The Treatment and Prevention of Adolescent Opioid and Prescription Misuse and Abuse

The United States is in the midst of ongoing opioid epidemic that is in large part, iatrogenic, meaning that it is associated with overprescribing of opioid analgesics by health care providers (Nelson et al., JAMA 314:1453–1454, 2015). Simultaneously, there is increasing prescribing of benzodiazepines and together, the increasing availability of these medications in American homes is adversely affecting all age groups, including adolescents (i.e., ages 12–21 years old) (Bachhuber et al., American Journal of Public Health 106:686–688, 2016). This chapter will review terminology including the pharmacological effects on persons using these substances, how effects change over time and characteristic withdrawal syndromes, epidemiology of adolescent opioid and benzodiazepine misuse, use disorder, treatment admissions, and associated morbidity such as overdose. Relevant risk factors will be reviewed followed by discussion of effective preventative, harm reduction and treatment approaches. Along the way, we will discuss common myths and misconceptions about prescription opioids and benzodiazepines, and heroin.