There has been a global surge in adolescents’ use of electronic nicotine delivery systems (ENDS)/vaping, cannabis (vaped, edible), and use of prescription opioids (POs) not-as-prescribed. The nature of these substances often renders them “difficult-to detect” due to limited physical and behavioral signs, along with subtle, but often, hazardous longer-term effects.

Here, Dr. Feldstein Ewing will address the nature of substance use presentation in the adolescent age group, including challenges in detection and related complications that impact screening and prevention. Further, in terms of intervention, many of the existing addiction treatments that we use with adolescents were originally designed for adults; however, the adolescent brain is increasingly being recognized as substantively different than the adult brain. And, likely for related reasons, adolescents engage with substances in different ways than adults.

Dr. Feldstein Ewing will begin by reviewing empirical data on “difficult-to-detect” effects, including acute effects at neural levels and longer-term neurocognitive and developmental changes that precede outward physical symptoms. Dr. Feldstein Ewing will also present translational approaches, integrating brain (developmental human neuroscience; fMRI) and behavior (clinical intervention programs) to begin to inform timely updates in how we approach defining addiction in this age group, along with how we update our approaches to behavioral treatment in this age group.

Learning Objectives 

• Highlight the nature of substance use and related risk behaviors during the teen years 

• Learn more about existing prevention and intervention approaches for adolescent health risk behavior



• Increase understanding of translational approaches to inform improvements in adolescent prevention and intervention approaches