The Role of the Pediatrician in Substance Abuse Counseling

Abstract

The past two decades have been marked by both an increasing recognition of the pediatrician's responsibilities toward the adolescent and the emergence of substance abuse as a critical concern for those who care for children and youth. The use and abuse of psychoactive substances have become common even among young adolescents, and the pediatrician must be prepared to address this issue as part of routine health care. In addition, the counsel of the pediatrician regarding substance abuse is often sought by families, schools, and community agencies. Familiarity with the extent and nature of adolescent drug use, as well as the health consequences of such use, has become a necessary part of the body of pediatric knowledge. The pediatrician must possess the skills necessary to determine which young patients are at risk from substance abuse and be able to offer appropriate counseling to the adolescent and his or her family so as to minimize the risk of future illness and dysfunction. The pattern of substance abuse among teenagers has undergone rapid change during the past 15 years. During the late 1960s the abuse of psychoactive drugs, previously a predominantly adult phenomenon, became widespread among adolescents. Opiates, amphetamines, barbiturates, hallucinogens, and inhalants were all used and abused by large numbers of teenagers.1 The use of tobacco in this age group represents a significant health threat, and during the past decade the use of cocaine and other intoxicants, in particular alcohol and marijuana, has increased dramatically among adolescents. These drugs now cause major concern to those who provide health care for teenagers.