Boston Children's Hospital

Eradicating the roots of addiction through prevention and early intervention Highly Ranked

Addiction services

We will establish pediatric addiction medicine (PADM) clinical programs and a physician workforce to implement substance use disorder (SUD) prevention, early intervention, and treatment nationwide.

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

Substance use disorders drive adult addiction and prevent teens from reaching their full potential. Over 90% of adults with addiction used drugs before age 18, though healthcare providers habitually overlook warning signs and almost never intervene. Few physicians have expertise in Pediatric Addiction Medicine resulting in a leadership void and a missed public health opportunity. This effort is among the first to recognize addiction as a pediatric onset chronic illness that can be prevented, ameliorated and treated early in life. Our goal is to improve lives and eliminate addiction at population scale through prevention and early intervention of teen substance use disorders (SUD) by teaching physicians to recognize the vulnerability and resilience of the developing adolescent brain and intervene accordingly. Our objectives are 1) launch adolescent substance use clinical programs based on our established and proven model 2) enlist new programs as training sites for physicians specializing in addiction medicine.

Problem Statement

Substance use disorders (SUD) during adolescence cause problems that derail lives and are antecedent to later addiction. Costs to the US economy are staggering, exceeding any other disease, though expenditures are heavily weighted toward treating adults with chronic, often treatment-resistant disorders and their medical, social and public health sequelae. Treatment for youth SUD is effective but not widely available. There is little focus on prevention and early intervention during childhood and adolescence while the brain is still very malleable and future addiction can be avoided. Teen substance use is common - 1 in 7 children start substance use in middle school and 1 in 3 by 10th grade - but problems are often unrecognized. For example, a 6th grader using vapes may be labelled as “experimenting”, but in real danger of serious problems. A college freshman who binge drinks may not be addicted to alcohol but can suffer serious consequences. A teen prescribed opioids may eventually lose control over use. A sexual assault survivor may use marijuana to block out painful memories, not recognizing that drug use worsens anxiety. These problems frequently present in some form to healthcare professionals, though their significance is often overlooked, misinterpreted or ignored. Difficulty managing substance use problems is consistently among the top concerns reported by pediatricians, and fewer than 10% of adolescents who need treatment receive any. We can take better care of our youth by building clinical programs and training physician specialists who will guide practice, research and policy.

Solution Overview

This project will spread the ASAP clinical and training models to academic medical centers across the US. For nearly 20 years, ASAP has honed evidence based therapies into an effective developmentally-tuned, family-oriented, treatment program with research-proven results that has sparked national interest. Our solution will replicate this model, providing direct services to teens and fostering a field of specialist physicians to promote effective prevention, provide care, write guidelines, teach colleagues, conduct research, engage communities and advocate for the interests of their patients, thereby shaping the practice of medicine nationally. The National Committee for Quality Assurance has published quality measures that specify appropriate care for adolescent substance use, though few healthcare systems meet targets. New clinical programs will be attuned to quality measures and trainees will learn, and later teach, these practices. We will demonstrate improvements across our sites within 5 years. By creating clinical programs tailored to local needs this project has immediate impact on communities. Fostering a new medical specialty serves the longer term goal of sustainable, national dissemination of best practices. At each institution, specialists will impact physician training from medical school through residency – enshrining the core concepts of PADM beyond specialty practice into primary care.The primary beneficiaries are adolescents. Young people at risk for SUD, looking for, or referred to help, will have access to professional advice, guidance, and treatment from an informed healthcare workforce. Helping our teens mature into healthy adults benefits everyone. Preventing future epidemics of addiction improves quality of life in the

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Project Funders

  • The Conrad N. Hilton FOundation 2013 - 2021
  • Substance Abuse and Mental Health Services Administration 2018 - 2023
  • The American Board of Addiction Medicine 2011 - 2018

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