Science + Technology

First Large-scale Study of Drug Abuse Treatment for Adolescents Spotlights Effectiveness of Community-based Programs


The first large-scale study of adolescent treatment programsreports some hopeful news in the treatment of teen drug abuse.

Published in the July edition of the Archives of GeneralPsychiatry, the study reports that adolescents who participated in community-basedtreatment programs in four U.S. cities significantly reduced drug use andcriminal behavior, and improved academic performance during the year aftertreatment.

The study of 1,167 adolescents (ages 11-18) admitted to 23community-based treatment programs in Chicago, Minneapolis, Pittsburgh, andPortland also linked longer stays in treatment with better results. The studywas conducted by researchers at the Drug Abuse Research Center of the UCLAIntegrated Substance Abuse Programs, National Development and ResearchInstitutes, the National Institute on Drug Abuse (NIDA), and the University ofNorth Carolina at Wilmington.

"Until now, little research has focused on the effectiveness oftreatment for adolescent substance abuse, and large-scale studies of treatmentresults have focused on adult patients," said Yih-Ing Hser, an adjunctprofessor in the UCLA Department of Psychiatry and Biobehavioral Sciences andlead author of the paper. "Adolescents are in a distinct developmental phase.Their substance abuse patterns and other factors influencing their livestypically differ from those of adults; thus, adolescent substance abusers mayrequire different treatment strategies. Providing adequate treatment at thisage may prevent the development of long-term addiction."

The naturalistic study — an assessment of treatment resultsin a non-experimental setting — examined the cases of 418 adolescents in eightresidential programs, 292 in nine outpatient drug-free programs, and 457 in sixshort-term inpatient programs.

Among participants in the study, 47 percent reportedmarijuana abuse as their primary drug problem, while 21 percent cited alcoholas the primary drug of abuse. In the year following treatment, 44 percentreported weekly marijuana use, compared with 80 percent in the year beforetreatment admission; 20 percent reported heavy drinking, compared with 34percent before treatment; and 42 percent reported use of other illicit drugs,compared with 48 percent before treatment.

Adolescents admitted to treatment typically reportedproblems in addition to drug abuse, such as trouble with the legal system (58percent) or a mental disorder (63 percent).Criminal involvement dropped to 53 percent in the year followingtreatment, compared with 76 percent in the year before treatment, and patientsalso reported improved psychological adjustment and school performance.

"Post-treatment improvements among adolescents in this studyare particularly impressive considering most patients faced multiplechallenges, such as abuse of more than one drug, mental disorders, and criminalinvolvement," said Christine Grella, an associate research psychologist in theUCLA Department of Psychiatry and Biobehavioral Sciences and co-author of thepaper. "In addition, the marked reductions in substance abuse are encouragingbecause most surveys of the general population report an acceleration inalcohol and drug use for adolescents. The reversal of this trend followingtreatment demonstrates the effectiveness of these programs."

Adolescents who stayed in treatment longer were more likelyto have more favorable outcomes. However, length of time in treatment wasgenerally short, particularly in outpatient drug-free and short-term inpatientprograms, which contributed to some of the exceptions to the general pattern ofimprovement. For example, there was an overall increase in cocaine use to 19percent at follow-up from 16 percent before treatment; the increases were foundamong those enrolled in these outpatient drug-free and short-term inpatientprograms. In addition, patients in outpatient drug-free programs showed noimprovement in their use of hallucinogens and stimulants.

"Despite the good news, much more needs to be done byprograms and governmental agencies to optimize the results of drug abusetreatment for adolescents, particularly in the areas of treatment retention andcompletion," said Douglas Anglin, a professor in residence in the Department ofPsychiatry and Biobehavioral Sciences at UCLA. "Helping adolescent patients toaddress the multiple problems in their lives, particularly those involvingclose family members or friends, remains a continuing challenge in thetreatment field."

Funding for the study was provided by the National Instituteon Drug Abuse (NIDA), part of the National Institutes of Health in Bethesda,Md.

In addition to Hser, Grella and Anglin, researchers involvedin the study were Shih-Chao Hsieh of UCLA; Robert L. Hubbard of the NationalDevelopment and Research Institutes Inc.; Bennett W. Fletcher of NIDA; andBarry S. Brown of the University of North Carolina at Wilmington.



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