An evaluation of drug treatments for adolescents in 4 US cities

Background: Little is known about outcomes of community-based treatment pro grams for adolescents with drug problems. Methods: We studied 1167 adolescents (age range, 11-18 years; 368 females, 799 males) from 4 US cities (Pittsburgh, Pa; Minneapolis, Minn; Chicago, Il l; and Portland. Ore) using a naturalistic, nonexperimental evaluation desi gn. These adolescents were consecutive admissions during the period from 19 93 to 1995 at 23 community-based treatment programs in the Drug Abuse Treat ment Outcome Studies for Adolescents. Included were 418 admissions to 8 res idential programs, 292 admissions to 9 outpatient drug-free programs, and 4 57 admissions to 6 short-term inpatient programs. Results: Adolescents in treatment typically had multiple problems (eg, 58.4 % of them were involved in the legal system, and 63.0% met diagnostic crite ria for a mental disorder). Nevertheless, less than half (43.8%) of all pat ients reported weekly marijuana use in the year following treatment (droppi ng from 80.4% in the year before admission). Similarly, there were decrease s in heavy drinking (dropping from 33.8% to 20.3%), use of other illicit dr ugs (dropping from 48.0% to 42.2%), and criminal involvement (dropping from 75.6% to 52.8%).;Additionally patients reported better psychological adjus tment and school performance after treatment. Longer stays in treatment wer e positively associated with several favorable outcomes, although length of time in treatment was generally short. Conclusions: Substance abuse treatment for adolescents is effective in achi eving many important behavioral and psychological improvements. Strategies specific to adolescents to improve their treatment retention and completion are needed to maximize the therapeutic benefits of drug treatment.