Grayken Center for Addiction and Department of Pediatrics, Boston Medical Center, Boston, Massachusetts;
Division of General Pediatrics, Department of Pediatrics, School of Medicine, Boston University, Boston, Massachusetts.
Pediatrics. 2021 Jan;147(Suppl 2):S204-S214. doi: 10.1542/peds.2020-023523D.
In summarizing the proceedings of a longitudinal meeting of experts in substance use disorders (SUDs) among adolescents and young adults, in this special article, we review principles of care related to SUD treatment of young adults. SUDs are most commonly diagnosed during young adulthood, but most of the evidence guiding the treatment of this population has been obtained from older adult study participants. Extrapolating evidence from older populations, the expert group asserted the following principles for SUD treatment: It is important that clinicians who work with young adults effectively identify and address SUD to avert long-term addiction and its associated adverse health outcomes. Young adults receiving addiction treatment should have access to a broad range of evidence-based assessment, psychosocial and pharmacologic treatments, harm reduction interventions, and recovery services. These evidence-based approaches should be tailored to young adults' needs and provided in the least restrictive environment possible. Young adults should enter care voluntarily; civil commitment to treatment should be a last resort. In many settings, compulsory treatment does not use evidence-based approaches; thus, when treatment is involuntary, it should reflect recognized standards of care. Continuous engagement with young adults, particularly during periods of relapse, should be considered a goal of treatment and can be supported by care that is patient-centered and focused on the young adult's goals. Lastly, substance use treatments for young adults should be held to the same evidence and quality standards as those for other chronic health conditions.
在总结青少年和年轻成年人物质使用障碍（SUD）专家的纵向会议记录时，在这篇特别文章中，我们回顾了与年轻成年人 SUD 治疗相关的护理原则。SUD 最常被诊断于年轻成年人时期，但指导该人群治疗的大部分证据均来自老年参与者的研究。专家组从老年人群的证据中推断出以下 SUD 治疗原则：临床医生在识别和治疗 SUD 时，务必要有效地避免长期成瘾及其相关的不良健康后果。接受成瘾治疗的年轻人应能够获得广泛的基于证据的评估、心理社会和药物治疗、减少伤害干预措施和康复服务。这些基于证据的方法应根据年轻人的需求进行调整，并在尽可能少限制的环境中提供。年轻人应自愿接受治疗；治疗的民事强制应是最后的手段。在许多情况下，强制性治疗不采用基于证据的方法；因此，在治疗是强制性的时候，它应该反映出公认的护理标准。与年轻人持续接触，尤其是在复发期间，应被视为治疗的目标，可以通过以患者为中心并关注年轻人目标的护理来支持。最后，针对年轻人的物质使用治疗应与其他慢性健康状况一样，符合证据和质量标准。
