Adolescent substance use and abuse: current issues.

Substance use and abuse among American adolescents account for significant morbidity and mortality in this age group. A good history is the mainstay in the evaluation, along with the identification of clinical clues of drug use or abuse. Issues of consent and confidentiality should be considered in the assessment, particularly when deciding whether to use drug testing in diagnosis and management. Establishing the patient's stage of substance use can help define the option of either management by the primary care physician or referral to a professional who is experienced in treating chemical dependency. Important research-based principles for prevention programs for children and adolescents include the need for programs to target all forms of drug abuse and to be age-specific, developmentally appropriate, culturally sensitive, and cost-effective.