Costs and consequences of drug use: a comparison of health care utilization and social-psychological consequences for clinical and nonclinical adolescents and their families.

A retrospective (case control) design was used to compare adolescents in treatment for alcohol and drug problems and their families with adolescents and families not in treatment to determine: (1) the extent to which adolescents' drug-using behavior was associated with greater physical and mental health services utilized by the adolescent and his/her family members over a period of 3 years; and (2) costs incurred for a health maintenance organization and social-psychological consequences for the individuals and their families. On the average, those families with an adolescent with alcohol and/or drug problems use more health services, resulting in greater costs to the prepaid health plan than the costs for families with adolescents not in treatment or not using drugs. For both the adolescents and other family members, significant differences between groups were found for utilization of mental health services, but not for services for physical health. Consequences of drug use--relational, health related, and social/legal--were greatest for adolescents in treatment. Adolescents whose drug use was similar to those in treatment, but who were not in treatment, also experienced drug-related consequences; this group can be considered at high risk for alcohol and drug problems that, in the future, may require treatment.