In the contemporary world, substance use has become one of the leading health concerns for the population. Teenagers and young adults are especially vulnerable to substance misuse. Substance use among adolescents can cause long-term health problems or even lead to death. Thus, it is vital to prepare nursing professionals for screening and treating adolescent patients using substances. Among substances, the most common and harmful in case of abuse are synthetic and prescribed opioids. This essay explores the misuse of opioids by adolescents, ethical considerations in screening and treating adolescent patients using opioids, and external stressors contributing to opioid abuse by the youth.
Contemporary adolescents are vulnerable to opioid use since they face numerous external stressors. These include parental and other forms of abuse, family dysfunction, adverse life events, substance use by family members, and trauma (Seney et al., 2020). It is likely that young people who experienced parental abuse, neglect, or any traumatic events, will resort to opioid use if they have no alternative coping mechanisms (Seney et al., 2020). Moreover, substance use is often one of the several outcomes of trauma in adolescents. Commonly it co-occurs with depression, anxiety, and other mental disorders (Seney et al., 2020). These issues can worsen opioid use and vice versa.
When screening for opioid abuse in adolescents, it is possible to use existing tools. One such device is the Problem Oriented Screening Instrument for Teenagers (POSIT) which has a questionnaire and a simplified self-administered computer version (Kelly et al., 2017). It is highly effective in determining substance abuse among young patients (Kelly et al., 2017). POSIT not only identifies the substance use and misuse but also covers the patient’s physical and mental health, family relations, and other factors which can either contribute to or co-occur with opioid abuse. Since POSIT consists of 139 “yes or no” questions, it can seem overwhelming and time-consuming in practice, yet it is highly informative. Another advantage of POSIT is that unlike other screening instruments, such as the effective Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), it targets specifically teenagers. Thus, when assessing adolescents’ substance use, medical professionals can either ask POSIT questions, print out the questioner or let the patient fill out a self-administered version of the screening.
The main ethical issue associated with assessing teenage opioid use is identifying what is appropriate to share with the family. Most importantly, it is crucial to establish a trustworthy relationship with the patient (Seney et al., 2020). Trust between the patient and the nurse may create an opportunity for the reframing of the issue and education. If poor parenting causes opioid use, a nurse might cause more damage by revealing the information about the matter to the parents. Otherwise, if the family situation is healthy, it might help explain the benefits of the family’s help to the patient. The care should be patient-centered, and the nurse should be careful to maintain the patient’s interests and wishes.
Generally, young patients use opioids to deal with some psychological trauma. Thus, it is helpful to recognize the patients’ issues and provide them with adaptive coping mechanisms. Apart from that, it might be necessary to search for co-occurring mental disorders. The care plan should be specific to the patient’s needs and circumstances. Sometimes, it is also useful to work with the patient’s family. Overall, the issue is complex and should be treated as such.
Kelly, S. M., O’Grady, K. E., Gryczynski, J., Mitchell, S. G., Kirk, A., & Schwartz, R. P. (2017). The concurrent validity of the Problem Oriented Screening Instrument for Teenagers (POSIT) substance use/abuse subscale in adolescent patients in an urban federally qualified health center. Substance abuse, 38(4), 382-388.
Seney, V., Insana, J., Alberto, A., & Hay, J. (2020). Opioid training development: Cultivating nurse competence through education. Journal of Child and Adolescent Psychiatric Nursing, 33(3), 141-147.