• Michael Krausz, Jean N Westenberg, Vivian Tsang, Janet Suen, Martha J Ignaszewski, Nickie Mathew, Pouya Azar, Maurice Cabanis, Julie Elsner, Marc Vogel, Renske Spijkerman, Laura Orsolini, Dzung Vo, Eva Moore, Jessica Moe, Johannes Strasser, Patrick Köck, Calin Marian, Kenneth M Dürsteler, Markus Backmund, Jeanette Röhrig, Marianne Post, Hans Haltmayer, Wolfgang Wladika, Thomas Trabi, Christian Muller, Gerhard Rechberger, Maree Teesson, Michael Farrell, Grant Christie, Sally Merry, Mostafa Mamdouh, Rachel Alinsky, Sharon Levy, Marc Fishman, Richard Rosenthal, Kerry Jang, and Fiona Choi.
• Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2A1, Canada.
• Medicina (Kaunas). 2022 Apr 13; 58 (4).

AbstractBackground and Objectives: Now more than ever, there is an obvious need to reduce the overall burden of disease and risk of premature mortality that are associated with mental health and substance use disorders among young people. However, the current state of research and evidence-based clinical care for high-risk substance use among youth is fragmented and scarce. The objective of the study is to establish consensus for the prevention, treatment, and management of high-risk substance use and overdose among youth (10 to 24 years old). Materials and Methods: A modified Delphi technique was used based on the combination of scientific evidence and clinical experience of a group of 31 experts representing 10 countries. A semi-structured questionnaire with five domains (clinical risks, target populations, intervention goals, intervention strategies, and settings/expertise) was shared with the panelists. Based on their responses, statements were developed, which were subsequently revised and finalized through three iterations of feedback. Results: Among the five major domains, 60 statements reached consensus. Importantly, experts agreed that screening in primary care and other clinical settings is recommended for all youth, and that the objectives of treating youth with high-risk substance use are to reduce harm and mortality while promoting resilience and healthy development. For all substance use disorders, evidence-based interventions should be available and should be used according to the needs and preferences of the patient. Involuntary admission was the only topic that did not reach consensus, mainly due to its ethical implications and resulting lack of comparable evidence. Conclusions: High-risk substance use and overdoses among youth have become a major challenge. The system's response has been insufficient and needs substantial change. Internationally devised consensus statements provide a first step in system improvement and reform.

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