Adolescent Substance Abuse (eBook)

Carl G. Leukefeld is a professor and chair of the Department of Behavioral Science and founding director of the Center on Drug and Alcohol Research at the University of Kentucky. He is also the Bell Alcohol and Addictions Endowed Chair. He came to the University of Kentucky in 1990 to establish the Center on Drug and Alcohol Research from the National Institute on Drug Abuse (NIDA), where he filled administrative and research positions. He was also the chief health services officer of the United States Public Health Service. Dr. Leukefeld has published articles, chapters, books, and monographs. He has taught undergraduate, graduate, and medical students. Thomas P. Gullotta (Tom) retired as the Chief Executive Officer of Child and Family Agency of Southeastern Connecticut in 2015 and as a member of the Psychology and Education Departments at Eastern Connecticut State University in 2014. His scholarship encompasses the co-authorship of two college textbooks, the founding editorship of The Journal of Primary Prevention (Kluwer/Academic 1980 - 2000), co-editor, Advances in Adolescent Development: An Annual Book Series (Sage 1985 - 2000), editor, Prevention in Practice Library: A Monograph Series (Plenum, 1996 - 2001), and senior editor, Issues in Children's' and Families' Lives: A Book Series (Springer 1990 - present). In addition to authoring nearly 100 chapters, papers or reviews, he has co-edited or authored over thirty volumes devoted to illness prevention / promotion of health for the treatment of children, adolescents, and families. Tom was the senior editor for the first edition of the Encyclopedia of Primary Prevention and Health Promotion (Kluwer / Academic, 2003) and returned to that same role for the four volume second edition of that reference work published in late 2014. Currently, he is the senior advisor to Serve Here CT. and the Chairman of the Town Council in his home town of Glastonbury, CT.  

Dedication 5
Acknowledgments 6
Contents 7
Editors and Contributors 9
Introduction 21
References 25
A Selected Social History of the Stepping-Stone Drugs and Opiates 26
The Sequence of Adolescent Drug Use 26
Beer: The Staff of Life 27
Tobacco 30
Marijuana 34
Heroin and Other Opiates 36
Closing Thoughts 38
References 39
A Biological/Genetic Perspective: The Addicted Brain 41
Introduction 41
Neurodevelopment 42
Pharmacology 43
Neuropharmacology 44
Summary 45
Caffeine 45
Mechanisms of Action 45
Epidemiology and Health Consequences of Prenatal, Early Childhood, and Adolescent Caffeine Exposure 46
Implications 48
Nicotine 48
Mechanisms of Action 48
Epidemiology and Health Consequences of Prenatal, Early Childhood, and Adolescent Nicotine Exposure 49
Implications 51
Alcohol 51
Mechanisms of Action 52
Epidemiology and Health Consequences of Prenatal, Early Childhood, and Adolescent Alcohol Exposure 53
Implications 54
Marijuana 55
Mechanisms of Action 55
Epidemiology and Health Consequences of Prenatal, Early Childhood, and Adolescent Marijuana Exposure 56
Implications 57
Opiates 57
Mechanisms of Action 58
Epidemiology and Health Consequences of Prenatal, Early Childhood, and Adolescent Opioid Exposure 59
Neonatal Abstinence Syndrome 60
Implications 61
Therapeutic Stimulants 61
Mechanisms of Action 62
Epidemiology and Health Consequences of Prenatal, Early Childhood, and Adolescent Stimulant Exposure 62
Implications 65
Conclusions 67
References 67
Needs, Services Received, and Outcomes of Adolescents and Young Adults in Substance Use Disorder (SUD) Treatment 84
Prevalence 85
Demographic Correlates 85
Severity of Substance Use 86
Need for Screening and Intervention in Multiple Systems 87
Variations by Level of Care 89
Trauma and Victimization 89
Costs to Society 90
Current Chapter 90
Measures 90
Analyses 92
Results 92
Overall Findings 92
Variation by Demographic Groups 121
Past Year Substance Problem 131
System Involvement 134
Level of Care 137
Emerging Topics 141
Discussion 148
Multimorbidity and Its Implications 148
Service Utilization and Costs to Society 149
Trauma and Its Implications 149
Importance of Standardized Screening and Assessment 150
References 151
Adolescent Substance Abuse Treatment: A Review of Evidence-Based Research 157
Introduction 157
Developmental Issues 158
Intensity of Treatment 159
Treatment Approaches 159
Treatment Outcome Research 159
Overview 159
12-Step-Based Treatment 164
Therapeutic Community 165
Family-Based Therapy 165
Behavioral Therapy 169
Cognitive Behavioral Therapy 170
Motivational Enhancement Therapy (MET)/Brief Intervention 170
Electronic-Based Therapy 171
Pharmacotherapy 173
Cannabis Youth Treatment Study 173
Meta-Analysis of Outpatient Treatment 174
Approaches Aimed at Maximizing Outcome 175
Recovery Schools 175
Employing Reinforcements to Promote Recovery 178
Adapting Treatment 178
Summary 179
References 180
Evidence-Based Family Treatment of Adolescent Substance-Related Disorders 188
Introduction 188
Prevalence of Substance Use 189
Illicit Drugs 189
Alcohol Abuse 190
Long-Term Impacts of Adolescent Substance Use 190
Treatment Gaps 191
Evidence-Based Family Treatments 191
Multisystemic Therapy 192
Multidimensional Family Therapy 194
Comparison of MDFT and MST 196
Functional Family Therapy 196
Brief Strategic Family Therapy 198
Promising Family Treatments 201
Cognitive-Behavioral Therapy and FFT (Integrative Treatment) 201
Family Treatments for Specific Abused Substances 201
Conclusion: Treatment Recommendations 202
References 203
Residential Treatment of Adolescents with Substance Use Disorders: Evidence-Based Approaches and Best Practice Recommendations 206
Introduction 206
Residential Treatment 207
Substance Abuse 210
Prevalence, Need for Treatment, and Population Parameters 211
The Prevalence of Alcohol Use 211
The Prevalence of Marijuana Use 211
Need for Treatment 212
Population Parameters 213
Theoretical Background and Principal Interventions 215
Interventions That Work—Features of Successful Programs 217
Interventions That Might Work—Application of Evidence-Based Practices in Residential Settings 218
Policy Changes Pertaining to Health Care 221
Best Practice Recommendations 222
Treatment Recommendations 223
Organizational Recommendations 225
References 225
The Treatment and Prevention of Adolescent Opioid and Prescription Misuse and Abuse 229
Introduction 229
Terminology 230
Opioid-Specific Terms, Pharmacologic Effects, and Withdrawal 231
Benzodiazepine-Specific Terms, Pharmacologic Effects, and Withdrawal 232
Epidemiology in the USA 233
Treatment 235
Assessment 235
Treatment of Opioid Use Disorders 236
Treatment of Benzodiazepine Use Disorders 239
Effective Prevention and Harm Reduction Approaches 239
Summary 241
References 241
The Prevention and Treatment of  Adolescent Stimulant and  Methamphetamine Use 246
Introduction 246
History of Stimulant Misuse 247
Prevalence of Adolescent Stimulant Use 248
Pharmacological and Clinical Characteristics of Stimulant Misuse 248
Receptor Pharmacology 250
Routes of Administration and Use Patterns 250
Short-Term Effects 251
Long-Term Effects 252
Primary Prevention Efforts 253
Population and Community-Level Efforts: Regulation and Media Campaigns 254
School-Based Programs 255
Family-Based Programs 256
Summary of Evidence-Based Primary Prevention Efforts 257
Evidence-Based Treatments 257
Screening and Brief Interventions 257
Cognitive-Behavioral Therapy 260
Contingency Management 260
Family-Based Approaches 261
Pharmacotherapy 261
Summary of Evidence-Based Interventions 263
Conclusions 263
References 263
Adolescent Self-Help in Substance Abuse Interventions 274
Introduction 274
Substance Abuse and Misuse Among US Adolescents and Youth 275
Substance Abuse and Misuse Treatment Utilization by US Adolescents and Youth 277
Adolescent Substance Abuse and Misuse Treatment 278
Group Therapy 279
Therapeutic Communities 279
Self-Help 280
Adolescent Self-Help/Mutual Help 281
Benefits of Self-Help/Mutual Help for Adolescents 282
Barriers to Self-Help/Mutual Help Attendance 283
Flexibility 284
Relapse 284
Recovery 285
Concluding Remarks 286
References 287
Primary Prevention in Adolescent Substance Abuse 290
What Is Primary Prevention? 290
History as Mirror to Today 291
Explanatory Models of Prevention and Substance Abuse 294
The Tools of Primary Prevention 297
Theory-And-Evidence-Based Practice and Evaluation-Informed Practice in Primary Prevention 300
Applications of These Theories/Research-Based Practices in Field Settings 301
Conclusion 303
References 303
Recovering to Recovery Among Adolescent Youth 306
Introduction 306
Why Recovering Is Important 306
A Common Theoretical Framework for Substance Use and Recovering 307
Defining Recovering 308
Relapse and Recovering 309
What Works to Support Recovering Outcomes 310
What Might Work to Support Recovering Outcomes 312
Recovery Schools 312
Self-Help Groups 313
What Does Not Support Recovering Outcomes 314
Summary 315
References 315
School-Based Prevention-Evolution of Evidence-Based Strategies 321
Introduction 321
History of Prevention Science 322
History of Introducing Effective Substance Use Prevention Interventions into Schools 324
The Application of Prevention Science to the Development of Evidence-Based Prevention Interventions 327
The International Standards on Drug Use Prevention 328
Evidence-Based Prevention Interventions for Schools 329
School Culture and School Bonding 329
School Policy 331
Classroom Curriculum 333
Interventions That Do Not Work 335
Recommendations for School-Based Prevention and Health Promotion 336
References 338
Evidence-Based Practices: Community-Based Interventions to Reduce Alcohol Use and Misuse 344
Introduction 344
What Is Community Prevention for Adolescent Substance Abuse? 345
What Is the Estimated Number of Adolescents Using/Misusing Substances Yearly? 346
Community Coalitions as a Mechanism for Preventing Substance Use 347
What Types of Preventive/Promotive Interventions Are Presently Used in Communities? 349
Research on Community-Based Preventive Interventions 356
Saving Lives Program 356
Project Northland 357
Communities Mobilizing for Change on Alcohol (CMCA) 371
Community Trials Intervention to Reduce High-Risk Drinking 373
Project SixTeen 373
Midwestern Prevention Project 374
Communities That Care Communities That Care (CTC) 375
Environmental Strategies/Policies That Address Alcohol Use and Misuse 376
Summary Research on Positive Youth Development 377
Promising Approaches for Prevention 377
Challenges for Communities 379
Summary 381
References 382
Epilogue: The Present State of Adolescent Substance Abuse Treatment and Prevention Practice 389
Evidence-Based Practice 390
Impressions 391
Treatment 391
Prevention 393
Final Thoughts 394
References 395
Index 396