Overview Adolescence is a time of subtle,

Overview Adolescence is a time of subtle, yet dynamic brain changes that occur in the context of major biological and psychosocial factors. This juncture marks a gradual shift from guided to independent functioning. Increased tendencies toward risk-taking and heightened vulnerability to psychopathology are well known within the adolescent milieu. Adolescence is a developmental period characterized by suboptimal decisions and actions that give rise to an increased incidence of unintentional injuries and violence. The unique characteristics of adolescent brain development, particularly aspects that predispose individuals to reward seeking and risky choices during this phase of life, create diagnostic challenges for clinicians. The introduction of substances on the developing brain can result in premature psychopathology. Nicholas is a14-year-old boy in the ED. He was brought in by school after he was seen pacing the playground on his own, mumbling and incoherent at times when approached by high school staff. His parents arrive shortly after the ambulance leaves, and report Alex has been quiet and a little irritable the past few weeks. It’s difficult to get him to talk. His parents tell you he hasn’t been sleeping at all for the last few nights and just staying in his room. He refuses to move onto the hospital stretcher shouting ‘let me leave.’ Tasks: How would you differentiate normal adolescent behavior from possible substance abuse or addiction? Describe nursing management for the care of an adolescent abusing substances. Include therapeutic communication approaches helpful with the adolescent client. What neural and behavioral profiles render youth at heightened risk for substance use problems? Discuss the influence of substance use on neuromaturation as well as probable mechanisms by which these substances influence neural development, and briefly summarize factors that may enhance risk-taking tendencies.

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