Indications for management and referral of patients involved in substance abuse

This statement addresses the challenge of evaluating and managing the vario us stages of substance use by children and adolescents in the context of pe diatric practice. Approaches are suggested that would assist the pediatrici an in differentiating highly prevalent experimental and occasional use from more severe use with adverse consequences that affect emotional, behaviora l, educational, or physical health. Comorbid psychiatric conditions are com mon and should be evaluated and treated simultaneously by child and adolesc ent mental health specialists. Guidelines for referral based on severity of involvement using established patient treatment-matching criteria are outl ined. Pediatricians need to become familiar with treatment professionals an d facilities in their communities and to ensure that treatment for adolesce nt patients is appropriate based on their developmental, psychosocial, medi cal, and mental health needs. The family should be encouraged to participat e actively in the treatment process.