Adolescent Substance Abuse Treatment

One of the great advantages of using the Global Appraisal of Individual Needs (GAIN) to assess individuals for substance abuse and mental health issues is the amount of high-quality data it collects that can be used to improve services and tailor treatment -- in this case, for adolescents. 
Before the GAIN, there wasn't a lot of reliable data available about adolescent needs. Now there is. By June 30, 2009 there were over 1,127 state, county, agencies and grantees (including 271 from the Center for Substance Abuse Treatment [CSAT]) using the GAIN.  This includes 271 CSAT grantees that have pooled their data and made it available for secondary analysis by local evaluators, researchers and students to help move the field forward with "practice-based evidence".  Close to 50 different scientists from over three dozen agencies are using the data. 

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? 

• Want to do something about juvenile justice reform right now? Then you should know that Act4JJ, a coalition supporting the reauthorization of the Juvenile Justice and Delinquency Prevention Act (JJDPA), is now on Facebook. (So is Reclaiming Futures, by the way: come on by and become a fan!)
• Interested in holding a conference on disseminating evidence-based practices in mental health and/or substance abuse? SAMHSA has two $50,000 grants available to help you do it. (Hat tip to the ATTC Network.)

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:

Seems to be the season for training folks in the juvenile justice system:

• The National Partnership for Juvenile Services is hosting a national symposium on juvenile services entitled "Representing America’s Youth:
  Transforming the Field of Juvenile Services," in Indiananopolis, October 11-14. Agenda topics include:
  • Juvenile Detention & Corrections
  • Education of Youth in Confinement
  • Community-Based & Residential Care
  • Presentation Skills & Training Techniques
  • Critical Issues

• 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.

"I really didn't even have a clue what a goal was, but to just get high. And now I have real goals ..."
So says David, age 17, one of five residents in this 10-minute video about New York City's Outreach House, a residential treatment center aimed at helping youth in the justice system change their behavior.
It's an eloquent testimonial to the fact that youth can and do change and an example of good storytelling to make a point about youth in the juvenile justice system.

 
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:

Anyone working on a Reclaiming Futures initiative -- or for that matter, anyone working to improve alcohol and drug treatment services, even if not for teens in the juvenile justice system -- will benefit from a new provider toolkit from the Network for the Improvement of Addiction Treatment (NIATx).

• 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.