Why the Treatment System is Failing Adolescents

While field professionals have long lamented the gaps in the treatment of addictions and mental illness, there is particular urgency on this issue when discussing adolescent care. More than 90% of adults who have a substance use disorder (SUD) began using as a teenager, says Kathleen Meyers, PhD, a senior scientist at the Treatment Research Institute (TRI).

Because of the high risk of long-term effects associated with teenage substance use, the field has to improve on identifying individuals who are at risk, providing additional types of programming, and allowing increased access through wellness benefits and insurance plans, Meyers says.

“We treat adolescent substance use as a discrete one-time condition,” Meyers explains. “We ignore risk factors and continuing care needs. If we’re thinking about substance use as a disease, we’ve got to look at it in the way that you would look at other conditions.”

Time for change

TRI recently released a report titled Paving the Way to Change: Advancing Quality Interventions for Adolescents Who Use, Abuse or Who are Dependent Upon Alcohol or Other Drugs. The report, for which Meyers was lead author, provides insight into the individual, societal and financial consequences of adolescent substance use disorders. It also shines light on the current treatment system and explains why it is “failing our kids.”

Currently, providers are doing the best they can with limited resources. However, a necessary addition, Meyers says, is holistic care. Because of the complexities associated with the youth population, holistic care is necessary to assist children with problems in multiple areas of their lives including family, mental health and school.

In addition to expanding adolescent treatment to include all aspects of holistic care, quality needs to be improved by figuring out how to achieve more funding for programs, hiring higher-level staff and linking clients with continuing care after leaving treatment, Meyers says.

After leaving a 25-day residential program or completing four weeks of outpatient care, the adolescent is typically released back into the lifestyle he or she came from. There is very little step-down care and the individuals do not necessarily have the skill set that will propel them in the long-term, says Meyers. Although they do see some short-term bursts of improvement, adolescents typically last anywhere between three weeks to six months before relapsing, and the vast majority relapse within the first three to six months after leaving treatment, she explains.

One of the main takeaways from the research was that “people don’t recognize that adolescence is the at-risk period for developing a substance use disorder,” says Meyers. Society needs to change the perception that low-level drug use is “not a big deal” because it indeed can lead to serious consequences.

In addition to laying out the issues, the report also provides suggestions for those looking to take action. Individuals and groups – whether it’s researchers, practitioners, family members, or advocates – can come together to determine which pieces each will tackle. Of course, a large part of the issue will be funding. The report makes suggestions regarding funding, including:

Re-allocating Block Grant savings to reimbursement/funding for early intervention services.

  • Working with treatment providers to rapidly assist individuals with insurance applications to insure all eligible are enrolled.
  • Identifying real (and potential) cost-savings and develop policies to re-allocate dollars for early intervention.
  • Ensuring that adolescent AOD (alcohol and other drugs) prevention and wellness programs are specifically included in state plans that receive dollars through the Prevention and Public Health Fund.
  • Challenging states to perform financial mapping.
  • Developing an Oversight Committee that will be responsible for addressing financing issues by identifying all potential funding streams as well as identifying where in a state’s portfolio dollars could be diverted (over and above Block Grant Dollars).

The Mental Health Parity and Addiction Equity Act and other legislation have created the opportunity for these changes to occur and make a difference for adolescents who are at risk or adolescents with substance use disorders.