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Extent of Substance Abuse
Several national studies provide information about trends in alcohol and other drug use by youth and can be used for comparison with jurisdictional data.1 The following summarizes recent trends in substance abuse among youth in the United States:
- Youth in the general population have reported steadily rising levels of alcohol and other drug use since 1992, but levels of use have not returned to the peak rates reported in the 1980's (Substance Abuse and Mental Health Services Administration [SAMHSA], 1998; Johnston, O'Malley, and Bachman, 1998).
- Youth are beginning to use alcohol and other drugs at earlier ages, and use increases steadily with age (SAMHSA, 1998; Johnston, O'Malley, and Bachman, 1998).
- As youth perceive that alcohol and other drugs are less harmful than they previously believed or their attitudes about the use of alcohol and other drugs become less negative, their use of these substances increases (SAMHSA, 1998; Johnston, O'Malley, and Bachman, 1998).
- Among male youth entering the juvenile justice system in 13 cities across the country, between 40.3 percent and 68.7 percent tested positive for illicit drugs at arrest or booking according to the 1998 report of the Drug Abuse Monitoring Program (National Institute of Justice [NIJ], 1999).
- Male juveniles with drug offenses have the highest rates of positive urinalyses for illegal drugs, but property and violent offenses clearly are also linked to drug use (NIJ, 1998). Unfortunately, national data about substance abuse by female delinquents are not available.
- There was a sharp increase (145 percent) in drug offense cases in juvenile court between 1991 and 1995 (Stahl, 1998).
- In the Monitoring the Future study (Johnston, O'Malley, and Bachman, 1998), 12th graders reported use of psychoactive substances throughout their lives, and the most frequently reported substances used were:
- Alcohol (81.7 percent).
- Cigarettes (65.4 percent).
- Marijuana/Hashish (49.6 percent).
- Smokeless Tobacco (25.3 percent).
- Stimulants (16.5 percent).
- Inhalants (16.1 percent).
- Hallucinogens (15.1 percent).
Although the prevalence of mental health and substance abuse disorders among youth in the juvenile justice system is largely unknown, research suggests that these problems are significantly greater for juvenile delinquents than for other youth (Bilchik, 1998). Applying the prevalence rates for youth in the general population to the approximately 848,100 youth annually involved in the juvenile court system when they developed their report, Otto and colleagues (1992) -estimated the following:
- Fourteen to twenty percent, or 118,700 to 186,500 youth, have at least one mental disorder.
- Thirty-two percent, or 271,400 youth, have an alcohol abuse or dependence disorder.
- Eleven percent, or 93,300 youth, have a substance abuse or dependence disorder.
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| Special Concerns About Treatment for Adolescents |
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Adolescent substance abusers are more difficult to treat than adult substance abusers. The pressures created by physical, hormonal, and emotional changes produce stressors that are magnified by typical adolescent developmental drives for individuality, separation, autonomy, and social acceptance. Lacking life experience, youth often have difficulty controlling their impulses or making appropriate decisions. Chemical dependence intensifies the behavior problems associated with adolescent development and simultaneously delays emotional development. Substance-abusing adolescents are frequently members of dysfunctional families in which there is no appropriate role model or support. An estimated 7 million children are growing up with at least one substance-abusing parent, and approximately 38 percent of all child abuse cases have parental substance abuse as a factor. These multiple disorders—mental, medical, and developmental—interfere with the progress and effectiveness of treatment. For that reason, the most successful treatment for any adolescent is based on an assessment of each contributing factor and is designed for that individual.
Just as services must be specialized for them, there are several pitfalls to avoid when planning a treatment program for adolescents, including the following: |
- Limiting assessment to substance abuse alone and thus excluding the diagnosis of contributing disorders that may complicate or interfere with treatment.
- Standardizing treatment and not considering adolescent developmental stages or the specific needs created by the age, gender, ethnicity, and other disorders of the adolescent substance abuser.
- Using adult criteria for treatment services that do not consider the psychological and clinical needs created by the developmental stages of adolescents.
- Ignoring the family's contribution to the adolescent's addictive disorder and possible solutions that could strengthen the family unit. Family-focused services for adolescents have more successful outcomes than those that focus only on individual youth.
Note: This material is based on contributions from Roberta Messalle, Office of Evaluation, Scientific Analysis and Synthesis, Center for Substance Abuse Treatment.
Source: Crowe, A.H., and Sydney, L. 2000. Ten Steps for Implementing a Program of Controlled Substance Testing of Juveniles. Bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.
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1. The Monitoring the Future study, supported by the National Institute on Drug Abuse, has surveyed high school seniors for more than 20 years; more recently, these surveys, in which a nationally representative sample of students answer questions about their alcohol and other drug use, have expanded to include college students and 8th and 10th graders (Johnston, O'Malley, and Bachman, 1998). Written questionnaires and interviewer-conducted surveys in participants' homes are used to gather data for the National Household Survey on Drug Abuse, sponsored by the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), which is administered to a sample of Americans, ages 12 and older, who live in the general community (noninstitutionalized), have a permanent address, and are not on active military duty (SAMHSA, 1998). The Arrestee Drug Abuse Monitoring Program implemented by the U.S. Department of Justice, National Institute of Justice (NIJ), was conducted with male juveniles in 12 cities across the country in 1997. They were asked to voluntarily submit to urinalysis and an interview about their use of illicit drugs at the time of their arrest or detention (NIJ, 1998). A statistical analysis of drug offense cases in juvenile court from 1986 to 1995, funded by the U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention, provides additional data regarding juveniles' involvement with alcohol and other drugs (Stahl, 1998). |
