Medicina (Apr 2022)
Towards an International Consensus on the Prevention, Treatment, and Management of High-Risk Substance Use and Overdose among Youth
- Michael Krausz,
- Jean N. Westenberg,
- Vivian Tsang,
- Janet Suen,
- Martha J. Ignaszewski,
- Nickie Mathew,
- Pouya Azar,
- Maurice Cabanis,
- Julie Elsner,
- Marc Vogel,
- Renske Spijkerman,
- Laura Orsolini,
- Dzung Vo,
- Eva Moore,
- Jessica Moe,
- Johannes Strasser,
- Patrick Köck,
- Calin Marian,
- Kenneth M. Dürsteler,
- Markus Backmund,
- Jeanette Röhrig,
- Marianne Post,
- Hans Haltmayer,
- Wolfgang Wladika,
- Thomas Trabi,
- Christian Muller,
- Gerhard Rechberger,
- Maree Teesson,
- Michael Farrell,
- Grant Christie,
- Sally Merry,
- Mostafa Mamdouh,
- Rachel Alinsky,
- Sharon Levy,
- Marc Fishman,
- Richard Rosenthal,
- Kerry Jang,
- Fiona Choi
Affiliations
- Michael Krausz
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2A1, Canada
- Jean N. Westenberg
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2A1, Canada
- Vivian Tsang
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2A1, Canada
- Janet Suen
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2A1, Canada
- Martha J. Ignaszewski
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2A1, Canada
- Nickie Mathew
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2A1, Canada
- Pouya Azar
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2A1, Canada
- Maurice Cabanis
- Center for Mental Health, Clinic for Addiction Medicine and Addictive Behavior, Klinikum Stuttgart, 70374 Stuttgart, Germany
- Julie Elsner
- Department of Psychiatry, Psychiatric University Clinics Basel, University of Basel, 4002 Basel, Switzerland
- Marc Vogel
- Department of Psychiatry, Psychiatric University Clinics Basel, University of Basel, 4002 Basel, Switzerland
- Renske Spijkerman
- Parnassia Addiction Research Centre (PARC), Brijder Addiction Treatment, Parnassia Group, 2512 The Hague, The Netherlands
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, 60121 Ancona, Italy
- Dzung Vo
- BC Children’s Hospital, Vancouver, BC V6H 3N1, Canada
- Eva Moore
- Division of Adolescent Health and Medicine, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
- Jessica Moe
- Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
- Johannes Strasser
- Department of Psychiatry, Psychiatric University Clinics Basel, University of Basel, 4002 Basel, Switzerland
- Patrick Köck
- Department of Psychiatry, Psychiatric University Clinics Basel, University of Basel, 4002 Basel, Switzerland
- Calin Marian
- Department of Psychiatry, Psychiatric University Clinics Basel, University of Basel, 4002 Basel, Switzerland
- Kenneth M. Dürsteler
- Department of Psychiatry, Psychiatric University Clinics Basel, University of Basel, 4002 Basel, Switzerland
- Markus Backmund
- Praxiszentrum im Tal, 80331 Munich, Germany
- Jeanette Röhrig
- Center for Mental Health, Clinic for Addiction Medicine and Addictive Behavior, Klinikum Stuttgart, 70374 Stuttgart, Germany
- Marianne Post
- Parnassia Addiction Research Centre (PARC), Brijder Addiction Treatment, Parnassia Group, 2512 The Hague, The Netherlands
- Hans Haltmayer
- Suchthilfe Wien, gGmbH, 1060 Vienna, Austria
- Wolfgang Wladika
- Department of Neurology and Psychiatry of Childhood and Adolescence, Klinikum Klagenfurt am Wörthersee, 9020 Klagenfurt, Austria
- Thomas Trabi
- Department for Child and Adolescent Psychiatry and Pschotherapy, LKH Graz II, 8053 Graz, Austria
- Christian Muller
- Department of Child & Youth Psychiatry and Psychotherapy, Psychosocial Service Burgenland GmbH, 7000 Eisenstadt, Austria
- Gerhard Rechberger
- Verein Dialog, Integrative Suchtberatung Gudrunstraße, 1100 Wien, Austria
- Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW 2006, Australia
- Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2031, Australia
- Grant Christie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
- Sally Merry
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
- Mostafa Mamdouh
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2A1, Canada
- Rachel Alinsky
- Division of Adolescent/Young Adult Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Sharon Levy
- Adolescent Substance Use and Addiction Program, Boston Children’s Hospital, Boston, MA 02115, USA
- Marc Fishman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD 21205, USA
- Richard Rosenthal
- Department of Psychiatry and Behavioral Health, Stony Brook University, New York, NY 11794, USA
- Kerry Jang
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2A1, Canada
- Fiona Choi
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2A1, Canada
- DOI
- https://doi.org/10.3390/medicina58040539
- Journal volume & issue
-
Vol. 58,
no. 4
p. 539
Abstract
Background and Objectives: Now more than ever, there is an obvious need to reduce the overall burden of disease and risk of premature mortality that are associated with mental health and substance use disorders among young people. However, the current state of research and evidence-based clinical care for high-risk substance use among youth is fragmented and scarce. The objective of the study is to establish consensus for the prevention, treatment, and management of high-risk substance use and overdose among youth (10 to 24 years old). Materials and Methods: A modified Delphi technique was used based on the combination of scientific evidence and clinical experience of a group of 31 experts representing 10 countries. A semi-structured questionnaire with five domains (clinical risks, target populations, intervention goals, intervention strategies, and settings/expertise) was shared with the panelists. Based on their responses, statements were developed, which were subsequently revised and finalized through three iterations of feedback. Results: Among the five major domains, 60 statements reached consensus. Importantly, experts agreed that screening in primary care and other clinical settings is recommended for all youth, and that the objectives of treating youth with high-risk substance use are to reduce harm and mortality while promoting resilience and healthy development. For all substance use disorders, evidence-based interventions should be available and should be used according to the needs and preferences of the patient. Involuntary admission was the only topic that did not reach consensus, mainly due to its ethical implications and resulting lack of comparable evidence. Conclusions: High-risk substance use and overdoses among youth have become a major challenge. The system’s response has been insufficient and needs substantial change. Internationally devised consensus statements provide a first step in system improvement and reform.
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