Pharmacotherapy for adolescent substance misuse

摘要: Adolescence is a critical period for the early identification and treatment of substance misuse. Substance use disorders (SUDs) are developmentally linked phenomena that reach peak prevalence during late adolescence, and early substance use confers heightened risk for a multitude of psychosocial difficulties across the lifespan, including persistent problems with addiction (Johnston, O’Malley, Miech, Bachman, & Schulenberg, 2015; Lubman, Yucel, & Hall, 2007; Swendsen et al., 2012). This heightened vulnerability coincides with nearly 400 youth, ages 12–17 years, admitted to publicly funded substance abuse treatment facilities in the United States each day (National Institute on Drug Abuse, 2014). Despite recognition of the critical need for effective treat-ment options, the best available interventions have limitations. Several psychosocial interventions demonstrate efficacy with youth, including family-focused or systemic approaches, contingency management, cognitive-behavioral therapy (CBT), and motivational enhancement techniques (Bender, Tripodi, Sar-teschi, & Vaughn, 2011; Winters, Tanner-Smith, Bresani, & Meyers, 2014). Yet, despite the modest effectiveness of these interventions, their beneficial effects often fade over time, and many youth do not respond to these treatments (Belendiuk & Riggs, 2014; Bender et al., 2011). Pharmacotherapy is a key component of best-practice treatment guidelines for myriad psychiatric conditions in adolescents. Indeed, the number of ado-lescents prescribed psychotropic medication for many psychiatric conditions increased markedly over the past two decades, with nearly 7% of adolescents …