Adolescent Substance Abuse Treatment

Two important newly-available tools to help you unravel adolescent substance abuse treatment funding are out from the Substance Abuse and Mental Health Services Administration (SAMHSA):

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. 

Just last Tuesday I met with a tired and distraught single mother over a cup of coffee to offer recovery support following the sentencing of her adolescent son to 6 years in prison.
 
Weeping, distraught, and full of fear about his life, she described how his path of drug use, criminal activity and resistance to all treatment efforts had failed. She felt helpless and like she was being “mean to him” because she recently called him a liar.
 
She admitted to being obsessed with worry and asked, “How do you let go of your children? Isn’t it different with our kids, isn’t it natural to want to rescue them and protect them from harm and difficulty?”

• 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.  

• The so-called "Missouri Model" of juvenile justice reform received more coverage on CNN.
• Meanwhile, Louisiana, which has been attempting for several years to reform its own juvenile justice system by importing the Missouri Model, is seeing mixed results.
• The New York Times reported that four youth prisons in New York routinely broke kids' bones, "shattered" their teeth, and gave them concussions in attempts to discipline them.

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.)

Those of us who keep up with the field of adolescent substance abuse, as well as substance abuse treatment in general, are well-versed in the idea that addiction is a chronic, relapsing disease, and that it is not a choice.
Psychologist Gene M. Heyman says in a new book from Harvard University Press that addiction is not a disease, and it's not involuntary. Instead, he says, it's a choice. He doesn't mean that individuals choose addiction, but that every time they use, they're making a cost-benefit analysis -- i.e., a choice. And furthermore, he argues, most addicts quit without treatment once the costs outweigh the benefits.

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. 

Adolescent substance abuse in the juvenile justice system is the subject of Laurie Chassin's excellent article in the Fall 2008 issue of The Future of Children.
But I urge you to check out the entire issue, whose theme is "juvenile justice." Edited by Laurence Steinberg (whose recent book, Rethinking Juvenile Justice, we gave away last March), the journal brings together research from a number of scholars connected with the MacArthur Foundation Research Network on Adolescent Development and Juvenile Justice, funded by the John D. and Catherine T. MacArthur Foundation. 

At The National Center on Addiction and Substance Abuse at Columbia University (CASA), we’ve been working for years to identify practical, realistic ways to keep kids drug-free. Why? Because a child who reaches age 21 without smoking, using illicit drugs or abusing alcohol is virtually certain never to do so. In other words, sober children become sober adults. And we’ve found that the best chance kids have of reaching age 21 drug-free is engaged parents. Parents have the greatest impact on whether their children will smoke, drink or use drugs.