Chapter

Treatment of Substance Use Disorders

Edited by Dwight L. Evans, Edna B. Foa, Raquel E. Gur, Herbert Hendin, Charles P. O'Brien, Martin E.P. Seligman and B. Timothy Walsh

in Treating and Preventing Adolescent Mental Health Disorders

Published on behalf of Oxford University Press

Published in print June 2005 | ISBN: 9780195173642
Published online August 2012 | e-ISBN: 9780199951024 | DOI: http://dx.doi.org/10.1093/9780195173642.003.0019

Series: Adolescent Mental Health Initiative

 Treatment of Substance Use Disorders

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The high rate of adolescent substance abuse in the United States makes the identification of effective treatment approaches a significant priority. Effective early intervention is crucial. Adolescents who initiate alcohol use by age 14 are significantly more likely to develop alcohol dependence as adults than those who initiate use by age 20, with significant reductions in the odds of developing dependence for each year of delayed initiation. Effective early intervention is also crucial with substance-abusing adolescents because it can play a preventive role in later years. Treatment of substance-abusing adolescents is complicated by a number of factors that appear to be particularly prevalent or problematic among adolescents. First, adolescents in treatment samples usually use multiple substances. Second, substance-using adolescents have very high rates of comorbid psychiatric disorders, which can greatly complicate treatment delivery and outcome. Treatment of substance-abusing adolescents is also complicated by high rates of substance abuse in their immediate families. Another obstacle to treatment for adolescents is that adolescents rarely seek treatment voluntarily but are usually coerced at some level after experiencing school, legal, or medical problems. Treatment is also complicated by their involvement in the multiple systems in which their legal, school, and medical problems are being addressed, as these problems may be identified prior to recognition of the presence of a substance use disorder. Finally, high attrition from treatment is a particular problem among adolescents, with treatment completion rates for adolescents in therapeutic communities estimated at less than 20%. Completion rates for outpatient programs are generally estimated at 50%.

Chapter.  11456 words. 

Subjects: Psychiatry ; Child and Adolescent Psychiatry

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