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Adolescents who enter treatment for substance use often do not complete the recommended program, return to regular use, and do not initiate continuing care services.
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Assertive approaches (counselor-initiated home or school-based continuing care) increase linkage to continuing care, and rapid initiation of continuing care makes a difference in reducing substance use.
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Findings suggest that continuing care is appropriate for those who successfully complete treatment.
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Evidence is accumulating to
Child and Adolescent Psychiatric Clinics of North America
Continuing Care for Adolescents in Treatment for Substance Use Disorders
Section snippets
Key points
Research on adolescent linkage to continuing care services
Despite evidence of the importance of continuing care and the emphasis placed on continuity of care by the American Society of Addiction Medicine and other organizations, most adolescents do not receive these services. Linkage rates to professional continuing care range from 35% to 45% within 90 days of discharge.15, 43 Less than one-half of youth receive a referral for continuing care because they leave treatment early—usually against staff advice or at staff request.53 Reports of linkage
Research on continuing care for adolescents after residential treatment for substance use disorders
Most research on adolescent continuing care has focused on delivery of services after discharge from residential treatment.
Adaptive approaches to continuing care
Because research shows that a large segment of youth who enter treatment do not complete the program and that many do not achieve abstinence or sobriety, it is important to examine continuing care interventions aimed at improving outcomes of poor responders to treatment. Godley and colleagues65 state that, because several episodes of treatment are the rule rather than the exception, noncompletion of services does not necessarily indicate that youth may fail to benefit from continuing care.
Research on other recovery supports for adolescents
Although most randomized studies of adolescent continuing care have investigated professionally provided programs, there has been research with varying levels of rigor into other recovery support services.
Which adolescents benefit most from continuing care?
Existing research with adults and adolescents provides preliminary ideas for which youth might benefit most from particular continuing care services. In the adult literature, when Lynch and colleagues83 compared telephone monitoring plus counseling with treatment as usual with telephone monitoring only, they found that telephone monitoring was more beneficial than treatment as usual for women and participants with lower readiness to change. McKay and colleagues51 discovered that adults with
Summary
Research shows that many adolescents who enter substance use treatment do not complete the program and, after discharge, do not initiate continuing care services. Furthermore, the majority of adolescents will return to some level of substance use either during or after treatment. As youth return to use and problems occur, many will re-enter treatment, and some will do so several times. This pattern of disjointed treatment episodes remains the norm in contemporary practice rather than the
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Widening Gaps and Disparities in the Treatment of Adolescent Alcohol and Drug Use Disorders
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2022, Drug and Alcohol Dependence ReportsAcute injury mortality and all-cause mortality following emergency department presentation for alcohol use disorder
2022, Drug and Alcohol DependenceCitation Excerpt :Acute injury deaths also accounted for one-third of all deaths among AUD patients aged 25–44 years. Although these younger patients’ overall mortality rates were lower than those of other age groups, their very high risk for unintentional poisoning, suicide, and homicide underscores the need for greater use of ED-based, evidence-backed overdose, suicide, and violence prevention approaches (Miller et al., 2017), potentially including assertive interventions (e.g., counselor-initiated home or school-based continuing care) for young patients (Passetti et al., 2016). In contrast, the acute injury deaths accounted for only 11% of deaths among patients aged 45–64 years (who made up nearly 40% of the cohort), and just 3% among patients aged ≥ 65 years.
Hospitalisation following therapeutic community drug and alcohol treatment for young people with and without a history of criminal conviction
2022, Drug and Alcohol DependenceCitation Excerpt :Nonetheless, future research needs to explore in further detail if a focus on employment, education, and general life skills in programs such as PALM provide health benefits beyond what is obtained from reductions in substance use. Appropriate and well-resourced aftercare also plays an important role in sustaining the long-term benefits of drug and alcohol treatment (Jason et al., 2007; Passetti et al., 2016) and may help explain some of the findings in the current study. All who participate in PALM are offered up to three years of ongoing support via the Continual Adolescent Life Management (CALM) programme.
Parent SMART (Substance Misuse in Adolescents in Residential Treatment): Pilot randomized trial of a technology-assisted parenting intervention
2021, Journal of Substance Abuse Treatment
The authors have no conflicts of interest.
Funding: NIH, R01AA021118.