Thirty-month relapse trajectory cluster groups among adolescents discharged from out-patient treatment

FRANÇAIS :
Pour identifier les types de trajectoire de rechute, 563 adolescents, âgés de 12 à 18 ans ont été suivis à 3, 6, 9, 12 et 30 mois après leur sortie de traitement. 5 trajectoires ont été observées
: une faible consommation et un nombre de jour limité dans un environnement contrôlé (traitement résidentiel ou prison), une faible consommation et un nombre de jour élevé dans un environnement contrôlé, modération de la consommation, augmentation de la consommation et consommation substantiellement élevée. Le cannabis et lalcool sont les deux produits les plus souvent consommés, avec en plus la cocaïne pour les 2 groupes dont les trajectoires sont les pires.
ENGLISH :
Aims: To identify adolescent relapse trajectory groups following discharge from out-patient substance abuse treatment. Design, setting and participants: Adolescents aged 12-18, who were assigned randomly to one of five out-patient interventions (n = 563) in four United States communities and followed-up 3, 6, 9, 12 and 30 months post-intake. Outcome measures: Self-report measures of days using any alcohol or other drugs (AOD), days of alcohol use, days of cannabis use, days of heavy use, days of crack/cocaine use, days of heroin/opiate use, days AOD use interfered with responsibilities and days in a controlled environment. Findings: Adolescents can be grouped empirically into five relapse trajectories over 30 months following out-patient treatment: (a) low AOD use with limited days in a controlled environment; (b) low AOD use with high days in a controlled environment; (c) moderate/decreasing AOD use; (d) increasing AOD use; and (e) consistently high AOD use. Conclusions: There was considerable heterogeneity in the relapse trajectories, varying by the initial response to treatment, the stability (versus increase/decrease) of the response and an interaction with time in a controlled environment. Cannabis and alcohol were the two main substances involved, although the two groups with the poorest trajectories had increasing levels of cocaine, opiate and other substance use at the 30-month follow-up. This study demonstrates the chronicity of substance use even among a subgroup of adolescents and the importance of studying more complex longitudinal patterns of recovery. (Author' s abstract)