Advertisement

How to Navigate Different Levels of Care

  • Dana SarveyEmail author
Chapter

Abstract

The vast majority of youth within the United States diagnosed with substance use disorders are not currently engaged in treatment. This disparity provides an opportunity for mental health practitioners to intervene early and refer adolescents to care. Learning how to conduct a multidimensional assessment is critical for identifying appropriate treatment needs for adolescents. Levels of care are discussed, along with an overview of evidenced-based psychosocial treatments, with an emphasis on reduction of use as the goal for most adolescents. A brief discussion on how to navigate insurance coverage and utilize available professional resources for referral is also included.

Keywords

Multidimensional assessment Treatment principles Outpatient treatment Intensive outpatient treatment Partial hospitalization Residential treatment Inpatient units Detoxification units Levels of care 

References

  1. 1.
    Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set (TEDS): 2002–2012. National admissions to substance abuse treatment services. Rockville: Substance Abuse and Mental Health Services Administration; 2014. BHSIS Series S-71, HHS Publication No. (SMA) 14–4850.Google Scholar
  2. 2.
    Substance Abuse and Mental Health Services Administration. Results from the 2009 national survey on drug use and health: summary of national findings. Office of Applied Statistics; Rockville: 2010. NSDUH Series H-38A, HHS Publication No. (SMA) 10-4586.Google Scholar
  3. 3.
    Ilgen M, Schulenberg J, Kloska D, et al. Prevalence and characteristics of substance use treatment utilization by US adolescents: national data from 1987 to 2008. Addict Behav. 2011;36(12):1349–52.CrossRefGoogle Scholar
  4. 4.
    Waldon H, Slesnick N, Brody J, et al. Treatment outcomes for adolescent substance abuse at 4- and 7-month assessments. J Consult Clin Psychol. 2001;69(5):802–13.CrossRefGoogle Scholar
  5. 5.
    Miller W, Walters S, Bennett M. How effective is alcoholism treatment in the United States? J Stud Alcohol Drugs. 2001;62:211–20.CrossRefGoogle Scholar
  6. 6.
    Saloner B, Carson N, Le Cook B. Explaining racial/ethnic differences in adolescent substance abuse treatment completion in the United States: a decomposition analysis. J Adolesc Health. 2014;54:646–53.CrossRefGoogle Scholar
  7. 7.
    Grella C, Her Y, Joshi V, et al. Drug treatment outcomes for adolescents with comorbid mental and substance use disorders. J Nerv Ment Dis. 2001;189:384–92.CrossRefGoogle Scholar
  8. 8.
    Chan YF, Dennis ML, Funk RR. Prevalence and comorbidity of major internalizing and externalizing problems among adolescents and adults presenting to substance abuse treatment. J Subst Abus Treat. 2008;34(1):14–24.CrossRefGoogle Scholar
  9. 9.
    Kennedy B, Minami M. The beech hill hospital/outward bound adolescent chemical dependency treatment program. J Subst Abus Treat. 1993;10(4):395–406.CrossRefGoogle Scholar
  10. 10.
    Han B, Compton W, Blanco C, et al. National trends in substance use and use disorders among youth. J Am Acad Child Adolesc Psychiatry. 2017;56(9):747–54.CrossRefGoogle Scholar
  11. 11.
    NIDA. Principles of adolescent substance use disorder treatment: a research-based guide. National Institute on Drug Abuse website. Available from: https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide. January 14, 2014. Accessed 7 Jan 2018.
  12. 12.
    Dow SJ, Kelly JF. Listening to youth: adolescents’ reasons for substance use as a unique predictor of treatment response and outcome. Psychol Addict Behav. 2013;27(4):1122–31.CrossRefGoogle Scholar
  13. 13.
    Rudd RA, Seth P, David F, et al. Increases in drug and opioid-involved overdose deaths — United States, 2010–2015. MMWR. 2016;65:1445–52.PubMedGoogle Scholar
  14. 14.
    Ramchand R, Griffin B, Hunter S, et al. Provision of mental health services as a quality indicator for adolescent substance abuse treatment facilities. Psychiatr Serv. 2015;66:41–8.CrossRefGoogle Scholar
  15. 15.
    Hser Y, Grella C, Hubbard R, et al. An evaluation of drug treatments for adolescents in 4 US cities. Arch Gen Psychiatry. 2001;58(7):689–95.CrossRefGoogle Scholar
  16. 16.
    Anthony J, Petronis K. Early onset drug use and risk of later drug problems. Drug Alcohol Depend. 1996;40(1):9–15.CrossRefGoogle Scholar
  17. 17.
    Dennis M, Babor T, Roebuck C, et al. Changing the focus: the case for recognizing and treating cannabis use disorders. Addiction. 2002;97(S1):4–15.CrossRefGoogle Scholar
  18. 18.
    Tanner-Smith E, Wilson S, Lipsey M. The comparative effectiveness of outpatient treatment for adolescent substance abuse: a meta-analysis. J Subst Abus Treat. 2013;44(2):145–58.CrossRefGoogle Scholar
  19. 19.
    Brown S, Vik P, Creamer V. Characteristics of relapse following adolescent substance abuse treatment. Addict Behav. 1989;14(3):291–300.CrossRefGoogle Scholar
  20. 20.
    Williams R, Chang S. A comprehensive and comparative review of adolescent substance abuse treatment outcome. Clin Psychol Sci Pract. 2000;7(2):138–66.CrossRefGoogle Scholar
  21. 21.
    Babbin S, Stanger C, Scherer E, et al. Identifying treatment response subgroups for adolescent cannabis use. Addict Behav. 2016;59:72–9.CrossRefGoogle Scholar
  22. 22.
    Macgowan M, Engle B. Evidence for optimism: behavioral therapies and motivational interviewing in adolescent substance abuse treatment. Child Adolesc Psychiatr Clin N Am. 2010;19(3):527.CrossRefGoogle Scholar
  23. 23.
    Dennis M, Godley S, Diamond G, et al. The cannabis youth treatment (CYT) study: main findings from two randomized trials. J Subst Abus Treat. 2004;27:197–213.CrossRefGoogle Scholar
  24. 24.
    Liddle H, Rowe C, Dakof G, et al. Early intervention for adolescent substance abuse: pretreatment to posttreatment outcomes of a randomized clinical trial comparing multidimensional family therapy and peer group treatment. J Psychoactive Drugs. 2004;36(1):49–63.CrossRefGoogle Scholar
  25. 25.
    Slesnick N, Prestopnik J, Meyers R, et al. Treatment outcome for street-living, homeless youth. Addict Behav. 2007;32(6):1237–51.CrossRefGoogle Scholar
  26. 26.
    Kelly J, Dow S, Yeterian J, et al. Can 12-step group participation strengthen and extend the benefits of adolescent addiction treatment? A prospective analysis. Drug Alcohol Depend. 2010;110(1–2):117–25.CrossRefGoogle Scholar
  27. 27.
    Stanger C, Ryan S, Scherer E, et al. Clinic- and home-based contingency management plus parent training for adolescent cannabis use disorders. J Am Acad Child Adolesc Psychiatry. 2015;54:445–53.CrossRefGoogle Scholar
  28. 28.
    Cornwall A, Blood L. Inpatient versus day treatment for substance abusing adolescents. J Nerv Ment Dis. 1998;186:482–580.CrossRefGoogle Scholar
  29. 29.
    French M, Popovici I, Tapsell L. The economic costs of substance abuse treatment: updated estimates and cost bands for program assessment and reimbursement. J Subst Abus Treat. 2008;35(4):462–9.CrossRefGoogle Scholar
  30. 30.
    Morral A, McCaffrey D, Ridgeway G. Effectiveness of community-based treatment for substance-abusing adolescents: 12-month outcomes of youths entering Phoenix academy or alternative probation dispositions. Psychol Addict Behav. 2004;18(3):257–68.CrossRefGoogle Scholar

Recommended Reading

  1. Belendiuk K, Riggs P. Treatment of adolescent substance use disorders. Curr Treat Options Psychiatry. 2014;1:175–88.CrossRefGoogle Scholar
  2. Mee-Lee D. The ASAM criteria: treatment criteria for addictive, substance-related, and co-occurring conditions. 3rd ed. Chevy Chase: American Society of Addiction Medicine; 2013.Google Scholar
  3. Mericle A, Arria A, Meyers K, Cacciola J, Winters K, Kirby K. National trends in adolescent substance use disorders and treatment availability: 2003-–2010. J Child Adolesc Subst Abuse. 2015;24(5):255–63.CrossRefGoogle Scholar
  4. NIDA. Principles of adolescent substance use disorder treatment: a research-based guide. National Institute on Drug Abuse website. Available from: https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide. January 14, 2014. Accessed 21 Jan 2018.

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Child and Adolescent PsychiatryMcLean HospitalBelmontUSA
  2. 2.Harvard Medical SchoolBostonUSA

Personalised recommendations