Blog: Adolescent Substance Abuse Treatment

If it is true that dollars drive decisions and the media shape attitudes on spending for public policy, we better all get off our couches, get involved, and mobilize to make sure policy makers understand how important it is to support youth and families in recovery.
Our family has suffered for years with generations of the disease of addiction. Two of our kids have made it; two have not. But when I was channel surfing last night, I saw enough images of  “rehab” to know there’s no hope that anyone would fund youth and family recovery services, given the current public will and culture.
 
Sensationalistic depictions of addiction are sold by the media business to get ratings, the media impacts public opinion and government, and the government impacts recovery spending on our health prospects and the future.

One of the most difficult things for adolescent substance abuse treatment service systems to do is to support teens in recovery.
Fostering peer support has long been seen as critical in adult recovery, but duplicating that for teens raises difficult-to-solve issues of liability and concern for their safety. 
Nevertheless, there's no question that peer support could be a powerful tool for teens in recovery, and many communities are looking at ways to accomplish it. Furthermore, new technological tools, like this iPhone app for 12 Step participants, may address some common barriers.
And now the Substance Abuse and Mental Health Services Administration (SAMHSA) is offering a small number of grants to commmunities wishing to build peer-to-peer recovery support services. (It would be great if one of the grantees focused specifically on adolescents in the justice system.) Deadline is February 10, 2010. 
However, note that the grant application specifies that "peer services must be designed and delivered primarily by individuals in recovery to meet the targeted community’s recovery support needs, as the community defines them." It also draws a sharp distinction between peer recovery and aftercare. 

This report on adolescent substance abuse and mental health issues in the federal legislation governing the juvenile justice system is reprinted, with permission, from the Spring/Summer 2009 issue of The Link: Connecting Juvenile Justice and Child Welfare, published by the Child Welfare League of America. The final fact sheet, suitable for printing, can be found on the Act-4-JJ website. 

 
The first part, below, describes the justification and the key issues; the second part contains recommendations for strengthening the Juvenile Justice and Delinquency Prevention Act.

When Congress considers legislation later this year to reauthorize the Juvenile Justice and Delinquency Prevention Act (JJDPA), mental health and substance abuse issues will be a top priority.
 
Available data from single site and multisite studies indicate that 70% or more of youth who are securely detained in a juvenile justice facility may suffer with mental health and related disorders; rates of mental health and substance abuse disorders appear to be somewhat higher for girls than boys; and more than 20% of such youth suffer disorders so severe that their ability to function is significantly impaired (Abram, Teplin, McClelland, & Dulcan, 2003; Skowyra & Cocozza, 2007; Teplin, Abram, McClelland, Dulcan, & Mericle, 2002).
 
Among youth under nonresidential court supervision (e.g., on probation), the rate of diagnosable mental health and substance abuse disorders is approximately 50%.
 
By comparison, in the general youth population, approximately 20% of youth suffer with mental health and substance abuse disorders. In addition, justice system involved youth may experience behavioral/emotional disorders for the first time because of contact with the juvenile justice system.

Your Juvenile Justice System: Share Local Needs with OJJDP

• What training and technical assistance does your system need?  The Office of Juvenile Justice and Delinquency Prevention (OJJDP) wants to know. Complete their online needs assessment for your juvenile justice system, and help them improve their understanding of local needs to build capacity and sustainability among juvenile justice organizations. 

 
Juvenile Justice System and Adolescent Substance Abuse Treatment News

• Laurence Steinberg, co-author of Rethinking Juvenile Justice, was just awarded $1 million for his work on adolescent developmental psychology -- work that has made him an expert on juvenile justice. Steinberg is the first winner of the Klaus J. Jacobs Research Prize, believed to be one of the largest prizes given in the social sciences.

Juvenile Justice Reform News

• The Coalition for Juvenile Justice has an update on the Congressional reauthorization of the federal Juvenile Justice and Delinquency Prevention Act (JJDPA), one of the key engines of juvenile justice reform. (Thanks to the Coalition for Juvenile Justice for sharing its slide deck.)
• Big news from Luzerne County, Pennsylvania, in the juvenile "kids for cash" case. The state Supreme Court overturned thousands of juvenile adjudications made by former Judge Mark A. Ciavarella, Jr., because he consistently failed to inform juveniles of their right to representation. Only the cases of youth still under court supervision would be eligible for retrial. (Hat tip to Youth Today.)

Yesterday, to celebrate the first anniversary of this blog, we began reposting our top 10 posts from the past year, including one on engaging the families of youth in the juvenile justice system, how to handle confidentiality and consent issues when connecting kids with adolescent substance abuse treatment, and more.
Today, our celebration continues with our top five posts (in reverse order of popularity): 

Help for Your Adolescent Substance Abuse Treatment System

Want to expand or improve your local recovery-oriented system of care for adolescents in the juvenile justice system who have alcohol and drug problems?
The federal Center for Substance Abuse Treatment (CSAT) has just announced new grants to help you do that. (The grant guidelines allow each applicant to specify a target population; my guess is that the proportion of applications submitted that focus on juveniles will be much smaller than those focusing on adults.) 
Up to 12 grants will be awarded with the anticipated award being up to $400,000/year for up to 3 years.
Deadline to Apply

And some more good news: you have until January 14, 2010 to submit your application. 

New federal funding has been awarded to expand the Reclaiming Futures model into three more juvenile drug courts across the country over the next four years.
The nearly $3.7 million federal investment was announced by The Substance Abuse and Mental Health Services Administration (SAMHSA) in collaboration with the U.S. Department of Justice’s Office of Juvenile Justice and Delinquency Prevention (OJJDP) and the Robert Wood Johnson Foundation (RWJF). RWJF is providing approximately $1 million in additional technical assistance to implement the Reclaiming Futures model.

In January 2007, the state of Washington mandated use of a 15-item, past-year version of the GAIN Short Screener (GAIN-SS) for all adolescents and adults seen by the Department of Social and Health Services in the state’s chemical dependency, mental health, child-welfare and justice programs.
 
Lucenko and colleagues1 recently used the data gathered through these sources to compile a report to the Washington legislature on the prevalence of co-occurring disorders in people presenting to these services. 
 
Figure 1 summarizes her results for adolescents. Consistent with prior research, the report shows that implementation of a simple screener identified youth with mental health, substance use or both in each setting.