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Abstract

Objective:

The authors examined the initial implementation of the Indiana Adolescent Addiction Access (AAA) program, modeled on the widely disseminated Child Psychiatry Access Program framework. The AAA program developed a statewide consultation helpline to connect health care providers with adolescent addiction specialists.

Methods:

The AAA line was staffed by a coordinator, who fielded initial questions, and on-call clinical specialists (social workers, nurse practitioners, psychiatrists, and psychologists), who were paged to complete telephone consultations and provide care recommendations. When necessary, AAA providers offered urgent clinical assessments and initiated treatment. Descriptive analyses were performed for key variables over the first 21 months of AAA operations.

Results:

From July 2021 to March 2023, a total of 125 consultations were completed. Most callers were health care providers (71%) or parents (27%). Calls pertained to youths ages 10–18 years (mean±SD age=16.4±1.3; 62% of callers were male, 84% White, and 11% Black), with concerns around cannabis (63%), opioids (38%), and other substances. About 26% of calls related to an overdose, and 41% of cases were rated as severe. Recommendations included starting new medications (17%) or outpatient therapy (86%), and 17% of consultations resulted in urgent evaluations.

Conclusions:

The Indiana AAA program helps overcome key barriers to adolescent substance use treatment. Increasing the capacity to initiate medication for opioid use disorder and other treatment rapidly through consultation and direct care is a promising, scalable approach for preventing overdose deaths among youths.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 979 - 985
PubMed: 38835252

History

Received: 23 June 2023
Revision received: 24 January 2024
Revision received: 19 February 2024
Accepted: 28 February 2024
Published online: 5 June 2024
Published in print: October 01, 2024

Keywords

  1. Adolescence
  2. Child psychiatry
  3. Drug abuse
  4. Overdoses
  5. Primary care
  6. Consultation

Authors

Details

Zachary W. Adams, Ph.D. [email protected]
Adolescent Behavioral Health Research Program (Adams, Smoker, Marriott, Mermelstein, Aalsma, Hulvershorn), Department of Psychiatry (Adams, Smoker, Marriott, Mermelstein, Ojo, Hulvershorn), and Department of Pediatrics (Aalsma), Indiana University School of Medicine, Indianapolis.
Michael P. Smoker, Ph.D.
Adolescent Behavioral Health Research Program (Adams, Smoker, Marriott, Mermelstein, Aalsma, Hulvershorn), Department of Psychiatry (Adams, Smoker, Marriott, Mermelstein, Ojo, Hulvershorn), and Department of Pediatrics (Aalsma), Indiana University School of Medicine, Indianapolis.
Brigid R. Marriott, Ph.D.
Adolescent Behavioral Health Research Program (Adams, Smoker, Marriott, Mermelstein, Aalsma, Hulvershorn), Department of Psychiatry (Adams, Smoker, Marriott, Mermelstein, Ojo, Hulvershorn), and Department of Pediatrics (Aalsma), Indiana University School of Medicine, Indianapolis.
Sharon P. Mermelstein, B.S.
Adolescent Behavioral Health Research Program (Adams, Smoker, Marriott, Mermelstein, Aalsma, Hulvershorn), Department of Psychiatry (Adams, Smoker, Marriott, Mermelstein, Ojo, Hulvershorn), and Department of Pediatrics (Aalsma), Indiana University School of Medicine, Indianapolis.
Olawale Ojo, M.D.
Adolescent Behavioral Health Research Program (Adams, Smoker, Marriott, Mermelstein, Aalsma, Hulvershorn), Department of Psychiatry (Adams, Smoker, Marriott, Mermelstein, Ojo, Hulvershorn), and Department of Pediatrics (Aalsma), Indiana University School of Medicine, Indianapolis.
Matthew C. Aalsma, Ph.D.
Adolescent Behavioral Health Research Program (Adams, Smoker, Marriott, Mermelstein, Aalsma, Hulvershorn), Department of Psychiatry (Adams, Smoker, Marriott, Mermelstein, Ojo, Hulvershorn), and Department of Pediatrics (Aalsma), Indiana University School of Medicine, Indianapolis.
Leslie A. Hulvershorn, M.D.
Adolescent Behavioral Health Research Program (Adams, Smoker, Marriott, Mermelstein, Aalsma, Hulvershorn), Department of Psychiatry (Adams, Smoker, Marriott, Mermelstein, Ojo, Hulvershorn), and Department of Pediatrics (Aalsma), Indiana University School of Medicine, Indianapolis.

Notes

Send correspondence to Dr. Adams ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

This work was supported by the Indiana Family and Social Services Administration, Division of Mental Health and Addiction of the Substance Abuse and Mental Health Services Administration (grant H79TI083595), and the National Institute on Drug Abuse (grant UG1DA050070).

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