Policy on Substance Use by Adolescent Patients

Policy statement

Substance use is a public health problem.¹¹ Advocacy for SUD prevention and interventions across health care disciplines is critical to mitigate the devastating effects of substance use. To this end, AAPD supports

• collaboration between medical and dental providers to address SUD in the pediatric population.
• legislation and public policies that have demonstrated success in reducing the prevalence of SUD among adolescents.
• educational campaigns and programs that raise awareness of the dangers of substance use.
• comprehensive third-party payor coverage for addiction medicine.
• adherence to evidence-based analgesic recommendations in pediatric populations in order to minimize potential for nonmedical prescription medication use.
• additional research to determine safe and effective non-addictive treatment modalities for acute pain

The AAPD recognizes providing dental care to patients with SUD requires awareness of clinical manifestations and may necessitate implementation of alternative treatment approaches. Therefore, the AAPD encourages oral health care professionals to

• gain knowledge of SUD and associated behavioral, physiological, and cognitive effects in adolescents.
• use a specific adolescent medical history documenting past and current substance use and previous treatments for SUD.
• recognize behaviors, clinical signs, and symptoms of adolescent substance use.
• provide brief interventions to educate the adolescent patient and family regarding the risks of substance use.
• provide brief interventions for encouragement, support, and positive reinforcement for avoiding substance use.
• provide referrals to primary care providers or behavioral health or addiction specialists for assessment and/or treatment of adolescents with suspected or confirmed SUD.
• be familiar with community resources, such as self-help groups and treatment facilities, specific to adolescents with SUD.
• be aware of drug interactions to avoid adverse responses when administering medications (eg, local anesthetics with vasoconstrictors, nitrous oxide, sedatives) to a patient having an SUD.
• consider SUD susceptibility when prescribing pain medications with potential for nonmedical use and dependency.
• respect patient confidentiality in accordance with state and federal laws.