Nicotine and Stimulant Use in Adolescents-Presentation

Video Transcription

Video Summary

Dr. Nicholas Chaddy, a pediatrician specializing in adolescent addiction medicine, presents an overview of nicotine and stimulant use among adolescents, focusing on trends, health risks, and evidence-based treatments. He highlights that e-cigarettes have become the predominant nicotine delivery method in youth, surpassing traditional cigarettes, cigars, and other tobacco products. E-cigarettes deliver nicotine efficiently through aerosols containing various harmful chemicals, posing risks including addiction, lung injury (such as EVALI), and adverse effects on the developing brain, particularly in reward and executive function regions.<br /><br />Screening tools like the S2BI aid in assessing adolescent substance use risk, enabling brief counseling and referral interventions. Behavioral counseling, involving motivational interviewing and family support, is essential, and nicotine replacement therapy (NRT) is endorsed for adolescents using nicotine regularly, with combined long- and short-acting forms preferred. However, e-cigarettes are not recommended as cessation tools for youth due to risks of dual use and subsequent substance use.<br /><br />Illicit stimulant use (cocaine, methamphetamine, MDMA) among adolescents has declined, though prescription stimulant misuse remains stable. There are no FDA-approved medications for stimulant use disorder; treatment relies on behavioral therapies such as cognitive behavioral therapy and contingency management.<br /><br />Caffeine use in adolescents is widespread and increasing, with risks of addiction, heightened sensitivity to other drugs, and potential overdose from high doses or powders.<br /><br />Key messages emphasize nicotine’s harmful effects on adolescent brain development, the need for comprehensive screening and counseling, cautious stimulant prescribing for ADHD, and awareness of caffeine risks.

Keywords

adolescent addiction medicine

nicotine use

e-cigarettes

lung injury

S2BI screening tool

nicotine replacement therapy

stimulant use disorder

behavioral therapy

caffeine risks