Services research on adolescent drug treatment. Commentary on "The Cannabis Youth Treatment (CYT) Study: Main findings from two randomized trials"

Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA.
Journal of Substance Abuse Treatment (Impact Factor: 3.14). 11/2004; 27(3):195-6. DOI: 10.1016/j.jsat.2004.07.003
Source: PubMed
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    ABSTRACT: Background: Marijuana is the most commonly used illicit substance in the United States and worldwide. Marijuana use is a problem of increasing magnitude among adolescents. Use typically begins in adolescence and is associated with a variety of adverse outcomes. Method: This article will present an overview of trends in marijuana use, and will review the endocannabinoid system and marijuana. It will discuss recent policy developments in US and their implications, especially for adolescents. Existing treatments will be reviewed, including findings from a recent randomized double-blind trial of N-acetylcysteine, a compound that reverses the dysregulation of the glutamate system that occurs in substance dependence. Conclusions: The core treatment approaches include psychosocial interventions, sometimes in combination with each other. While a reduction in days of use is often achieved with most of these approaches, abstinence is a much more elusive goal. The evidence base for effective treatments remains inadequate especially with regard to adolescents, and there is an urgent need for more research in this area. Promising new treatments include N-acetylcysteine in conjunction with contingency management.
    10/2013; 3(4). DOI:10.2174/221067660304140121173215
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    ABSTRACT: ABSTRACT Background: To investigate the efficacy of a voucher based reinforcement therapy (VBRT) rewarding drug free urine for adolescents with cannabis use disorder. Methods: A controlled 10-week study where 59 adolescents age 14-18 years were assigned by cohorts into groups of either an integrated cognitive behavioral therapy (CBT) and VBRT or CBT with attendance-based reward program. Substance use was monitored by twice-weekly urinalysis. Other measures were collected at pre-, post-treatment, and at 3-month follow-up. Results: There was no significant difference in the linear change between conditions for cannabis use either from session one to ten or between end-of -treatment to three-month follow-up. Also, self-efficacy and coping response did no show improvement during treatment. Conclusions: In this study, the addition of contingency management (CM) to CBT in youth was not found to be more efficacious than similar compensation rewarding attendance only. Continued examination of the efficacy of CM and its interaction with the associated mechanisms of behavior change (MBCs) of CBT in youth is necessary. Examination of the effect of the magnitude of the reward as well as considering the emotional and cognitive developmental differences from adults is warranted.
    Substance Abuse 07/2014; 35(4). DOI:10.1080/08897077.2014.933724 · 1.62 Impact Factor
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    ABSTRACT: To date, few studies have been conducted evaluating predictors of treatment seeking for substance use disorders as persons make the transition from preadolescence (a period of very low substance use) to young adulthood (a period of peak substance use). The few studies of this area which have been conducted to date have generally been limited by their use of a cross-sectional rather than a longitudinal study design. We have conducted a longitudinal etiology study (CEDAR) to assess whether an index of behavioral undercontrol called the Transmissible Liability Index (TLI) measured during preadolescence serves as a predictor of the development of substance use disorders (SUD) and of treatment utilization during young adulthood. Our recent work has focuses on subjects with cannabis use disorders (CUD), since CUD are the most common SUD. In recent analyses, we found that TLI serves as a predictor of the development of cannabis use disorder (CUD) among young adults (Kirisci et al., 2009).
    Advances in psychology research 01/2013; 98:85-94.