Three-year Chemical Dependency and Mental Health Treatment Outcomes Among Adolescents: the Role of Continuing Care

Overview

Journal Alcohol Clin Exp Res

Specialty Psychiatry

Date 2009 May 6

PMID 19413644

Citations 13

Authors

Stacy Sterling

Felicia Chi

Cynthia Campbell

Constance Weisner

Affiliations

Soon will be listed here.

Abstract

Background: Few studies have examined the effects of treatment factors, including the types of services [chemical dependency (CD), psychiatric, or both], on long-term outcomes among adolescents following CD treatment, and whether receiving continuing care may contribute to better outcomes. This study examines the effect of the index CD and ongoing CD and psychiatric treatment episodes, 12-step participation, and individual characteristics such as CD and mental health (MH) severity and gender, age, and ethnicity, on 3-year CD and MH outcomes.

Methods: Participants were 296 adolescents aged 13 to 18 seeking treatment at 4 CD programs of a nonprofit, managed care, integrated health system. We surveyed participants at intake, 1 year, and 3 years, and examined survey and administrative data, and CD and psychiatric utilization.

Results: At 3 years, 29.7% of the sample reported total abstinence from both alcohol and drugs (excluding tobacco). Compared with girls, boys had only half the odds of being abstinent (OR = 0.46, p = 0.0204). Gender also predicted Externalizing severity at 3 years (coefficients 18.42 vs. 14.77, p < 0.01). CD treatment readmission in the second and third follow-up years was related to abstinence at 3 years (OR = 0.24, p = 0.0066 and OR = 3.33, p = 0.0207, respectively). Abstinence at 1 year predicted abstinence at 3 years (OR = 4.11, p < 0.0001). Those who were abstinent at 1 year also had better MH outcomes (both lower Internalizing and Externalizing scores) than those who were not (11.75 vs. 15.55, p = 0.0012 and 15.13 vs. 18.06, p = 0.0179, respectively).

Conclusions: A CD treatment episode resulting in good 1-year CD outcomes may contribute significantly to both CD and MH outcomes 3 years later. The findings also point to the value of providing a continuing care model of treatment for adolescents.

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References

Grella C, Joshi V . Treatment processes and outcomes among adolescents with a history of abuse who are in drug treatment. Child Maltreat. 2003; 8(1):7-18. DOI: 10.1177/1077559502239610. View

Helzer J, Pryzbeck T . The co-occurrence of alcoholism with other psychiatric disorders in the general population and its impact on treatment. J Stud Alcohol. 1988; 49(3):219-24. DOI: 10.15288/jsa.1988.49.219. View

McConaughy S, Stanger C, Achenbach T . Three-year course of behavioral/emotional problems in a national sample of 4- to 16-year-olds: I. Agreement among informants. J Am Acad Child Adolesc Psychiatry. 1992; 31(5):932-40. DOI: 10.1097/00004583-199209000-00023. View

Chi F, Sterling S, Weisner C . Adolescents with co-occurring substance use and mental conditions in a private managed care health plan: prevalence, patient characteristics, and treatment initiation and engagement. Am J Addict. 2006; 15 Suppl 1:67-79. DOI: 10.1080/10550490601006022. View

Blood L, Cornwall A . Pretreatment variables that predict completion of an adolescent substance abuse treatment program. J Nerv Ment Dis. 1994; 182(1):14-9. DOI: 10.1097/00005053-199401000-00004. View

Hesselbrock M . Gender comparison of antisocial personality disorder and depression in alcoholism. J Subst Abuse. 1991; 3(2):205-19. DOI: 10.1016/s0899-3289(05)80037-9. View

Wise B, Cuffe S, Fischer T . Dual diagnosis and successful participation of adolescents in substance abuse treatment. J Subst Abuse Treat. 2001; 21(3):161-5. DOI: 10.1016/s0740-5472(01)00193-3. View

Kelly J, Myers M . Adolescents' participation in Alcoholics Anonymous and Narcotics Anonymous: review, implications and future directions. J Psychoactive Drugs. 2007; 39(3):259-69. DOI: 10.1080/02791072.2007.10400612. View

Kelly J, Myers M, Brown S . The Effects of Age Composition of 12-Step Groups on Adolescent 12-Step Participation and Substance Use Outcome. J Child Adolesc Subst Abuse. 2007; 15(1):63-72. PMC: 2136436. DOI: 10.1300/J029v15n01_05. View

10.

Sterling S, Kohn C, Lu Y, Weisner C . Pathways to chemical dependency treatment for adolescents in an HMO. J Psychoactive Drugs. 2005; 36(4):439-53. DOI: 10.1080/02791072.2004.10524427. View

11.

Breda C, Heflinger C . Predicting incentives to change among adolescents with substance abuse disorder. Am J Drug Alcohol Abuse. 2004; 30(2):251-67. DOI: 10.1081/ada-120037377. View

12.

Chi F, Kaskutas L, Sterling S, Campbell C, Weisner C . Twelve-Step affiliation and 3-year substance use outcomes among adolescents: social support and religious service attendance as potential mediators. Addiction. 2009; 104(6):927-39. PMC: 2722376. DOI: 10.1111/j.1360-0443.2009.02524.x. View

13.

Chung T, Martin C . Classification and short-term course of DSM-IV cannabis, hallucinogen, cocaine, and opioid disorders in treated adolescents. J Consult Clin Psychol. 2006; 73(6):995-1004. DOI: 10.1037/0022-006X.73.6.995. View

14.

Godley M, Godley S, Dennis M, Funk R, Passetti L . The effect of assertive continuing care on continuing care linkage, adherence and abstinence following residential treatment for adolescents with substance use disorders. Addiction. 2007; 102(1):81-93. DOI: 10.1111/j.1360-0443.2006.01648.x. View

15.

Mertens J, Weisner C, Ray G . Readmission among chemical dependency patients in private, outpatient treatment: patterns, correlates and role in long-term outcome. J Stud Alcohol. 2006; 66(6):842-7. DOI: 10.15288/jsa.2005.66.842. View

16.

Duncan S, Alpert A, Duncan T, Hops H . Adolescent alcohol use development and young adult outcomes. Drug Alcohol Depend. 1998; 49(1):39-48. DOI: 10.1016/s0376-8716(97)00137-3. View

17.

RIVERS S, Greenbaum R, Goldberg E . Hospital-based adolescent substance abuse treatment: comorbidity, outcomes, and gender. J Nerv Ment Dis. 2001; 189(4):229-37. DOI: 10.1097/00005053-200104000-00004. View

18.

Aday L, Begley C, Lairson D, Slater C, Richard A, Montoya I . A framework for assessing the effectiveness, efficiency, and equity of behavioral healthcare. Am J Manag Care. 1999; 5 Spec No:SP25-44. View

19.

Anderson K, Ramo D, Schulte M, Cummins K, Brown S . Substance use treatment outcomes for youth: integrating personal and environmental predictors. Drug Alcohol Depend. 2006; 88(1):42-8. PMC: 3408389. DOI: 10.1016/j.drugalcdep.2006.09.014. View

20.

Wittchen H, Frohlich C, Behrendt S, Gunther A, Rehm J, Zimmermann P . Cannabis use and cannabis use disorders and their relationship to mental disorders: a 10-year prospective-longitudinal community study in adolescents. Drug Alcohol Depend. 2007; 88 Suppl 1:S60-70. DOI: 10.1016/j.drugalcdep.2006.12.013. View