Drug Abuse Treatment

Research Findings from May, 2003 Director's Report

This section lists selected summaries from NIDA funded research projects that investigate the child and adolescent drug abuse treatment. The summaries provided were selected from recent issues of the Director's Report to the National Advisory Council on Drug Abuse. For a more comprehensive listing of NIDA funded projects see the Director's Report.

A Clinical Approach to Integrating Treatment for Adolescent Depression and Substance Abuse

This study provides a preliminary, but empirically derived, clinical treatment algorithm which could be useful as a starting point to help clinicians structure an integrated approach to the treatment of depression in adolescents with SUD. Adolescents with substance use disorders (SUD) commonly suffer from co-occurring major depression (MDD), which impairs psychosocial functioning, contributes to the severity of substance abuse, and interferes with effective engagement in substance treatment. Because the magnitude of the public health impact and the clinical complexity of adolescents with comorbid disorders are so great, it is important to at least begin to derive a more standardized clinical treatment algorithm to guide our approach to integrated treatment from the current empirical base. Riggs, P.D. and Davies, R.D. A Clinical Approach to Integrating Treatment for Adolescent Depression and Substance Abuse. J Am Acad Child Adolesc Psychiatry., 41(10). pp. 1253-1255, October 2002.

Family-Based Treatment For Drug Abuse

Dr. Howard Liddle and colleagues at the University of Miami's Center for Treatment Research on Adolescent Drug Abuse (CTRADA) conducted a comprehensive review of the status of family-based treatment for drug abuse in 1995 and concluded that this modality offered a "promising, but not definitive" approach to treating drug abuse among adolescents and adults. Less than a decade later, significant progress can be seen in the treatment of drug abuse problems using family-based approaches, particularly with adolescents. Family-based treatments are currently recognized as among the most effective approaches for adolescent drug abuse. Family-based treatment of adult drug abuse problems has also advanced in important ways with the recent systematic application and testing of engagement techniques and behavioral couples therapy approaches. The current review characterizes and discusses the developmental status of this subspecialty and outlines areas in which continued research attention is needed. Rowe, C.L. and Liddle, H.A. Journal of Marital and Family Therapy, 29(1), pp. 97-120, January 2003.

Mental Health and Addiction Problems Among American Indian Youth

This study examined the addiction and mental health service use of American Indian adolescents. The Diagnostic Interview Schedule and the Service Assessment for Children and Adolescents were used to ask Southwestern American Indian youth about their mental health needs, substance use, and service configurations. Seventy-nine percent had mental health or addiction problems, with half meeting criteria for at least one diagnosis. One in 4 youth met criteria for drug dependence/abuse or conduct disorder, 1 in 5 for depression, and 1 in 8 for alcohol dependence/abuse. Most youth received treatment services from a combination of providers. Youth meeting more diagnostic criteria were increasingly likely to use service configurations with adults, nonspecialist professionals, and specialists, respectively. Regardless of disorder, youth were least likely to use configurations with traditional healers or specialists, and there was little difference in rates of use between the two. The lack of services from specialist providers was potentially offset by use of an extensive range of informal adults, nonspecialist professionals, and peers. Since informal helpers, peers, and nonspecialist providers, but not specialists, are providing the bulk of services to these adolescents, they must be given support and skills so they can function effectively. Stiffman, A.R., Striley, C.W., Brown, E., Limb, G., and Ostmann, E. American Indian Youth: Who Southwestern Urban and Reservation Youth Turn To for Help with Mental Health or Addictions. Journal of Child & Family Studies, 12, pp. 319-333, 2003.

Cost Analysis of Cannabis Youth Treatment Approaches

The present study conducted an economic cost analysis of several outpatient adolescent treatment approaches. The Cannabis Youth Treatment (CYT) study evaluated five structured treatments for cannabis-using adolescents. Using the Drug Abuse Treatment Cost Analysis Program (DATCAP), the economic cost of each site-specific treatment was determined. The average economic costs of the five types of outpatient treatments ranged from $837 to $3334 per episode, and varied by both direct factors (e.g. hours of treatment, treatment retention) and indirect factors (e.g. cost of living, staff level, case-load variation). These adolescent treatment cost estimates are examined in terms of their calculation, variability by condition, variability by site within condition and comparability with previous DATCAP results from outpatient drug-free programs for adults. Future research will integrate treatment outcomes and costs to complete cost-effectiveness and benefit-cost analyses of the five therapies. French, M.T., Roebuck, M.C., Dennis, M.L., Diamond, G., Godley, S.H., Tims, F., Webb, C. and Herrell, J.M. The Economic Cost of Outpatient Marijuana Treatment for Adolescents: Findings from a Multi-site Field Experiment. Addiction. 97, Suppl 1, pp. 84-97, 2002.