Substance use disorders (SUD) in adolescents are often complicated by co-occurring psychiatric disorders, especially ADHD. We also note a special relationship between early cannabis use and the onset of schizophrenia. Alcohol use disorder and cannabis use disorder are the most common SUD in adolescents. Opioid use disorders in this population is less common, though, associated with a significant mortality and morbidity risk.
Adolescents are often first exposed to opioids after medical procedures, or from friends or family members who are prescribed opioid pain medications. Their tolerance to opioids is low by virtue of their age, and lack of prior exposure to opioids, and as such, they carry a very high risk of overdose with the mortality rate of at least 1% per year.
It is imperative for any clinician working with adolescents to screen for substance use focusing on the frequency of use as a proxy for risk.
The screen to brief intervention S2BI is a modified SBIRT that is particularly useful for adolescents.
Access “13: Co-occurring Psychiatric Illness and Substance Use in Youth” at: https://pcssnow.org/education-training/training-courses/13-co-occurring-psychiatric-illness-substance-use-youth/
More information can be found here:
https://store.samhsa.gov/product/TIP-31-Screening-and-Assessing-Adolescents-for-Substance-Use-Disorders/SMA12-4079