Teen Addiction Treatment: How Addiction & Treatment Differs for TeensAnna Ciulla
The teenage years present an often-tumultuous period of growth and development. Learning how to effectively cope with raging hormones, conflicting emotions, rapid or delayed physical and emotional growth, peer pressure, problems at home and experimentation with alcohol and drugs can take a toll. When teens, who are already vulnerable to suggestion and peer pressure and may experience great self-doubt, go beyond experimentation and become addicted to substances of abuse, getting them effective help may mean seeking professional drug and alcohol treatment. Teens are not yet adults, however, and their treatment needs may be quite different. This article will educate you on these different considerations when choosing a drug or alcohol rehab program for your teen.
HOW ADDICTION AFFECTS TEENS
Drinking alcohol has both short- and long-term consequences for teenage brains, which are still under development until sometime in their 20’s. In addition to the well-known short-term effects on the brain of teen alcohol consumption, such as difficulty making smart decisions and an increased propensity for risky behaviors (driving while intoxicated, having unprotected sex, etc.), there are long-term effects to be concerned about. Long-term drinking can interfere with teen brain development, negatively affecting information learning and processing and increasing the likelihood of developing an alcohol use disorder later in life.
Chronic drug use (of any addictive drug, prescription, and street) can lead to addiction. Consequences of short- and long-term drug use depend on the type of drug consumed, yet all are concerned about the damage they can cause teens, especially during their developmental years. Addiction to methamphetamine, for example, can occur very quickly, sometimes after first use. Research shows that regular meth use can lead to molecular and chemical changes in the brain that may persist for a long time. Changes to the teen body from chronic meth use include violent behavior, mood swings, anxiety, confusion, psychoses, severe dental problems, cognitive problems (thinking, memory, and emotion).
As heroin deaths increase, researchers have also found that high school seniors who currently use heroin also use multiple other addictive drugs, specifically other opioids, and benzodiazepines.
ADDICTION TREATMENT FOR TEENS
Treatment for addicted teens must address the whole person, not simply focus on his or her addiction. As such, and like effective approaches for adult addiction treatment, teen treatment must support his or her ongoing life needs, including medical, psychological, social well-being, school, transportation, legal and others. Unlike adult addiction treatment, medication-assisted therapies are rarely used in the treatment of teen alcohol use disorder. The Food and Drug Administration (FDA) does not recommend the use of Subutex or Suboxone for treatment of pediatric patients, and the safety and effectiveness of this drug for treating opioid addiction in teens below the age of 16 have not been established. Also, no current FDA-approved medications exist for the treatment of cannabis, cocaine or methamphetamine addiction (for adults or adolescents).
Treatment must also be tailored to the teen’s unique needs after a thorough assessment is made and considering his or her gender, family and peer relationships, how well the teen is doing in school, stage of psychological development, and any pertinent physical, behavioral, cultural and/or ethnic factors. Any diagnosed mental health conditions must also be addressed and treated concurrently with treatment for substance use disorder (SUD). Any issues involving violence, child abuse, and suicide risk must be identified and addressed. A combination of therapies may be best for the adolescent’s treatment plan, and the course of treatment will include monitoring for drug use.
TEENS AND MENTAL HEALTH PROBLEMS
The prevalence of teen depression has increased by 30 percent in just the last decade. Some of this has been linked to incidences of cyberbullying, especially among teenage girls. The risk of depression sharply increases during adolescent years, with a 2010 study reporting that approximately one in every four to five adolescents meet criteria for a serious mental health disorder across their lifetime. Authors reported anxiety disorders as the most common condition (nearly 32 percent), followed by behavior disorders (19 percent), mood disorders (14 percent), and SUDs (11 percent).
More recently, a 2016 study examining the 12-month prevalence of major depressive episodes (MDEs) among adolescents and young adults found MDEs increasing, with such increases larger and statistically more significant among those aged 12 to 20. Study authors noted an increase in specialty mental health providers for adolescents and young adults and an increase in both medications and inpatient hospitalizations for adolescents. However, the researchers emphasized that the growing number of young people suffering from untreated depression underscores the need for expanded service capacity to meet this population’s mental health needs.
Suicide is the second-leading cause of death for adolescents (ages 15-19) in the U.S. Suicide-related hospital visits nearly doubled among children aged 5 to 17 years from 2008-2015, with the highest increases reported in adolescents aged 15-17, and higher among adolescent girls across age groups.
TYPES OF BEHAVIORAL THERAPIES APPROPRIATE FOR TEENS
Since teens’ needs are unique regarding addiction treatment, any therapies or treatment approaches utilized for adults must be modified to specifically address addicted and drug-abusing adolescents. The National Institute on Drug Abuse (NIDA) has identified several behavioral treatment approaches proven effective for treating addicted teens—among them, multisystemic therapy, multidimensional family therapy, brief strategic family therapy, functional family therapy, and adolescent community reinforcement approach and assertive continuing care:
- Multisystemic Therapy-Substance Abuse (MST-SA) – Multisystemic therapy is an evidence-based treatment that is effective in treating teens with conduct-related problems. An adaptation of MST for teens with substance use disorders (SIDs), Multisystemic Therapy-Substance Abuse (MST-SA), has shown favorable results in treating adolescents diagnosed with SIDs. Although the treatment dropout rate of substance-dependent or substance-abusing adolescents is high, a study examining home-based MST found that its features of home visits, less waiting time, more frequent client contacts, high levels of therapist commitment to the client, and provision of concrete treatment services tended to reduce adolescent addiction treatment dropout.
- Multidimensional Family Therapy (MDFT) – Multidimensional family therapy is a family-focused therapy that is empirically supported and specializes in treating teen drug abuse and delinquency. According to research, MDFT participants’ substance use significantly decreased (between 41 and 66 percent from baseline to one-year follow-up). They also reported a reduction in substance abuse-related problems (antisocial, delinquent and externalizing behavior): 93 percent of MDFT youth reported no substance-related problems at the one-year follow-up.
- Brief Strategic Family Therapy (BSFT) – This is a flexible, problem-focused approach treatment that targets family interactions believed to exacerbate or maintain drug abuse and co-occurring problem behaviors. The therapist works with the family to identify patterns that foster or maintain problematic behavior in the teen and change these patterns by encouraging positive family interactions. BSFT can be used in several different settings and treatment modalities, drug abuse treatment centers, outpatient treatment, in combination with inpatient or residential treatment, continuing care and aftercare treatment.
- Functional Family Therapy (FFT) – A short-term (3-5 months) intervention program, FFT first assesses and then addresses risks and protective factors both within and outside of the family that affects the teen referred to treatment for behavioral or emotional problems. Treatment can be provided in clinic and home settings, as well as in schools and mental health facilities.
- Adolescent Community Reinforcement Approach (A-CRA) and Assertive Continuing Care – A behavioral intervention, A-CRA seeks to replace contingencies in a substance-using teen’s environment that have contributed to such use. Through pro-social activities and behaviors supporting recovery, A-CRA works with teens and their parents to promote teen abstinence and recovery, to assist teens in effective problem-solving to deal with everyday stressors and improving satisfaction with life without substance use.
- Assertive Continuing Care (ACC) – A home-based continuing care approach, ACC helps prevent teen substance use relapse following completion of residential, outpatient or intensive outpatient drug and alcohol treatment. This is known as continuing care or aftercare and is considered a critical part of managing adolescents’ recovery.
THE IMPORTANCE OF PEER SUPPORT GROUPS IN RECOVERY
One similarity with adult addiction treatment and recovery is the strong recommendation of participation in support groups. The most well-known support group is Alcoholics Anonymous (AA), whose teen support group (for other teen family members coping with a sibling’s addiction) is Alateen. Other self-help groups include Narcotics Anonymous (NA), Cocaine Anonymous (CA), and Teen-Anon.
Parents of the teen in recovery from drug or alcohol abuse may wish to consider enrolling their son or daughter in a recovery high school, specifically designed for students who are in recovery from substance use or dependency. Peer recovery support services, such as recovery community centers, may also be available in the family’s community to help the newly-sober teen continue to make progress in recovery and benefit from other teens’ recovery support and experiences.
WHY FAMILY TREATMENT IS CRITICAL TO TEENS’ RECOVERY
Even before your teen goes in for addiction treatment, there are things you can do to keep the family environment more stable. NIDA has a useful family checkup tool to help you communicate with your teen more effectively and calmly about relationship problems, advice on setting limits for teen behavior, negotiating emotional conflicts and working toward solutions, encouraging positive behaviors, and monitoring your teen’s time to ensure less unsupervised peer time.
Adults in the family can and should participate in self-help and support groups such as Al-Anon, so that they can learn to cope with the challenges of living with an addict and find hope and encouragement from listening to the experiences of others facing similar problems.
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