When Depressed Teenagers Abuse Drugs, Take Action!

Most likely, if a teen struggles with substance abuse, he or she also suffers from some form of mental illness. Of adolescents who enter drug and alcohol rehabilitation programs, the majority of them (55-74%) have diagnoses of a psychiatric disorder. The presence of depression is a key predictor of substance use, and unfortunately, it may be a roadblock for effective treatment.

In a dangerous cycle, adolescents who suffer from depression are more likely to abuse substances, and substance abuse typically prevents youth from responding effectively to treatments for depression. So why not treat these teenagers for substance abuse? Well, to compound the desperation of this issue, the presence of depression may also impede a teen’s response to substance abuse treatment. It is this last factor that has researchers concerned and looking for new solutions to inform the scientific community and substance abuse rehabilitation programs.

Relapse:  A Greater Danger for Teens

Youth who require treatment for substance use and who have a psychiatric disorder are at an increased risk for relapse. Unfortunately, little research clearly evaluates comorbid depression (depression that exists simultaneously with another illness) among adolescents, specifically those receiving treatment for substance abuse. A recent review in Substance Abuse draws attention to the lack of significant research leading to effective therapies for youth who also have depression. Researchers and therapists know that an association exists between depression and substance use, but hypotheses and suggestions conflict with one another. The authors of the Substance Abuse review propose new methods of study concerning “the role of comorbid depression among adolescents in substance abuse treatment”.

What To Do

1.  Look At Time-Lines. The first recommendation of the review is that researchers evaluate depressive symptoms in spans of time. For example, depression exists for an individual in terms of lifetime narrative and current life situation. Additionally, researchers should assess these indicators at the start and finish of a particular substance abuse treatment period. These steps may help therapists and researchers understand the status of depression by examining periods of an increase or decrease in the use of substances.

2.  Measure Phases of Depression.  The second suggestion regards the acknowledgment of depression during the treatment of substance abuse. It is first essential to evaluate patients for depressive symptoms, and if diagnosable depression exists, it is equally important to measure phases of depression during the treatment process. Even if treatment facilities were unable to provide therapy for depression, taking steps to identify the relationship between depression and substance abuse treatment would improve scientific studies.

3.  Test for Depression.  Researchers and therapists should use valid and standardized assessments. Inventories that assess severity and classify symptoms will help mental health professionals gather essential data to support the treatment of both issues. Some prevalent depressive symptoms do not always indicate a diagnosis of clinical depression. Further, people with mild depression may react differently to substance abuse treatment, or may use substances at a different rate than those with major depression.

4.  Examine The Relationship Between Depression And Drug Use.  The fourth and last proposal of the review highlights the importance of identifying when depressive symptoms occur in relation to substance abuse. Substance use disorders can transpire during any time in a person’s life. Experimentation and use can take place before depressive symptoms arise, or people can start using substances after the onset of depression. Again, the relationship between the two is unclear, and by evaluating the timing of this relationship, researchers may come closer to understanding how the presence of depression affects substance use treatment.

Take Action Now!

5.  Take Action Now.  So now that we know more research is necessary to treat, effectively, adolescents with comorbid symptoms, how do therapists proceed in the substance abuse treatment of teenagers with depression?  Treatment providers should respond to these co-existing disorders, rather than wait for more definitive evidence to materialize.

6.  Build A Healthy Community. The Adolescent Community Reinforcement Approach (A-CRA) is a behavioral intervention program that works on the premise that behavior results from environment. Its goals are to help adolescents adopt a “clean and healthy lifestyle”. Other objectives of A-CRA are to improve mental and physical health, social stability, and reduce substance use. “A-CRA is a well-tested intervention for substance use disorders that has demonstrated potential as a treatment for co-morbid youth," states Dr. Susan H. Godley, lead author of the Substance Abuse Special Issue. "… A-CRA procedures are consistent with procedures in evidence-supported treatments for common co-occurring mental health problems.”

7.  Create Your Own A-CRA Community The A-CRA can take place in any location and is intended to help adolescents ages 12 to 22. It is a substance abuse treatment program that deals with current abuse, aftercare and reentry, community awareness, and classroom curricula.

- Melissa Lavery, M.S.

References

comorbid. (n.d.) The American Heritage® Medical Dictionary. (2007). Retrieved January 13 2015 from http://medical-dictionary.thefreedictionary.com/comorbid

Program Profile: Adolescent Community Reinforcement Approach. (n.d.). Retrieved January 13, 2015, from https://www.crimesolutions.gov/ProgramDetails.aspx?ID=137

Substance Use Associated with Low Response to Depression Treatment Among Teens. (2009, December 9). Retrieved January 13, 2015, from http://www.nimh.nih.gov/news/science-news/2009/substance-use-associated-with-low-response-to-depression-treatment-among-teens.shtml

Taylor & Francis. (2014, December 18). Is there a better way to treat substance use in adolescents with co-occurring mental health disorders?. ScienceDaily. Retrieved January 13, 2015 from www.sciencedaily.com/releases/2014/12/141218103115.htm

Taylor & Francis. (2014, November 19). Should we adjust substance use disorder treatment for depressed adolescents?. ScienceDaily. Retrieved January 13, 2015 from www.sciencedaily.com/releases/2014/11/141119112458.htm