Adolescents and Substance Use

This webpage identifies the major literature in the field of substance abuse and child welfare practice: adolescents and substance use. The time frame is from January 2000 through December 2014.

Alarid, L. F, Montemayor, C. D., & Dannhaus, S. (2012). The Effect of Parental Support on Juvenile Drug Court Completion and Postprogram Recidivism. Youth Violence and Juvenile Justice, 10(4), pp. 354-369. DOI: 10.1177/1541204012438422

This study examined client behavior and parental support through various phases to determine factors that contribute toward successful program completion and post-program recidivism reduction. Family support was a significant predictor of both graduation and of post-supervision re-arrest. Time spent in the drug court program and client age were additional predictors of re-arrest, while less prior adjudications were an additional predictor of whether a youth would complete the drug court program. Some of the policy considerations to consider include how to better engage parents in juvenile court, sealing of court records 6-months post-program completion and how to handle youth who need to remain in the program longer.

Becker, S. J., Stein, G. L., Curry, J. F., & Hersh, J. (2012). Ethnic differences among substance-abusing adolescents in a treatment dissemination project. Journal of Substance Abuse Treatment, 42(3), pp. 328–336. DOI: 10.1016/j.jsat.2011.08.007

In this article, authors investigated baseline and post-treatment differences in a sample of White, African American, and Latino youth who received the same evidence-based outpatient treatment. The results of the study show that there were no ethnic differences in substance use outcomes among assessment completers when controlling for baseline differences. However, African Americans, older adolescents, and males were less likely to complete the post-treatment assessment.

Chen, P., &. Jacobson, K. C. (2012). Developmental Trajectories of Substance Use from Early Adolescence to Young Adulthood: Gender and Racial/Ethnic Differences. Journal of Adolescent Health, 50(2), pp. 154–163. DOI: 10.1016/j.jadohealth.2011.05.013

This study examined gender and racial/ethnic (Hispanics, non-Hispanic Caucasians, non- Hispanic African Americans, and non-Hispanic Asians) differences in developmental trajectories of alcohol use, heavy drinking, smoking, and marijuana use from early adolescence to young adulthood using a nationally representative sample. Results showed that females showed higher levels of substance use in early adolescence, although males exhibited greater changes overtime and higher levels of use in mid-adolescence and early adulthood. Findings from the current study suggest that the critical periods for intervention and prevention of substance use may differ across gender and race/ethnicity, and that future research needs to identify common and unique mechanisms underlying developmental patterns of different forms of substance use.

DiCola, L. A., Gaydos, L. M., Druss, B. G., & Cummings, J. R. (2013). Health Insurance and Treatment of Adolescents with Co-Occurring Major Depression and Substance Use Disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 52(9), pp. 953-960.

The goals of this study were to identify treatment rates among adolescents with co-occurring major depressive episode (MDE) and substance use disorder (SUD), and to examine the role of health insurance in the treatment of these disorders. Results of this study show that less than one-half (48%) of adolescents received any form of MDE treatment in the past year, and only 10% received any form of SUD treatment. Only 16% of adolescents who received MDE treatment also received SUD treatment. Relative to no insurance, public insurance was associated with an increased likelihood of receiving MDE treatment alone, but not with an increased likelihood of receiving both MDE and SUD treatment. Involvement in the criminal justice system was the major factor affecting the likelihood that an adolescent would receive both MDE and SUD treatment, as opposed to either no treatment or treatment for MDE alone. The authors conclude that exceptionally low rates of SUD treatment were observed in this high-risk sample.

Joe, G. W., Knight, D. K., Becan, J. E., & Flynn, P. M. (2014). Recovery among adolescents: Models for post-treatment gains in drug abuse treatments. Journal of Substance Abuse Treatment, 46(3), pp. 362-373.

This article looks at how the treatment process, including motivation, treatment engagement, psychological distress, and retention along with legal pressures, mental health problems, and demographics impact long-term recovery among youth. According to the authors, motivation, therapeutic relationship, and other factors aid in the recovery process. The results document the importance of motivation and therapeutic relationships on recovery, even when taking into account the relative effects of legal pressures, DSM diagnoses, and demographics.

Magid, V., & Moreland, A. (2014). The Role of Substance Use Initiation in Adolescent Development of Subsequent Substance-Related Problems. Journal of Child & Adolescent Substance Abuse, 23(2), pp. 78-86.

This is a literature review on the role of substance use initiation in subsequent use and problems among adolescents. Results of the literature review show that age of onset is related to subsequent substance-related problems, however no clear explanation for the association was found. The authors also review available prevention programs with specific focus on prevention of early substance use initiation and subsequent use.

Traube, D. E., James, S., Zhang, J., & Landsverk, J. (2012). A national study of risk and protective factors for substance use among youth in the child welfare system. Addictive Behaviors, 37(5), pp. 641–650. DOI: 10.1016/j.addbeh.2012.01.015

This study looks at data from the first National Survey of Child and Adolescent Well-Being (NCSACW), in order to examine the association between baseline psychosocial risk and protective factors on engagement in substance use behavior for child welfare involved adolescents. According to the authors, prevention efforts for this population require a better understanding of biological, psychological, and social protective factors. The child welfare system is an untapped resource that has the potential to be a gateway to and a platform for substance abuse prevention services that should be incorporated into child welfare safety and permanency interventions.

Wechsler-Zimring, A., Kearney, C. A., Kaur, H., & Day, T. (2012). Posttraumatic stress disorder and removal from home as a primary, secondary, or disclaimed trauma in maltreated adolescents. Journal of Family Violence, 27(8), pp. 813-818. DOI: 10.1007/s10896-012-9467-8

This study compares maltreated adolescents who 1) endorsed removal from home as their primary traumatic event, 2) endorsed removal from home as a secondary traumatic event, but not their primary traumatic event, or 3) did not endorse removal from home as traumatic. According to findings, adolescents who endorsed removal from home as their primary traumatic event reported significantly lower levels of PTSD and related symptoms than adolescents in the other groups did.

Whittle, S., Dennison, M., Vijayakumar, N., Simmons, J. G., Yucel, M., Lubman, D. I., Pantelis, C., and Allen, N. B. (2013). Childhood maltreatment and psychopathology affect brain development during adolescence. Journal of the American Academy of Child & Adolescent Psychiatry, 52(9), pp. 940-952.

This study investigated whether childhood maltreatment was associated with hippocampal and amygdala development from early to mid-adolescence and whether the experience of psychopathology during this period mediated the relation. According to the study’s results childhood maltreatment was associated with larger baseline left hippocampal volumes and retarded growth of the left amygdala over time and was indirectly associated, through the experience of psychopathology, with retarded growth of the left hippocampus and accelerated growth of the left amygdala over time. According to the authors childhood maltreatment was associated with altered brain development during adolescence. The experience of Axis I psychopathology during adolescence may be one mechanism by which childhood maltreatment has continuing effects on brain development during the adolescent years. These findings highlight the importance of early intervention for individuals who have experienced childhood maltreatment.

Wilens, T. E., & Rosenbaum, J. F. (2013). Transitional aged youth: a new frontier in child and adolescent psychiatry. Journal of the American Academy of Child & Adolescent Psychiatry, 52(9), pp. 887-890.

This article provides brief background and overview on the issues faced by the population known as transitional aged youth (TAY). The article is written from a clinical perspective, providing information on treatment issues this population faces as well as what types of treatment works with this population. Thus, as a field, we must be prepared to address the major concerns and opportunities in focusing on TAY, specifically early recognition of the first signs and symptoms, identifying risk and protective factors, and early and effective intervention for psychopathology and substance abuse.

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