Adolescent Community Reinforcement Approach outcomes differ among emerging adults and adolescents

Abstract

One-fifth of all public treatment admissions are emerging adults, and few studies have considered whether treatments are developmentally appropriate. This study compares outcomes between substance use-disordered adolescents and emerging adults that received the Adolescent Community Reinforcement Approach (A-CRA). Propensity score matching was used to create a weighted comparison group of adolescents (n=151) that had similar demographic characteristics, clinical severity, and treatment retention as the group of emerging adults (n=152). We examined age differences in abstinence and other psychosocial outcomes at the last available follow up. Emerging adults and adolescents both reduced their substance use at follow-up. However, emerging adults were less likely to be abstinent and in remission, and had more days of alcohol use when compared to adolescents. This study’s findings are consistent with prior work on emerging adults. Additional research should examine features of interventions that are most effective in addressing the developmental needs of emerging adults.

Emerging adult age status predicts poor buprenorphine treatment retention

“…For instance, among intravenous drug users, one study has shown that emerging adults enrolled less frequently than older adults in continuing care programs after detoxification, and were less likely to enroll in opioid agonist therapy (Shin, Lundgren, & Chassler, 2007). In studies of the community reinforcement approach for youths with alcohol abuse, emerging adults had more days of alcohol use compared to adolescents, and were less likely to be abstinent (Smith, Godley, Godley, & Dennis, 2011). The difference in willingness to stop using substances was seen by the authors as partially due to lower levels of interpersonal motivation for abstinence among emerging adults, who were no longer having daily interactions with school and families of origin (Smith, Cleeland, & Dennis, 2010).…”

Self-perceived emerging adult status and substance use.

“…Among its distinct characteristics, emerging adults (EAs) have higher rates of current illicit drug use (21.5%) when compared to adolescents (10.1%) and adults aged 26 or older (6.6%) (Substance Abuse and Mental Health Services Administration, 2011). Mounting evidence also suggests that EAs have worse substance use treatment outcomes compared to both adolescents and older adults (Rossman, Roman, Zweig, Rempel, & Lindquist, 2011; Satre, Mertens, Arean, &Weisner, 2003; Satre, Mertens, Arean, & Weisner, 2004; Smith, Godley, Godley, & Dennis, 2011). It would be an advance if researchers could pinpoint aspects of development associated with substance use that may moderate the relationship between age and substance use treatment outcomes.…”

Initiation of addiction treatment and access to services: Young adults' accounts of their help-seeking experiences

“…Although the question of access to substance abuse treatment is central, it is also important to look at the specific characteristics of the youngest users (Bukstein et al, 2005;Evans et al, 2013;Gulliver et al, 2010;Hoeppner et al, 2014;Parthasarathy & Weisner, 2005;Priester et al, 2016;SchumanOlivier et al, 2014;Smith et al, 2011;Sterling et al, 2010). While older individuals may have more experience with services, fruitful or not, young users are often still unfamiliar with these settings; they can then express specific needs which, if they are met, will influence their treatment access experiences.…”