use.