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Yih-Ing Hser, PhD; Christine E. Grella, PhD; Robert L. Hubbard, PhD; Shih-Chao Hsieh, MS; Bennett W. Fletcher, PhD; Barry S. Brown, PhD; M. Douglas Anglin, PhD

Arch Gen Psychiatry. 2001;58:689-695.

Background  Little is known about outcomes of community-based treatment programs for adolescents with drug problems.

Methods  We studied 1167 adolescents (age range, 11-18 years; 368 females, 799 males) from 4 US cities (Pittsburgh, Pa; Minneapolis, Minn; Chicago, Ill; and Portland, Ore) using a naturalistic, nonexperimental evaluation design. These adolescents were consecutive admissions during the period from 1993 to 1995 at 23 community-based treatment programs in the Drug Abuse Treatment Outcome Studies for Adolescents. Included were 418 admissions to 8 residential programs, 292 admissions to 9 outpatient drug-free programs, and 457 admissions to 6 short-term inpatient programs.

Results  Adolescents in treatment typically had multiple problems (eg, 58.4% of them were involved in the legal system, and 63.0% met diagnostic criteria for a mental disorder). Nevertheless, less than half (43.8%) of all patients reported weekly marijuana use in the year following treatment (dropping from 80.4% in the year before admission). Similarly, there were decreases in heavy drinking (dropping from 33.8% to 20.3%), use of other illicit drugs (dropping from 48.0% to 42.2%), and criminal involvement (dropping from 75.6% to 52.8%). Additionally, patients reported better psychological adjustment and school performance after treatment. Longer stays in treatment were positively associated with several favorable outcomes, although length of time in treatment was generally short.

Conclusions  Substance abuse treatment for adolescents is effective in achieving many important behavioral and psychological improvements. Strategies specific to adolescents to improve their treatment retention and completion are needed to maximize the therapeutic benefits of drug treatment.

From the UCLA Drug Abuse Research Center, Neuropsychiatric Institute, University of California, Los Angeles (Drs Hser, Grella, and Anglin and Ms Hsieh); the National Development and Research Institutes Inc, Raleigh, NC (Dr Hubbard); the National Institute on Drug Abuse, Bethesda, Md (Dr Fletcher); and the University of North Carolina at Wilmington (Dr Brown).

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