Prevalence of Adolescent Substance Use Disorders Across Five Sectors of Care

doi:10.1097/00004583-200104000-00010

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 40, Issue 4, April 2001, Pages 419-426

https://doi.org/10.1097/00004583-200104000-00010 Get rights and content

ABSTRACT

Objective

To examine the prevalence of substance use disorders (SUDs) among adolescents who received services in one or more of the following public sectors of care: alcohol and drug (AD), juvenile justice (JJ), mental health (MH), public school-based services for youths with serious emotional disturbance (SED), and child welfare (CW), in relation to age, gender, and service sector affiliation.

Methods

Participants included 1,036 adolescents aged 13 to 18 years, randomly sampled from all youths who were active in at least one of the above five sectors of care (N = 12,662) in San Diego County California. SUDs were assessed through structured diagnostic interviews conducted from October 1997 through January 1999.

Results

SUDs were found for youths in all sectors of care, with lifetime rates of 82.6% in AD, 62.1% in JJ, 40.8% in MH, 23.6% in SED, and 19.2% in CW. Rates of SUDs were significantly higher among older youths and males. Sector differences held even when accounting for the effects of age and gender.

Conclusions

SUDs are highly prevalent among youths receiving care in the AD service sector as well as other sectors, particularly JJ and MH. These findings have implications for assessment, treatment, and service coordination for youths with SUDs in diverse sectors of public care.

Section snippets

Participants

The sample for the present study was drawn from youths in a larger study of service use in publicly funded youth-serving agencies in San Diego County, California (see Garland et al., 2001). Youths were deemed eligible to participate in the larger study by virtue of having received services from one or more of five public service sectors serving youths at risk for substance use or mental health problems between January 1, and June 30, 1997. Eligible participants were between the ages of 6 and 17

RESULTS

As shown in Figure 1, 39.5% of the sample met criteria for at least one SUD in their lifetime, and 24.1% met criteria for a SUD within the past year. Also as shown in Figure 1, lifetime and past-year diagnoses of alcohol and cannabis use disorders were most prevalent, followed by amphetamines, hallucinogens, cocaine, and opiates.

DISCUSSION

As expected, SUDs were prevalent among youths from all five sectors of care. Aggregated across all sectors, more than one-third of youths in the sample met criteria for at least one of the six SUDs in their lifetime, and one-quarter met criteria for at least one of the SUDs in the past year. These rates were markedly higher than those found in community (e.g., 6.2%) (Kandel et al., 1999) and school studies (e.g., 8%) (Rohde et al., 1996). Rates of SUDs among youths with involvement in the AD

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The aim of this study is to investigate the prevalence of substance-use disorders and their association with childhood adversities and impulsive behavior among child welfare-and juvenile justice-involved adolescents in residential care.
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Moreover, fragmented systems of care (Hoberman, 1992; Maschi, Hatcher, Schwalbe, & Rosato, 2008) are also likely to cause JIY to “get lost” in the referral process between justice and behavioral health systems (Penchansky & Thomas, 1981; Pescosolido et al., 1998; Stiffman et al., 2001) as these youth move from the justice system to the community behavioral health system for SU treatment. Models of treatment seeking and service use among youth frequently acknowledge that they enter into behavioral health services via several different pathways (e.g. parent, behavioral health providers, child welfare, juvenile justice, or education workers) (Aarons, Brown, Hough, Garland, & Wood, 2001; Costello, Pescosolido, Angold, & Burns, 1998; Stiffman, Pescosolido, & Cabassa, 2004). In particular, due to age and lack of independence, caregivers play an important role in how and when youth access treatment services; youth tend not to self-refer.
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View all citing articles on Scopus

: This research was supported by NIMH grant U01 MH55282 (to Dr. Hough) and by grants AA07033 and MH01695.

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ArticlesPrevalence of Adolescent Substance Use Disorders Across Five Sectors of Care

ABSTRACT

Objective

Methods

Results

Conclusions

Section snippets

Participants

RESULTS

DISCUSSION

J Adolesc Health

J Am Acad Child Adolesc Psychiatry

Drug Alcohol Depend

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Drug Alcohol Depend

Diagnostic and Statistical Manual of Mental Disorders, 3rd edition-revised (DSM-III-R)

Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)

Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: basic findings from the national comorbidity survey

Exp Clin Psychopharmacol

Conduct disorder among adolescent alcohol and drug abusers

J Stud Alcohol

Measuring child, adolescent, and family service use

Advantages of the CIDI family of instruments in epidemiological research of substance use disorders

Int J Methods Psychiatr Res

The CIDI-Core substance abuse and dependence questions: cross-cultural and nosological issues

Br J Psychiatry

The reliability of the CIDI-SAM: a comprehensive substance abuse interview

Br J Addict

Articles
Prevalence of Adolescent Substance Use Disorders Across Five Sectors of Care