Drugs and Kids Exam #3

Stats showing treatment does not reach everyone

• Less than 10% of adolescents with alcohol or drug problems receive treatment (SAMHSA, 2007)

• 94% of people aged 12 or older with a substance use disorder did not receive any treatment in 2021 (SAMHSA, 2023).

Treatment Considerations

Barriers to treatment, which treatment setting is best, developmental considerations in treatment

Internal barriers to treatment

• Stigma

• Psychological reasons (e.g., depression)

• Personal barriers - lack of problem recognition

• Attitudes about abuse

• Attitudes about treatment

External Barriers to treatment

• Financial reasons (cost)

• Time conflicts

• Logistical reasons

• Limited treatment options, availability and accessibility

• Lack of knowledge, understanding about options

• Enforced treatment

• Accessibility of drugs

Does treatment work?

Getting treatment is better than no treatment, no evidence of treatment setting, length, intensity, types of populations, or types of adolescents for settings

Developmental considerations for treatment

• Consider brain development

• Possibility to weigh pros/cons

• Adolescents’ need for independence, setting own goals, and control

over their life

• Immediate rewards

• Limited life experience, different outlook in life, limited consequences

• Strength of peers

• Realistic goals and approach

• Labeling

• Address at adolescents’ level

• Flexibility

• Confidentiality

Treatment in a context of comorbidity

• We should be discussing substance use with our teens regardless of extend

of use or impairment.

• No use

• Experimentation

• Abuse

• Flexible treatment plans to meet the needs of the individual pt and their

unique presentation

• Do we need a substance specific treatment or standard care with substance

use adjunct?

• We must ID and treat the comorbidities: psychiatric, neuropsychological

and school based struggles

When it comes to mental health care, most adults

could not afford cost over other barriers

When it comes to substance use care, most adults were

not ready to stop using over other barriers

Harm reduction

• Public Health approach

• Minimize the problems associated with use

• Alternative to moral, criminal and medical/disease models

• Lots of treatments can fall under this approach

Insite (Vancouver)

• Allowed individuals to use on sight without prosecution

• A constitutional challenge was heard by the Supreme Court of British Columbia to keep Insite open.

• Court ruled that laws prohibiting possession/trafficking of drugs were unconstitutional because they denied drug users access to Insite's health services.

• Insite currently operates under a constitutional exception to the Controlled Drugs and Substances Act.

• Often a gateway to treatment