ISSUES IN THE PHARMACOLOGICAL TREATMENT OF ADOLESCENT SUBSTANCE-ABUSE

Pharmacotherapy of substance-related disorders (SRD) in adolescents is a neglected therapeutic modality that has only recently shown some progress, primarily in the form of published single case studies and pilot studies. There has been no systemic research evaluating the efficacy and safety of any psychotropic medication in the treatment of adolescents with SRD. Pharmacotherapy for abuse and dependence on nicotine, alcohol, cocaine, and opioids is reviewed, with special emphasis on adolescents' needs and characteristics of their drug use. Marijuana, hallucinogens, inhalants, and polysubstance abuse are not discussed, due to the lack of empirical data on their pharmacotherapy. There is no reason to assume that detoxification protocols should be different in adolescents and adults. No single strategy appears likely to treat all adolescents with SRD, and it seems likely that the cumulative effect of several treatment modalities is better than a single pharmacological intervention. Adolescents give low priority to pharmacotherapy among their SRD treatments. ''Treatment dosage,'' as a summation of the effects of comprehensive treatment modalities based patient-treatment matching, may improve the public understanding of treatment programs.