Clinical Manual of Adolescent Substance Abuse Treatment

519 Pages·2010·2.96 MB·English

by  Yifrah Kaminer

Clinical Manual
of Adolescent
Substance Abuse
Treatment
This page intentionally left blank
Clinical Manual
of Adolescent
Substance Abuse
Treatment
Edited by
Yifrah Kaminer, M.D., M.B.A.
Ken C. Winters, Ph.D.
Washington, DC
London, England
Note: The authors have worked to ensure that all information in this book is accurate
at the time of publication and consistent with general psychiatric and medical standards,
and that information concerning drug dosages, schedules, and routes of administration
is accurate at the time of publication and consistent with standards set by the U.S.
Food and Drug Administration and the general medical community. As medical
research and practice continue to advance, however, therapeutic standards may change.
Moreover, specific situations may require a specific therapeutic response not included
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Library of Congress Cataloging-in-Publication Data
Clinical manual of adolescent substance abuse treatment / edited by Yifrah Kaminer,
Ken C. Winters. — 1st ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-58562-381-5 (pbk. : alk. paper)
1. Teenagers—Substance use. 2. Substance abuse—Treatment. I. Kaminer, Yifrah,
1951– II. Winters, Ken C.
[DNLM: 1. Substance-Related Disorders—diagnosis. 2. Substance-Related
Disorders—therapy. 3. Adolescent. 4. Comorbidity. WM 270 C64135 2011]
RJ506.D78C65 2011
616.86′060835--dc22
2010015528
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
Contents
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiii
Yifrah Kaminer, M.D., M.B.A.
Ken C. Winters, Ph.D.
1
Prevalence and Clinical Course of Adolescent
Substance Use and Substance Use Disorders. . .1
Tammy Chung, Ph.D.
Christopher S. Martin, Ph.D.
Adolescence as Critical Developmental Period
for Initiation of Substance Involvement. . . . . . . . . . . . .2
Substance Use Prevalence in Adolescents. . . . . . . . . . .3
Trajectories of Substance Use
During Adolescence. . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Diagnosis of Substance Use Disorders. . . . . . . . . . . . . .7
DSM-IV SUD Prevalence in Adolescent Samples. . . . . .8
SUD Diagnosis and Treatment Utilization . . . . . . . . . . .9
Limitations of DSM-IV SUDs . . . . . . . . . . . . . . . . . . . . .10
Developmentally Informed SUD Assessment . . . . . . .11
Course of Adolescent-Onset SUDs. . . . . . . . . . . . . . . .12
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Key Clinical Concepts . . . . . . . . . . . . . . . . . . . . . . . . . .18
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Suggested Readings. . . . . . . . . . . . . . . . . . . . . . . . . . . .23
Relevant Websites . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
2
Prevention of Substance Use and Substance
Use Disorders: Role of Risk and Protective
Factors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
Richard F. Catalano, Ph.D.
Kevin P. Haggerty, M.S.W.
J. David Hawkins, Ph.D.
Jenna Elgin, M.Ed.
Nature and Extent of the Problem . . . . . . . . . . . . . . . .26
Role of Risk Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
Role of Protective and Promotive Factors . . . . . . . . . .37
Tested and Effective Programs . . . . . . . . . . . . . . . . . . .42
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48
Key Clinical Concepts. . . . . . . . . . . . . . . . . . . . . . . . . . .50
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50
Suggested Readings. . . . . . . . . . . . . . . . . . . . . . . . . . . .63
Relevant Website . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
3
Screening and Brief Interventions for
Adolescent Substance Use in the General
Office Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . .65
Sharon Levy, M.D., M.P.H.
Ken C. Winters, Ph.D.
John R. Knight, M.D.
Screening. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66
Brief Interventions in Primary Care. . . . . . . . . . . . . . . .69
Adolescents Who Screen Negative for
High-Risk Drug Use . . . . . . . . . . . . . . . . . . . . . . . . . . . .69
Adolescents Who Screen Positive
for High-Risk Drug Use. . . . . . . . . . . . . . . . . . . . . . . . . .71
Follow-Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78
Key Clinical Concepts. . . . . . . . . . . . . . . . . . . . . . . . . . .78
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
Suggested Readings. . . . . . . . . . . . . . . . . . . . . . . . . . . .80
Relevant Website . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81
4
Biomarker Testing for Substance Use
in Adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . .83
Janelle E. Arias, M.D.
Albert J. Arias, M.D.
Yifrah Kaminer, M.D., M.B.A.
Social Context of Youth Drug Testing. . . . . . . . . . . . . .84
Concordance Among Reports. . . . . . . . . . . . . . . . . . . .87
Available Biomarkers . . . . . . . . . . . . . . . . . . . . . . . . . . .89
Overview of Testing by Sample Source . . . . . . . . . . . .90
Drug Enforcement Administration Schedule
for Selected Drugs of Abuse . . . . . . . . . . . . . . . . . . . . .92
Testing for Specific Drugs of Abuse . . . . . . . . . . . . . . .92
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .105
Key Clinical Concepts. . . . . . . . . . . . . . . . . . . . . . . . . .105
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106
Suggested Reading. . . . . . . . . . . . . . . . . . . . . . . . . . . .111
Relevant Websites . . . . . . . . . . . . . . . . . . . . . . . . . . . .112
5
Placement Criteria and Treatment Planning
for Adolescents With Substance Use
Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113
Marc Fishman, M.D.
General Principles of Treatment
Planning and Placement . . . . . . . . . . . . . . . . . . . . . . .114
Dimensional Assessment and Treatment
Planning Using the ASAM PPC-2R . . . . . . . . . . . . . . .117
Treatment Matching and Placement . . . . . . . . . . . . .128
Key Clinical Concepts. . . . . . . . . . . . . . . . . . . . . . . . . .135
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135
6
Adolescent Behavioral Change:
Process and Outcomes . . . . . . . . . . . . . . . . . . .143
Ken C. Winters, Ph.D.
Yifrah Kaminer, M.D., M.B.A.
Advances in Youth Treatment Research. . . . . . . . . . .144
The Therapeutic Process . . . . . . . . . . . . . . . . . . . . . . .145
How to Differentiate Youth From Adults
in Preparation for Treatment. . . . . . . . . . . . . . . . . . . .146
Assessment Reactivity . . . . . . . . . . . . . . . . . . . . . . . . .147
Heterogeneity of Response to Adolescent
Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149
Aftercare or Continued Care . . . . . . . . . . . . . . . . . . . .151
Adaptive Treatment for Youth. . . . . . . . . . . . . . . . . . .154
Future Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . .156
Key Clinical Concepts . . . . . . . . . . . . . . . . . . . . . . . . .156
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157
Suggested Reading. . . . . . . . . . . . . . . . . . . . . . . . . . . .161
7
Pharmacotherapy of Adolescent
Substance Use Disorders . . . . . . . . . . . . . . . . .163
Yifrah Kaminer, M.D., M.B.A.
Lisa A. Marsch, Ph.D.
Challenges in the Development of
Pharmacotherapy for Adolescents With AOSUDs . . .164
Drug-Specific Pharmacotherapy . . . . . . . . . . . . . . . . .165
Future Directions and Conclusion. . . . . . . . . . . . . . . .180
Key Clinical Concepts. . . . . . . . . . . . . . . . . . . . . . . . . .181
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181
8
Club Drug, Prescription Drug, and
Over-the-Counter Medication Abuse:
Description, Diagnosis, and Intervention . . . .187
Christian Hopfer, M.D.
Club Drugs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188
Prescription and Over-the-Counter Medications. . . .200
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .207
Key Clinical Concepts. . . . . . . . . . . . . . . . . . . . . . . . . .208
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .208
Relevant Websites . . . . . . . . . . . . . . . . . . . . . . . . . . . .212
9
Brief Motivational Interventions,
Cognitive-Behavioral Therapy, and
Contingency Management for Youth
Substance Use Disorders . . . . . . . . . . . . . . . . .213
Yifrah Kaminer, M.D., M.B.A.
Anthony Spirito, Ph.D., A.B.P.P.
William Lewander, M.D.
Brief Motivational Interventions . . . . . . . . . . . . . . . . .214
Cognitive-Behavioral Therapy . . . . . . . . . . . . . . . . . . .225
Contingency Management
Reinforcement Approach. . . . . . . . . . . . . . . . . . . . . . .229
Key Clinical Concepts. . . . . . . . . . . . . . . . . . . . . . . . . .232
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .232
Relevant Website . . . . . . . . . . . . . . . . . . . . . . . . . . . . .237