Youth Substance Use And Abuse: Challenges And Strategies For Identification And Intervention

Jeremy is 17 and has lived on the street for 3 years. He visits the emergency department for the fifth time in the past month reporting chest pain: "My heart's jumping out of my chest. Think I'm having a heart attack or something." He further reports symptoms of anxiety and panic attacks. He admits to using cannabis daily, and cocaine and ecstasy several times a week. The emergency physician takes a few minutes to ask Jeremy about his health concerns. Jeremy says he wants "to know that I'm not crazy." The physician wonders why Jeremy has not visited the substance abuse treatment agency he has been referred to and subsequently allays his fear that he will be "locked up" if he goes for treatment. With Jeremy's permission, the physician leaves a message for a worker at the street youth centre where Jeremy often hangs out. The following week, the worker accompanies Jeremy for an assessment at the treatment agency and to an appointment to see a psychiatrist. With support from the youth centre, Jeremy applies to stay at a group home to stabilize his living situation while he seeks treatment.

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