Rounds-Bryant J L, Kristiansen P L, Hubbard R L
National Development and Research Institutes, Incorporated, Raleigh, North Carolina 27605, USA.
Am J Drug Alcohol Abuse. 1999 Nov;25(4):573-91. doi: 10.1081/ada-100101880.
The present study presents background and pretreatment characteristics of adolescent substance abuse treatment clients, and it provides a mechanism for describing perhaps the largest research sample of adolescents who were in drug treatment in this decade.
The sample was 3382 subjects who presented for treatment from 1993 to 1995 in 37 programs in Pittsburgh. Pennsylvania: Miami, Florida; Minneapolis, Minnesota; Chicago, Illinois; Portland, Maine; and New York City, New York. Informed permission for the youth to participate was obtained from the subject's custodial parent/guardian, and both the youth and the youth's parents or guardians provided informed assent if they agreed to participate as subjects. Adolescents then were interviewed privately and confidentially by a trained professional interviewer who was independent of the treatment programs. The interviews queried subjects about their background, including education and employment; physical and mental health; use of tobacco, alcohol, and other drugs; sexual experiences; legal problems: religious beliefs; and treatment experience.
The long-term residential treatment modality was the least gender balanced of the modalities and had the most African-American and Hispanic clients. This modality was distinguished by the proportion of clients who were referred to treatment by the juvenile or criminal justice system. Compared with other clients in other modalities, short-term inpatient clients were more likely to be female and white. Inpatient clients also reported more indicators of psychiatric impairment. Outpatient clients were slightly younger than clients in the other modalities, and more of them were attending school at the time of admission to treatment. Outpatient clients had the least criminally involved lifestyles, their rates of (regular daily or weekly) drug use were also the lowest of the three modalities for all drugs assessed, and they had the least drug treatment experience.
These results merit several recommendations. One is the need for more community-based adolescent substance abuse treatment programs. An additional recommendation is for more substance abuse treatment programs in facilities that serve incarcerated youth. Finally, and perhaps most critically, it is recommended that programs be designed to address such specialized issues as comorbid substance abuse and psychiatric problems, family dysfunction, physical and sexual abuse, gender and ethnic differences, and academic performance.
本研究介绍了青少年药物滥用治疗对象的背景和治疗前特征，并提供了一种机制来描述这十年中可能是接受药物治疗的最大规模青少年研究样本。
样本为1993年至1995年在宾夕法尼亚州匹兹堡、佛罗里达州迈阿密、明尼苏达州明尼阿波利斯、伊利诺伊州芝加哥、缅因州波特兰和纽约市的37个项目中接受治疗的3382名受试者。已从受试者的监护父母/监护人处获得其参与的知情许可，并且如果青少年及其父母或监护人同意作为受试者参与，则他们提供了知情同意。然后，由一名独立于治疗项目的训练有素的专业访谈员对青少年进行私下和保密的访谈。访谈询问了受试者的背景，包括教育和就业情况；身心健康状况；烟草、酒精和其他药物的使用情况；性经历；法律问题；宗教信仰；以及治疗经历。
长期住院治疗模式在性别平衡方面是各种模式中最差的，并且非裔美国人和西班牙裔客户最多。这种模式的特点是由少年或刑事司法系统转介接受治疗的客户比例。与其他模式的其他客户相比，短期住院客户更可能是女性和白人。住院客户还报告了更多精神障碍指标。门诊客户比其他模式的客户略年轻，并且在入院接受治疗时更多人正在上学。门诊客户的犯罪相关生活方式最少，在所有评估药物中，他们（每天或每周定期）吸毒率也是三种模式中最低的，并且他们的药物治疗经历最少。
这些结果值得提出几项建议。一是需要更多基于社区的青少年药物滥用治疗项目。另一项建议是在为被监禁青少年提供服务的设施中增加药物滥用治疗项目。最后，也许也是最关键的是，建议设计项目来解决诸如药物滥用与精神问题共病、家庭功能失调、身体和性虐待、性别和种族差异以及学业成绩等特殊问题。
