Welsh Justine W, Dopp Alex R, Durham Rebecca M, Sitar Siara I, Passetti Lora L, Hunter Sarah B, Godley Mark D, Winters Ken C
Emory University, Atlanta, Georgia.
RAND Corporation Santa Monica, California.
J Am Acad Child Adolesc Psychiatry. 2025 Feb;64(2):123-142. doi: 10.1016/j.jaac.2024.03.010. Epub 2024 Mar 25.
In 2014, the US National Institute on Drug Abuse released the "Principles of Adolescent Substance Use Disorder Treatment," summarizing previously established evidence and outlining principles of effective assessment, treatment, and aftercare for substance use disorders (SUD). Winters et al. (2018) updated these principles to be developmentally appropriate for adolescents. This review builds on that formative work and recommends updated adolescent assessment, treatment, and aftercare principles and practices.
The Cochrane, MEDLINE-PubMed, and PsychInfo databases were searched for relevant studies with new data about adolescent substance use services. This article updates the 13 original principles; condenses the 8 original modalities into 5 practices; and highlights implications for public policy approaches, future funding, and research.
Key recommendations from the principles include integrating care for co-occurring mental health disorders and SUDs, improving service accessibility including through the educational system, maintaining engagement, and addressing tension between agencies when collaborating with other youth service systems. Updates to the treatment practices include adoption of Screening, Brief Intervention and Referral to Treatment (SBIRT), investment in social programs and family involvement in treatment, expanding access to behavioral therapies and medications, increasing funding to harm reduction services, supporting reimbursement for continuing care services, and increasing investment in research.
These revised principles of adolescent assessment, treatment, and aftercare approaches and practices aim to establish guidance and evidence-based practices for treatment providers, while encouraging necessary support from policymakers and funding agencies to improve the standard of care for adolescent SUD services.
In this review article and building upon previous work in this area, the authors describe principles and practices for adolescent substance use treatment and identified areas of treatment in need of further research. The authors also outline recommendations for policy changes and support for funding to implement these principles and practices to further improve the standard of care for adolescent substance use disorders services.
2014年，美国国家药物滥用研究所发布了《青少年物质使用障碍治疗原则》，总结了先前确立的证据，并概述了物质使用障碍（SUD）有效评估、治疗和后续护理的原则。温特斯等人（2018年）对这些原则进行了更新，使其在发育方面更适合青少年。本综述基于这项开创性工作，推荐更新后的青少年评估、治疗和后续护理原则及实践。
在考克兰、医学期刊数据库 - PubMed和心理学文摘数据库中检索有关青少年物质使用服务新数据的相关研究。本文更新了13条原始原则；将8种原始模式浓缩为5种实践；并强调了对公共政策方法、未来资金和研究的影响。
这些原则的主要建议包括整合对共病心理健康障碍和物质使用障碍的护理，通过教育系统等方式提高服务可及性，保持参与度，以及在与其他青少年服务系统合作时解决机构间的紧张关系。治疗实践的更新包括采用筛查、简短干预和转介治疗（SBIRT），投资社会项目以及让家庭参与治疗，扩大行为疗法和药物的可及性，增加对减少伤害服务的资金投入，支持持续护理服务的报销，并增加对研究的投资。
这些修订后的青少年评估、治疗和后续护理方法及实践原则旨在为治疗提供者建立指导和循证实践，同时鼓励政策制定者和资助机构提供必要支持，以提高青少年物质使用障碍服务的护理标准。
在这篇综述文章中，作者基于该领域先前的工作，描述了青少年物质使用治疗的原则和实践，并确定了需要进一步研究的治疗领域。作者还概述了政策变革建议以及对资金支持的需求，以实施这些原则和实践，进一步提高青少年物质使用障碍服务的护理标准。
