Blog: Adolescent Substance Abuse Treatment

When I first entered recovery at age 17, a man in long-term recovery looked me in the eye and told me, "It's simple. There's only one thing you need to change: everything."
I fought, pushed back, and resisted. I mean, I got that I couldn’t drink and drug the way I had before, but come on. Change everything? Really? 

I often hear people refer to the distinction between drug "use" and drug "abuse" as if it were an immutable, medical fact. A review of recent history suggests otherwise. Just as the American Psychiatric Association once viewed homosexuality as a mental disorder, the meaning of "substance use disorder" has evolved over time. The definitions we use today are partly a social construction, subject to changing mores, values, and even our political culture.
As readers of this blog certainly know, social service professionals use a variety of screening and assessment instruments to detect drug problems. Many tools still rely on the underlying logic of the American Psychiatric Association's Diagnostic and Statistical Manual, or DSM.
The DSM is widely endorsed, but few policymakers and other nonclinicians appreciate how much it has evolved. Consider this passage from the DSM 1980 edition:

• Startling news from the Centers for Disease Control that in 16 states, the number of people who die from prescription drug overdoses outnumbers the number who die in car accidents.
• Simple Explanation Department: Reseachers in Britain have used longitudinal data to show that children who eat too much candy are more likely to be violent later in life. For further reading: the American Journal of Preventive Medicine had a special 2008 issue on youth violence prevention.

 
Concerned about the kids in the juvenile justice system? Then check out the video above of a 29-year-old woman given life without parole at 16 for killing her pimp. I found it on this blog, without a lot of information about where or when the video was made. But man oh man, it's sure moving.
Other stories:

• A potential game-changer in the field of adolescent (and adult) substance abuse: hospitals may soon be required to screen and provide brief intervention for addictions in order to be accredited.
• According to the 2008 National Survey on Drug Use and Health (NASDUH), adolescent misuse of prescription drugs has dropped, but even so, teens say it's easier to get marijuana than cigarettes. And just in time for back-to-school, SAMHSA released its Treatment Episode Data Set (TEDS) report on referrals of schoolchildren to alcohol and drug abuse treatment. 

Tackling adolescent substance abuse isn’t getting any easier, what with shrinking budgets for treatment and support services and trends like the rise in prescription drug abuse. So I was pleased to have the opportunity to see Charlotte Sisson (shown at left), Policy Analyst for the Office of National Drug Control Policy (ONDCP), give an informal address to a group of Reclaiming Futures judges over lunch at a judicial training in Greensboro, NC on August 28th. 

• Something to think about the next time you drug test a youth: one in five teens share prescription drugs (and so do 40% of adults). 
• Making methamphetamine is now easier, thanks to the growing popularity of an alternate, "shake and bake" method. It's easier for addicts to make in small batches and requires only a small amount of pseudophedrine to manufacture -- well under the mandatory limits set in place several years ago to halt meth's spread.  

Over 60% of youth in the juvenile justice system meet criteria for three or more mental health disorders, per a 2006 multi-state study by the National Center for Mental Health and Juvenile Justice. And 60.8% of youth who meet criteria for a mental health disorder also meet criteria for a substance abuse disorder. (Thanks to Paul Savery of the North Carolina Division of Mental Health, Developmental Disabilities and Substance Abuse Services for the tip.)

When it comes to the juvenile justice system and adolescent substance abuse, there's always something cooking. Check out this week's bonanza of resources and new stories:

• Washington, D.C.'s juvenile justice agency is offering a free service to the elderly: lawns mowed by teens doing community service.
• Nicholas D. Kristof, writing in The New York Times, argued that it makes little sense -- financial or otherwise -- to prioritize prisons over health care.