Research by Health Center child and adolescent psychiatrists sheds new light on the importance of “aftercare” when treating teens for drinking and drug abuse problems.
“Aftercare, more appropriately termed continued care, can help prevent relapse and chronic disease,” says Dr. Yifrah Kaminer, professor of psychiatry and co-director of research in the child and adolescent psychiatry division at the Health Center’s Alcohol Research Center.
“About 60 percent of adolescents relapse within three to 12 months of completing treatment for alcohol and/or other substance abuse disorders,” Kaminer says.
The study was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and the results published in the Journal of the American Medical Association.
Kaminer and co-investigator, Dr. Joseph Burleson in the Department of Community Medicine and Healthcare, conducted a randomized controlled study of 177 adolescents with alcohol use disorders, 80 percent of whom also abused marijuana.
The teenagers completed treatment that included nine weekly group cognitive behavioral therapy sessions aimed at improving their ability to refuse alcohol and drugs. After they completed their treatment, participants were randomly selected to receive three months of aftercare that included integrated cognitive behavioral therapy and motivational enhancement therapy. The therapy was delivered in either 50-minute face-to-face sessions or 15-minute telephone sessions. A control group received no aftercare intervention.
At the end of the study, the researchers found that both active aftercare interventions were associated with lower alcohol and cannabis use and fewer suicidal ideations. The innovative brief telephone intervention, which was not only feasible but acceptable to both therapists and participants, may prove a cost-effective way to deliver aftercare in general, and particularly to people in geographically remote areas, Kaminer says.
Teen substance abuse is a serious problem in Connecticut. Underage drinking is between 26 percent and 28 percent higher than the national average. Young people in the state are introduced to drinking on average at age 11 – two years earlier than youths in many other states.
And research shows that young people who start drinking before age 15 are five times more likely to have alcohol-related problems later in life.
| Dr. Yifrah Kaminer, a professor of psychiatry at the Health Center, has conducted research on adolescents with alcohol use disorders.
|Photo by Sheryl Rosen
“Underage drinking also plays a key role in the top three teen killers – car accidents, homicides, and suicides,” says Kaminer, “and is associated with youth drownings, violence, unprotected sex, date rape, and other risky and problematic behaviors.”
Research also indicates that underage smoking, drinking, and substance abuse can cause harm to the vulnerable adolescent brain, which continues to develop until at least the mid-20s, by making it more susceptible to developing addictive disorders.
Even short-term or moderate drinking impairs learning and memory far more among young people than among adults, and adolescents need drink only half as much as adults to suffer the same negative effects.
Kaminer says even though substance abuse usually starts in adolescence, most resources for drug treatment target programs for adults.
Yet research has found that the greater the age similarity between adolescents and other Alcoholics Anonymous and Narcotics Anonymous attendees, the more likely young people are to attend meetings, rate them as important to recovery, and have positive outcomes. Earlier treatment potentially could avert lifelong disorders.
Kaminer, the editor of a new book, Adolescent Substance Abuse: Psychiatric Comorbidity and High-Risk Behaviors, says treatment also needs to simultaneously address other psychiatric problems, which affect up to 80 percent of young people with substance use disorders.
In spring 2008, Kaminer and other Health Center researchers will begin a new study addressing the treatment needs of adolescents with alcohol problems. To learn more about the study, contact Kaminer at Kaminer@psychiatry.uchc.edu.