The first large-scale study designed specifically to evaluate drug abuse treatment outcomes among adolescents found that community-based treatment programs can reduce drug and alcohol use, improve school performance, and lower involvement with the criminal justice system.
The study, which is published in the July, 2001, issue of the Archives of General Psychiatry, evaluated the treatment outcomes for nearly 1,200 adolescents, ranging in age from 11 to 18, who were enrolled in one of 23 community-based treatment programs in four cities -- Pittsburgh, Minneapolis, Chicago, and Portland – between 1993 and 1995.
“It is clear from this evaluation that treating drug abuse in teens reduces their use of drugs and improves many aspects of their lives, “ says NIDA Director Dr. Alan I. Leshner. “The years of research spent developing effective treatment approaches are beginning to pay off for these young people.” This study, conducted by Dr. Yih-Ing Hser and her colleagues at the University of California, Los Angeles, is part of NIDA’s ongoing Drug Abuse Treatment Outcome Studies for Adolescents (DATOS-A).
The research team evaluated outcomes for 799 boys and 368 girls enrolled in a variety of drug treatment programs, including residential programs, outpatient drug-free programs, and short-term inpatient programs. Dr. Hser says the teens made significant progress, even though their length of time in treatment was generally short. The study found that longer stays in treatment resulted in lower drug use and lower rates of arrest following treatment. “Community-based drug treatment programs do work for adolescents,” says Dr. Hser. “But in order to maximize their therapeutic benefits, we need to devise strategies specific to adolescents to improve retention and completion of the programs.” Details about the study
More than 400 teens participated in residential treatment, in which they were provided with education, individual and group counseling, and interventions to develop social responsibility. Almost 300 participated in outpatient drug-free programs, which included counseling sessions, education, and skills training. Nearly 460 were admitted to short-term inpatient programs, which provided counseling, 12-step sessions within a medically controlled environment, and referral for continued outpatient treatment.
About a quarter the study’s participants had used three or more drugs prior to treatment. Nearly two-thirds were dependent upon marijuana, over one-third dependent on alcohol, and 10 percent were addicted to cocaine. In addition to substance abuse problems, more than half were criminally active and 63 percent met diagnostic criteria for a mental disorder. About one-third had dropped out of school.
Improvements Cited After Treatment
Comparing the year before treatment to the year following treatment, improvements were seen in the following areas:
- Drug Use--weekly or more frequent marijuana use dropped from 80.4 percent to 43.8 percent; abstinence from use of other illicit drugs increased from 52 percent to 57.8 percent.
- Heavy Drinking--dropped from 33.8 percent to 20.3 percent
- Criminal Activities--dropped from 75.6 percent to 52.8 percent.
Following treatment, the teens showed better psychological adjustment as indicated by having fewer thoughts of suicide, lower hostility, and higher self-esteem.
More of the teens attended school and reported average or better-than-average grades following treatment.
Some Exceptions Noted
However, there were some exceptions to the general pattern of improvement. Cocaine use increased three percentage points, from 16.5 percent prior to treatment to 19.2 percent after treatment. This was attributable primarily to increases in cocaine use among teens in the short-term inpatient and the outpatient drug-free programs. Among those in the outpatient treatment group, the use of hallucinogens and stimulants did not improve.
The researchers evaluated whether a minimum length of stay for 90 days in residential and outpatient programs and 21 days in short-term inpatient care were related to better outcomes. Almost 60 percent of the residential treatment group, 27 percent of the outpatient group, and 63.7 percent of the inpatient group met or exceeded these goals.
The patients who met or exceeded these length of stay criteria had significantly better outcomes than those who did not. They were about one and a half times more likely to be abstinent from marijuana, alcohol, and other drug use in the year after treatment. They were 1.45 times less likely to be arrested and about one and a third times more likely to have average or better grades in school than adolescents who did not reach these treatment stays.
The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports more than 85 percent of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and other topics can be ordered free of charge in English and Spanish through NIDA Infofax at 1-888-NIH-NIDA (644-6432) or 1-888-TTY-NIDA (889-6432) for the deaf. These fact sheets and further information on NIDA research and other activities can be found on the NIDA home page at http://www.drugabuse.gov.
Journal
Archives of General Psychiatry