Benefitting Brad: An Interprofessional Case of Adolescent Substance Use and ADHD

Abstract

Abstract Introduction Adolescents with attention deficit hyperactivity disorder (ADHD) are more likely to try alcohol and other drugs earlier than their peers, and they are also more likely to develop a substance use disorder. Additionally, medications used to treat ADHD have abuse potential and may be diverted. Given that adolescents with ADHD will present to different providers for care (e.g., mental health, nutrition, medical), all providers in an interprofessional team should consider screening patients for substance use in addition to the nutritional, physical, and cognitive issues associated with ADHD and its treatment. Methods This resource is a case presentation in four sessions. Materials include a list of assigned readings, modules to be assigned and/or utilized during case sessions, a motivational interviewing exercise to be used during Case Session 4, and an instructor's guide. The case evolves over each session to facilitate learners' development of skills in the screening, assessment, management, and treatment of substance use and ADHD, highlighting the strengths of different specialties of the interprofessional team. Results Over the past 3 academic years starting in 2013, we have successfully implemented this case with three cohorts of interprofessional postgraduate health care professionals training in adolescent health. On standard pre− and postcase ratings, using 4-point Likert scales, we found an increase in learners' confidence in their ability to identify, counsel, and treat ADHD and substance use problems among adolescents. Learners also reported that the case experience improved their understanding of the role of a medical doctor, nurse practitioner, nutritionist, psychologist, and social worker in the care of adolescents with ADHD and substance abuse. Discussion We developed this case to provide an opportunity for learners to explore challenges common to the clinical management of substance use and ADHD while also providing exposure to current trends and evidence in ADHD and adolescent substance use. The case introduces learners to aspects of program development and allows them to identify opportunities for advocacy and leadership.

Keywords

• Screening
• Substance-Related Disorders
• Motivational Interviewing
• Brief Intervention
• SBIRT
• Adolescent Health