UTHSC Affiliation
College of Medicine
Department or Division
Preventive Medicine
Document Type
Article
Abstract
Substance use (SU) has long been a significant cause of morbidity and mortality in adolescents and young adults (AYA) worldwide, with the United States (US) accounting for more than half of drug overdoses internationally prior to the COVID-19 pandemic (hereafter, “COVID”).1 In the wake of COVID, however, SU epidemiology has shifted dramatically. Driven by the ubiquity of illicitly-manufactured fentanyl, a high-potency opioid, throughout the illicit drug supply in the US,2 drug-related poisonings and overdoses have become the third leading cause of death among American children and adolescents under 20 and the single leading cause of death in adults under 45.3 SU contributes to over one million emergency department visits per year among AYA,4 and to the other top causes of death in Americans under 20 (i.e., firearm-related injuries and motor vehicle crashes).5 Morbidity and mortality have risen despite adolescent SU declining to among the lowest rates observed in nearly 50 years.6,7 Overall, SU is less common but more hazardous, and clinicians caring for AYA—including physicians, nurses, social workers, clinical psychologists, and other professionals—must be prepared for this shifting landscape in the US and beyond. As fentanyl and its associated overdose burden spread to more and more countries across the globe, clinicians in other countries may also benefit from proactively incorporating SU-related skills into their practice.
Here, we briefly review the evolving epidemiology of AYA SU in the US; review US policy changes impacting SU disorder treatment since COVID’s onset; and provide guidance for clinicians worldwide around having nonjudgmental, meaningful, well-informed SU-related discussions with AYA.
Comments
This is a pre-print version of a commentary published in the Journal of Adolescent Health: https://www.sciencedirect.com/science/article/pii/S1054139X24003859?dgcid=author
DOI: https://doi.org/10.1016/j.jadohealth.2024.07.024