The gap I want to address in this exercise is the gap between adolescent substance use and the diagnosis of substance use disorder/linkage to substance use treatment.
Adolescence represents a developmental stage in which many health behaviors begin. Several nationwide studies including Monitoring the Future (NIDA) and National Survey of Drug Use and Health (SAMSHA) have identified a decline in tobacco and illicit drug usage among youth; however, a marked increase in marijuana, opiate and electronic nicotine delivery systems (ENDS) usage has been noted. Substance abuse has a major impact on individuals, families, and communities, as its effects are cumulative, contributing to costly social, physical, financial and mental health problems. Thus, early identification and treatment is vital to limiting the morbidity and mortality associated with substance use. Many treatment interventions from the adult literature exist, many of which have been studied and validated in adolescent populations (i.e. school based prevention programs, family based interventions, individual substance abuse counseling/therapy, group therapy and medical treatment). However, despite endorsement from the American Association of Pediatrics and the Society of Adolescent Medicine, the diagnosis of substance abuse disorder and linkage to appropriate care remains underutilized. The gap between usage and linkage to care is likely multifactorial including limited screening in primary care, resistance to treatment due to youth health beliefs and risk perception surrounding substance use, limited experience and comfort in medical management of substance use disorder, and limited substance abuse mental health support.