INTERVENTIONS FOR ADOLESCENT DRUG ABUSE:

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INTERVENTIONS FOR ADOLESCENT DRUG ABUSE

• Individual, Group, Family, and Community
  Approaches

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Objectives for Today

• Describe four approaches for treatment of
  adolescent drug abuse.
• Describe the active ingredients for each
  intervention model.
• Evaluate the evidence (or lack thereof)
  supporting each approach.
• Propose future applications and research.

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Presenters

• James A. Hall, Ph.D., LISW, University of Iowa
• Pamela E. Noel, Ph.D., University of Iowa
• Douglas C. Smith, LMSW, University of Iowa
• Michael Mason, Ph.D., Georgetown University
• Brad Richardson, Ph.D., University of Iowa

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Agenda

• Introduction to key concepts
• adolescence,
• drug abuse,
• drug treatment.
• Group treatment with teens only
• Case management for individual teens
• Family treatment with teens parents
• Community strengthening

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What is Adolescence?

• Ages 10-23 years (WHO)
• Onset of puberty average age
• girls 11,
• boys 13.
• Average age of onset of puberty has decreased 4
  months per decade since 1900 still true? Why?
• Implications of this decrease for developmental
  needs such as independence what is biologic and
  what is cultural?

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Stereotypes and Adolescence

• Storm stress theory
• Needs of individuation
• Pressure to be independent
• Time of raging hormones
• Others?
• So, what is TRUE about adolescence? (follow the
  data)

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DefinitionsLevels of Drug Use

• Abstinence Is this possible in todays society?
• Drug use or social use Can this be true for
  adolescents? Legal constraints.
• Drug abuse Problems due to use. (What makes a
  problem a problem?)
• Addiction Chronic disorder with remissions and
  relapses like any chronic disease.

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Prevalence of Teen Drug Use

• Cant cover all substances
• See Monitoring the Future website
• Today, we examine rates of so-called Gateway
  drugs
• Marijuana
• Alcohol
• Cigarettes (tobacco)

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FIGURE 1 Trends in Annual Prevalence of an
Illicit Drug Use Index
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ASAM Levels of Severity

• 0.5 Early Intervention
• 1.0 Standard Outpatient Treatment
• 2.1 Intensive Outpatient Treatment
• 3.0 Residential Treatment
• (Beyond 3.0, more intensive treatment for
  adolescents probably does not exist.)

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DSM-IV Diagnosesby Substance Type

• Drug type Abuse
• Drug type Dependence
• Diagnoses do not always match up with ASAM
  severity levels.
• Impact of Co-Occurring Disorders

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So, What about Treatment?

• Who needs drug treatment?
• Why?
• Who thinks so?
• Treatment model versus active ingredients
• Matching clients with treatment model and/or
  active ingredients?
• Use of Evidence-based Treatment?
• What is evidence?

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Definition of Evidence

• Ask counselors in drug treatment
• Ask administrators of drug treatment agencies
• Ask state government staff
• Ask researchers

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Leshner, 1/14/05

• The plural of anecdote is not evidence.

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And now, the featured presentations.

• Standard approach Groups of teens
• Next most used is individual approach
• More evidence, but expensive family
• Examining the environment - Communities