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The Pediatrician's Role in the Diagnosis and Treatment of Substance Abuse

Elizabeth Meller Alderman MD1
S. Kenneth Schonberg MD2
Michael I. Cohen MD3
 1 Assistant Professor of Pediatrics, Division of Adolescent Medicine, Department of Pediatrics, Albert Einstein College of Medicine/Montefiore Medical Center
2 Professor of Pediatrics and Director, Division of Adolescent Medicine, Department of Pediatrics, Albert Einstein College of Medicine/Montefiore Medical Center
3 Professor and Chairman, Department of Pediatrics, Albert Einstein College of Medicine/Montefiore Medical Center

Abuse of drugs and alcohol is pervasive in our society. The role of the pediatrician as a health-care provider from birth through young adulthood includes recognizing the stigmata in newborns of prenatally ingested drugs as well as being able to treat neonatal drug withdrawal syndromes. Questioning about drug use and other closely related topics should be incorporated into all health-care maintenance visits, starting at the age of 10 y, with parental participation and anticipatory guidance being offered. Physical examination and laboratory testing are not as helpful in confirming an impression of substance abuse as a comprehensive interview and a full appreciation of the warning signs of substance abuse.

Treatment of the problematic user with a multidisciplinary team that understands adolescent development and behavior as well as the problem of substance abuse is crucial. The decision to treat the teen in an ambulatory or inpatient setting is determined by the extent of abuse, underlying medical problems and psychopathology, and the degree of family dysfunction.

The pediatrician must not avoid addressing these issues with patients. If, however, upon identifying an adolescent or a newborn with a drug problem, the pediatrician feels uncomfortable or ill-prepared to manage the patient, appropriate professional referrals are warranted. Despite exercising the referral option for treatment, as advocate for child and family, the pediatrician remains professionally bound to track all drug abuse-related referrals while continuing to participate in the general ongoing care of the patient and family.




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Home page
 PediatricsHome page
Committee on Substance Abuse
Alcohol Use and Abuse: A Pediatric Concern
Pediatrics, July 1, 2001; 108(1): 185 - 189.
[Abstract] [Full Text] [PDF]


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