Division of Adolescent Medicine and Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana.
Division of Adolescent and Young Adult Medicine, Massachusetts General Hospital.
Curr Opin Pediatr. 2023 Aug 1;35(4):408-414. doi: 10.1097/MOP.0000000000001249. Epub 2023 Mar 28.
Adolescent and young adult overdoses and overdose fatalities continue to increase despite reductions in self-reported substance use. This review aims to explore factors contributing to this overdose epidemic, highlight signs of overdose and the role of the overdose reversal medication naloxone, and provide recommendations for practice change to support patients and decrease their risk of unintentional overdose.
The potent opioid fentanyl is a common contaminant in nonopioid substances, as well as in heroin and counterfeit pills, heightening risk of fatal overdose. Adolescents and young adults who die of overdose are rarely engaged in substance use disorder treatment. Medications for opioid use disorder are effective at reducing risk of fatal overdose but are underutilized, as is the opioid reversal medication naloxone.
Pediatric clinician engagement in harm reduction with adolescents and young adults, starting with screening through a confidential interview, may enhance pathways to care and reduce the risk of overdose.
目的综述：尽管自我报告的物质使用有所减少，但青少年和年轻成年人的过量用药和过量用药死亡人数仍在继续增加。本综述旨在探讨导致这一过量用药流行的因素，强调过量用药的迹象和纳洛酮作为过量用药逆转药物的作用，并为支持患者和降低其意外过量用药风险的实践改变提供建议。
最新发现：强效阿片类药物芬太尼是常见的非阿片类物质、海洛因和假药中的污染物，使致命过量用药的风险增加。死于过量用药的青少年和年轻成年人很少接受物质使用障碍治疗。阿片类药物使用障碍的药物治疗在降低致命过量用药风险方面非常有效，但使用率低，阿片类药物逆转药物纳洛酮也是如此。
总结：儿科临床医生与青少年和年轻成年人一起参与减少伤害，从通过机密访谈进行筛查开始，可能会增强获得治疗的途径并降低过量用药的风险。
