Drug and alcohol dependence and abuse among adolescents has consistently been a concern in the scope of national health policy. Given that degree of concern, there has been movement towards creating treatment options that are specific to the adolescent population. Early exposure and initiation to drug use and abuse can lead to a myriad of behavioral problems down the road, including legal problems, driving under the influence as well as physical, sexual and emotional abuses. Also given the fact that alcohol and drug use during adolescence can lead to changes and impairments in brain structure and chemistry, the need for quality treatment for young people is paramount.
In a historical context, treatment approaches for adolescents were culled from those serving adult populations. Adolescents were often sent to either correctional institutions or rehabilitation facilities that catered to the adult population. While drug treatment facilities and programs has its roots starting in the 1950’s, the development of programs that specifically targeted the special needs of young people only and truly started to gain traction in the 1990’s. Currently, an adolescent will be referred to one of five treatment levels as designated by the American Society of Addiction Medicine patient placement criteria.
This placement occurs after a professional assessment has been conducted. Those levels are as follows:
- Early intervention services—consists mainly of educational and/or brief intervention services.
- Outpatient treatment—treatment for a period of six weeks or less dependent on both progress and nature of treatment plan.
- Intensive outpatient—adolescents attend treatment during the day but live at home. This can have a duration anywhere between two months and one year.
- Residential—programs are provided in a residential “in-house” setting where the patient lives and resides for a period of time (between one month to one year, again depending on progress and nature of treatment plan among other factors).
- Intensive inpatient—often medically supervised and is most appropriate for severe cases of substance use and co-occurring emotional and biomedical issues.
Based on this continuum, there can be a wide array of treatment and therapeutic options that practitioners have at their disposal. Common modalities include family-based therapy as well as cognitive behavioral therapy (CBT). CBT is centered on the notion that thoughts are the root cause of behavior and thus thoughts determine how people perceive and act within the environment. Those thoughts that are maladaptive can be modified to change the thought process itself, even though the surrounding environment may not change.
Other interventions such as Twelve-Step programs (i.e. Alcoholics Anonymous, Narcotics Anonymous) may also be of value. Also gaining traction are the use of therapeutic communities (TC), or long-term residential programs that focus on emphasizing self-help and fostering shared values for a healthy drug-free lifestyle through individual counseling sessions, family therapy and life skills education.