During the past three decades, the responsibility of pediatricians to their patients and their patients' families regarding the prevention of substance abuse and the diagnosis and management of problems related to substance abuse has increased. The American Academy of Pediatrics (AAP) has highlighted the importance of such issues in a variety of ways, including its guidelines for preventive services. Nonetheless, many pediatricians remain reluctant to address this issue. The harmful consequences of tobacco, alcohol, and other drug use are a concern of medical professionals who care for infants, children, adolescents, and young adults. Thus, pediatricians should include discussion of substance abuse as a part of routine health care, starting with the prenatal visit and as a part of ongoing anticipatory guidance. Knowledge of the extent and nature of the consequences of tobacco, alcohol, and other drug use as well as the physical, psychological, and social consequences is important for pediatricians. Pediatricians should incorporate substance abuse prevention into daily practice, acquire the skills necessary to identify young people at risk for substance abuse, and provide or obtain assessment, intervention, and treatment as necessary.

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