14
Treatment
Population-Specific Considerations
Adolescents and Young Adults
Adolescent and Young Adult Assessment and Treatment Planning
29. Clinicians should avoid routine drug testing to screen adolescents
and young adults for StUD (CC-S).
a. When considering drug testing in patients under the age of 18, clinicians should
ask patients for permission to test, even if parental/guardian consent was given,
unless obtaining assent is not possible (eg, loss of consciousness; CC-S).
30. Clinicians should pay particular attention to signs or symptoms of ADHD
and eating disorders in adolescent and young adult patients (CC-S).
31. If available, clinicians should refer adolescent and young adult
patients to age-specific treatment and support programs to address
identified biopsychosocial needs (CC-S).
Adolescent and Young Adult Treatment
32. When treating adolescents and young adults for StUD, clinicians should:
a. consider delivering behavioral interventions that have been demonstrated to
be effective in the treatment of other SUDs in adolescents and young adults
(eg, contingency management, cognitive behavioral therapy, community
reinforcement approach, family therapy) and in the treatment of StUD in
adults (eg, contingency management, cognitive behavioral therapy, community
reinforcement approach; L-S);
b. use an adolescent- and young adult-specific treatment model (eg, adolescent
community reinforcement approach) or tailor existing treatments to be
developmentally responsive (M-S);
c. use peer-age groups for behavioral treatment in group formats when possible
and avoid incorporating adolescents and young adults into group behavioral
treatment with older adults (VL-S);
d. consider treating adolescents and young adults with StUD with the off-
label pharmacotherapies detailed in the Pharmacotherapy section when the
developmentally contextualized benefits outweigh the harms (VL-W);
e. counsel parents/guardians to not conduct home drug tests to assess stimulant use in
adolescents and young adults without the oversight of a trained clinician (CC-S);
f. recognize that involvement of family members is often beneficial in the
treatment of adolescents and young adults with SUDs and involve family
members and/or trusted adults when appropriate (CC-S);
g. be familiar with state laws* on adolescents' ability to consent to treatment
when treating minors under age 18; in some states, minors can proceed with
treatment without involvement of a parent or legal guardian in their care,
whereas in other states, parental/guardian consent may be required before
proceeding with some or all aspects of treatment (CC-S); and
h. understand that while parental/guardian consent is not required for treatment
of young adults, clinicians should initiate a conversation with the young adult
patient about whether their treatment plan might be enhanced by involving a
trusted adult (CC-S).
* https://publications.aap.org/pediatrics/article/149/6/e2021053458/187003/State-
by-State-Variability-in-Adolescent-Privacy
