Adams Zachary W, Smoker Michael P, Marriott Brigid R, Mermelstein Sharon P, Ojo Olawale, Aalsma Matthew C, Hulvershorn Leslie A
Adolescent Behavioral Health Research Program (Adams, Smoker, Marriott, Mermelstein, Aalsma, Hulvershorn), Department of Psychiatry (Adams, Smoker, Marriott, Mermelstein, Ojo, Hulvershorn), and Department of Pediatrics (Aalsma), Indiana University School of Medicine, Indianapolis.
Psychiatr Serv. 2024 Oct 1;75(10):979-985. doi: 10.1176/appi.ps.20230289. Epub 2024 Jun 5.
The authors examined the initial implementation of the Indiana Adolescent Addiction Access (AAA) program, modeled on the widely disseminated Child Psychiatry Access Program framework. The AAA program developed a statewide consultation helpline to connect health care providers with adolescent addiction specialists.
The AAA line was staffed by a coordinator, who fielded initial questions, and on-call clinical specialists (social workers, nurse practitioners, psychiatrists, and psychologists), who were paged to complete telephone consultations and provide care recommendations. When necessary, AAA providers offered urgent clinical assessments and initiated treatment. Descriptive analyses were performed for key variables over the first 21 months of AAA operations.
From July 2021 to March 2023, a total of 125 consultations were completed. Most callers were health care providers (71%) or parents (27%). Calls pertained to youths ages 10-18 years (mean±SD age=16.4±1.3; 62% of callers were male, 84% White, and 11% Black), with concerns around cannabis (63%), opioids (38%), and other substances. About 26% of calls related to an overdose, and 41% of cases were rated as severe. Recommendations included starting new medications (17%) or outpatient therapy (86%), and 17% of consultations resulted in urgent evaluations.
The Indiana AAA program helps overcome key barriers to adolescent substance use treatment. Increasing the capacity to initiate medication for opioid use disorder and other treatment rapidly through consultation and direct care is a promising, scalable approach for preventing overdose deaths among youths.
作者研究了印第安纳青少年成瘾接入(AAA)项目的初步实施情况,该项目以广泛传播的儿童精神病接入项目框架为蓝本。AAA项目设立了一条全州范围的咨询热线,以便将医疗保健提供者与青少年成瘾专家联系起来。
AAA热线配备了一名协调员,负责接听初步咨询,还有随叫随到的临床专家(社会工作者、执业护士、精神科医生和心理学家),他们会被呼叫来完成电话咨询并提供护理建议。必要时,AAA的提供者会进行紧急临床评估并启动治疗。对AAA运营的前21个月的关键变量进行了描述性分析。
从2021年7月到2023年3月,共完成了125次咨询。大多数来电者是医疗保健提供者(71%)或家长(27%)。来电涉及10至18岁的青少年(平均年龄±标准差年龄=16.4±1.3;62%的来电者为男性,84%为白人,11%为黑人),涉及大麻(63%)、阿片类药物(38%)和其他物质。约26%的来电与过量用药有关,41%的病例被评为严重。建议包括开始使用新药物(17%)或门诊治疗(86%),17%的咨询导致了紧急评估。
印第安纳AAA项目有助于克服青少年物质使用治疗的关键障碍。通过咨询和直接护理迅速提高启动阿片类药物使用障碍及其他治疗的药物治疗能力,是预防青少年过量用药死亡的一种有前景、可扩展的方法。