Dial for therapy: aftercare for adolescent substance use disorders

ENGLISH :
Substance abuse among American youths continues to pose a serious public health concern. However, only a small segment of the adolescent subpopulation with alcohol and other substance use disorders (AOSUD), in particular those with high severity of AOSUD, comorbid psychiatric disorders, and legal problems, usually end up in treatment. The more therapeutic services received during treatment, the better is the short-term outcome. The more therapeutic services received post-treatment, however, the poorer is the short-term outcome. Use of outside services after treatment completion presented a response to rather than a cause of substance use. Maintenance of treatment gains in the months after treatment has been problematic in youths with AOSUD. An approximately 60% relapse was reported during the first 3 months after treatment completion and an additional 20% relapse during the rest of the first year. Approximately 60% of adolescents continued either to vacillate in and out of recovery after discharge from the Cannabis Youth Treatment study or to manifest at least some form of substance abuse. Lack of continuity of care or aftercare programs for adolescents with AOSUD is the rule rather than the exception. There is a need to increase the overall effectiveness of treatment as well as maintain treatment gains by developing and testing the efficacy of behavioral aftercare interventions and services tailored to match the adolescent daily lifestyle. The only aftercare intervention with youths successfully tested so far has been the Assertive Community Reinforcement Approach. (Extract of the publication)