Study of Teens in Four Cities Finds
Drug Treatment Effective
NIDA News Release
July 11, 2001
The first large-scale study designed specifically to evaluate drug
abuse treatment outcomes among adolescents found that community-based
treatment programs can reduce drug and alcohol use, improve school
performance, and lower involvement with the criminal justice system.
The study, which is published in the July, 2001, issue of the Archives
of General Psychiatry, evaluated the treatment outcomes for nearly
1,200 adolescents, ranging in age from 11 to 18, who were enrolled
in one of 23 community-based treatment programs in four cities
Pittsburgh, Minneapolis, Chicago, and Portland between 1993
"It is clear from this evaluation that treating drug abuse
in teens reduces their use of drugs and improves many aspects of
their lives, " says NIDA Director Dr. Alan I. Leshner. "The
years of research spent developing effective treatment approaches
are beginning to pay off for these young people."
This study, conducted by Dr. Yih-Ing Hser and her colleagues at
the University of California, Los Angeles, is part of NIDA's ongoing
Drug Abuse Treatment Outcome Studies for Adolescents (DATOS-A).
The research team evaluated outcomes for 799 boys and 368 girls
enrolled in a variety of drug treatment programs, including residential
programs, outpatient drug-free programs, and short-term inpatient programs.
Dr. Hser says the teens made significant progress, even though
their length of time in treatment was generally short. The study
found that longer stays in treatment resulted in lower drug use
and lower rates of arrest following treatment.
"Community-based drug treatment programs do work for adolescents,"
says Dr. Hser. "But in order to maximize their therapeutic
benefits, we need to devise
strategies specific to adolescents to improve retention and completion
of the programs."
Details about the study
More than 400 teens participated in residential treatment, in which
they were provided with education, individual and group counseling,
and interventions to develop social responsibility. Almost 300 participated
in outpatient drug-free programs, which included counseling sessions,
education, and skills training.
Nearly 460 were admitted to short-term inpatient programs, which
provided counseling, 12-step sessions within a medically controlled
environment, and referral for continued outpatient treatment. About
a quarter the study's participants had used three or more drugs
prior to treatment. Nearly two-thirds were dependent upon marijuana,
over one-third dependent on alcohol, and 10 percent were addicted
to cocaine. In addition to substance abuse problems, more than half
were criminally active and 63 percent met diagnostic criteria for
a mental disorder. About one-third had dropped out of school.
Improvements Cited After Treatment
Comparing the year before treatment to the year following treatment,
improvements were seen in the following areas:
Drug Use weekly or more frequent marijuana use dropped from
80.4 percent to 43.8 percent; abstinence from use of other illicit
drugs increased from 52
percent to 57.8 percent.
Heavy Drinking dropped from 33.8 percent to 20.3 percent
Criminal Activities dropped from 75.6 percent to 52.8 percent.
Following treatment, the teens showed better psychological adjustment
as indicated by having fewer thoughts of suicide, lower hostility,
and higher self-esteem.
More of the teens attended school and reported average or better-than-average
grades following treatment.
Some Exceptions Noted
However, there were some exceptions to the general pattern of improvement.
Cocaine use increased three percentage points, from 16.5 percent
prior to treatment to 19.2 percent after treatment. This was attributable
primarily to increases in cocaine use among teens in the short-term
inpatient and the outpatient drug-free programs. Among those in
the outpatient treatment group, the use of hallucinogens and stimulants
did not improve.
The researchers evaluated whether a minimum length of stay for
90 days in residential and outpatient programs and 21 days in short-term
inpatient care were
related to better outcomes. Almost 60 percent of the residential
treatment group, 27 percent of the outpatient group, and 63.7 percent
of the inpatient group met or
exceeded these goals.
The patients who met or exceeded these length of stay criteria
had significantly better outcomes than those who did not. They were
about one and a half times more likely to be abstinent from marijuana,
alcohol, and other drug use in the year after treatment. They were
1.45 times less likely to be arrested and about one and a third
times more likely to have average or better grades in school than
adolescents who did not reach these treatment stays.