The expansive piece of work aims to start a much-needed dialogue within the medical community about treatment for young adult substance misuse
By William Wagner
February 4, 2021No one can accuse Scott Hadland, M.D., MPH, MS, and his far-flung band of pediatric addiction medicine experts of skimping on their subject matter. But even though their efforts in the realm of substance use disorder (SUD) among young adults (ages 18 to 25) wound up being a heavy lift, they wouldn’t have done it any other way.
There are significant cognitive and developmental changes taking place during young adulthood that need to be considered when determining how best to address substance use disorder in this unique patient population.”—Scott Hadland, M.D., MPH, MS, co-author of “Principles of Care for Young Adults with Substance Use Disorders” and pediatric addiction specialist at the Grayken Center for Addiction at Boston Medical Center
Last month their “Principles of Care for Young Adults with Substance Use Disorders” was published in the journal Pediatrics. Mind you, this isn’t some run-of-the-mill guidebook. It has the bulk of a Dostoevsky tome, weighing in with 11 different peer-reviewed papers. The topic, Hadland believes, deserves nothing less than what he and his colleagues from around the country put into it.
“There are significant cognitive and developmental changes taking place during young adulthood that need to be considered when determining how best to address substance use disorder in this unique patient population,” Hadland, a pediatric addiction specialist at the Grayken Center for Addiction at Boston Medical Center and the first and co-author on several of the papers, said upon the work’s publication. “We must incorporate, at every opportunity, a way to reduce harm and consequences of use, and address any compounding health conditions that factor into their ability to realize recovery.”
Our goal in publishing this supplement is to bring attention to the unique needs and challenges faced by this age group, and highlight the opportunities to best address these needs in order to lead to improved outcomes.”—Michael Silverstein, M.D., co-author of “Principles of Care for Young Adults with Substance Use Disorders” and associate chief medical officer for research and population health at Boston Medical Center
Young Adults and Substance Misuse
According to the introduction to the papers, young adults “use substances at higher rates than any other age group in the United States, and they face higher burdens of illness, including injury, infection, and overdose, that result from using substances.” The authors add that, inexplicably, there has been relatively little research conducted on the plights of young adults with SUD, which is part of what inspired the sprawling exploratory project.
“Our goal in publishing this supplement is to bring attention to the unique needs and challenges faced by this age group and highlight the opportunities to best address these needs in order to lead to improved outcomes,” said Michael Silverstein, M.D., associate chief medical officer for research and population health at Boston Medical Center and a central player in bringing together the research group of 60-odd individuals. “We hope that this will start the much-needed dialogue within the medical community about young adult addiction medicine and lead to the development of recommendations and treatment guidelines specific to the needs of these patients.”
Ambitious Goals for Principles Project
In addition to outlining theories about SUD treatment for young adults, the project seeks to inform the views of and motivate policymakers. Six principles of care serve as the work’s pillars:
- ONE: “Evidence-Based Treatment of Young Adults with Substance Use Disorders”
- TWO: “Engaging the Family in the Care of Young Adults with Substance Use Disorders”
- THREE: “Support Services for Young Adults with Substance Use Disorders”
- FOUR: “Principles of Care for Young Adults with Co-Occurring Psychiatric and Substance Use Disorders”
- FIVE: “Principles of Harm Reduction for Young People Who Use Drugs”
- SIX: “The Justice System and Young Adults with Substance Use Disorders”
As the character Holden Caulfield—an enduring symbol of youth angst—says in J.D. Salinger’s novel The Catcher in the Rye, “Every time I came to the end of a block and stepped off the goddam curb, I had this feeling that I’d never get to the other side of the street.” The group that put together “Principles of Care for Young Adults with Substance Use Disorders” is here to help as many of the world’s Holden Caulfields as possible get to the other side of the street.
Photo: Lucas Lenzi
