JMATE 2012: How Can Research Inform Development of More Collaborative and Integrated Care Models for Youth and Families?

Half of all psychiatric disorders occur before the age of fifteen. Most childhood onset psychiatric disorders increase the risk of developing early onset substance use disorder. And substance use increases the risk of developing psychiatric disorders.
So, what can treatment providers do to improve the care of kids who are using substances and may have (or be developing) psychiatric disorders?
According to Dr. Paula Riggs (director, Division of Substance Dependence, University of Colorado's School of Medicine), treatment providers need to compile a detailed history of substance use disorders for the child and his/her family. The history should include:

• school risk factors (such as poor academic performance and substance use among the child’s friends);
• attention to any substance used more than five times;
• onset of substance use;
• the progression to current substance use; and
• frequency of use.

Dr. Riggs explained that this history is vital to understanding the cause of cause and risk of substance use and dependence. By gathering and analyzing this information, treatment providers will be able to provide a good diagnosis, which should drive treatment. “We shouldn’t be treating things unless we know what we are treating,” she said.

Early prevention is key to stopping the cycle of addiction. Dr. Riggs explained that kids are more vulnerable to addiction because they are experiencing rapid brain development that continues into their late 20s. So if they start using at a young age, they are much more likely to become addicted. Adolescents also take more risks than adults, which is also part of the brain development process.
As part of early prevention, providers should get at-risk kids involved in pro-social activities like karate that can continue for a lifetime and provide reinforcement and awards for achievement, said Dr. Riggs. Encouraging (and making sure that) at-risk youth are building relationships with non-using peers is also vital.
For those already struggling with substance abuse, making sure that treatment is accessible is essential. As Dr. Riggs explained, “if you offer free treatment, 80% will come in without court mandates.”
And of course, evidence based practices are key. “It’s time to get serious about systemic diagnosis and outcomes,” said Dr. Riggs.

Liz Wu is a Digital Accounts Manager at Prichard Communications, where she oversees digital outreach for Reclaiming Futures and edits Reclaiming Futures Every Day. Before joining the Prichard team, Liz established the West Coast communications presence for the New America Foundation, where she managed all media relations, event planning and social media outreach for their 6 domestic policy programs. Liz received a B.A. in both Peace and Conflict Studies and German from the University of California at Berkeley. She tweets from @LizSF.