Problematic Substance Use in Adolescent Psychiatric Inpatients: Rates, Clinical Correlates and Effects on Therapeutic Outcomes

2021 ◽  
Vol 11 ◽  
Author(s):  
Xavier Benarous ◽  
Pierre Morales ◽  
Cora Cravero ◽  
Barbara Jakubowicz ◽  
Nadège Bourvis ◽  
...  
Keyword(s):  
Substance Use ◽  
High Risk ◽  
Clinical Global Impression ◽  
Inpatient Care ◽  
Psychiatric Inpatient ◽  
Clinical Correlates ◽  
Therapeutic Outcomes ◽  
Problematic Substance Use ◽  
Problematic Substance ◽  
Adolescent Inpatients

Aims: : We aimed to document the clinical rates and correlates of problematic substance use among adolescent inpatients. Background: Adolescents referred to psychiatric inpatient care are likely to present family and social risk factors making them at high-risk of substance use disorder Objective: To document the rates, clinical correlates and effects on therapeutic outcomes of associated problematic substance use in adolescents referred to psychiatric inpatient care. Method: The DEP-ADO questionnaire was used to systematically screen out problematic substance use in two 12-18 adolescent inpatient units between January 2017 and December 2018. Inpatients screened positively based on the DEP-ADO questionnaire and/or information gathered from repeated interviews with the youth and his/her family were reported to the liaison addiction unit for diagnosis. Chart-review procedure was used to document clinical correlates (i.e., suicidal behavior, DSM-5 psychiatric diagnoses, the Clinical Global Impression-Severity score) and therapeutic outcomes (i.e., the Clinical Global Impression-Improvement score, change in Children-Global Assessment Scale score during patients’ stay and length of stay). Result: Over two years, 150 adolescents completed the DEP-ADO questionnaire (Mean Age =14.7 ± 1.7; 42% girls). Thirty percent of adolescent inpatients reported some type of problematic substance use, with a higher likelihood of daily tobacco use (OR=2.4), regular cannabis use (OR=2.3) and occasional opioid/heroin use (OR=9.8) compared to general population. Adolescent inpatients who misused illegal substance prior admission were 2.5 times more likely to report suicidal behaviors. A strong association was reported between binge drinking behavior and a discharge diagnosis of bipolar disorder (OR=11.0). Therapeutic outcomes were not statistically different with regards to alcohol or illicit substance use status. Conclusion: Inpatient adolescents were at high-risk of having associated problematic substance use. Patients with co-existing problematics seem to have more severe and chronic forms of mood disturbances, although the response rate to therapeutics provided during their stay were not lower compared to their counterparts without problematic substance use.

scholarly journals Alcohol, marijuana, and tobacco use trajectories from age 12 to 24 years: Demographic correlates and young adult substance use problems

2014 ◽  
Vol 27 (1) ◽  
pp. 253-277 ◽  
Author(s):  
Sarah E. Nelson ◽  
Mark J. Van Ryzin ◽  
Thomas J. Dishion
Keyword(s):  
Substance Use ◽  
High Risk ◽  
Tobacco Use ◽  
Early Adolescence ◽  
Early Adulthood ◽  
Marijuana Use ◽  
Rapid Onset ◽  
Substance Use Problems ◽  
Problematic Substance Use ◽  
Problematic Substance

AbstractSubstance use trajectories were examined from early adolescence to young adulthood among a diverse sample of 998 youths. Analysis of longitudinal data from ages 12 to 24 identified distinct trajectories for alcohol, marijuana, and tobacco use. Modeling revealed 8 alcohol, 7 marijuana, and 6 tobacco use trajectories. Analyses assessed risk for substance use problems in early adulthood within each trajectory, as well as overlap among alcohol, marijuana, and tobacco use trajectories. Findings confirmed that adolescents with early- and rapid-onset trajectories are particularly vulnerable to the development of problematic substance use in early adulthood. However, analyses also identified an escalating high school onset trajectory for alcohol and for marijuana use that was equally prognostic of problem use in adulthood. Moreover, tobacco use in early adolescence was associated with developing high-risk marijuana and alcohol use patterns. Random assignment to the Family Check-Up intervention was found to reduce risk for membership in the high-risk marijuana use trajectories, suggesting that family-based approaches delivered during adolescence can prevent escalations to problematic substance use. These findings suggest the importance of developmental heterogeneity and equifinality in considering prevention for alcohol and drug use.

scholarly journals Mapping, assessing and promoting multiple psychological senses of community (MPSOC) through clinical pathways for treating substance use problems

2021 ◽  
pp. 145507252098597
Author(s):  
Nina Kavita Heggen Bahl ◽  
Anne Signe Landheim ◽  
Hilde Eileen Nafstad ◽  
Rolv Mikkel Blakar ◽  
Morten A. Brodahl
Keyword(s):  
Substance Use ◽  
Clinical Pathways ◽  
Collaborative Study ◽  
Social Situation ◽  
National Guidelines ◽  
Social Situations ◽  
Recovery Processes ◽  
Substance Use Problems ◽  
Problematic Substance Use ◽  
Problematic Substance

Aim: The recent nationally implemented clinical pathways for the treatment of substance use problems in Norway require mapping and assessing of patients’ needs, challenges, and resources. However, there is a lack of tools for systematically mapping and assessing patients’ social situations and social networks as part of the national guidelines. The aim of this article is to present a tool developed to map and assess the patient’s social situation, and to propose approaches for promoting multiple psychological senses of community (MPSOC) through clinical pathways for treating substance use problems. Methods: The proposed tool and approaches are developed based on findings in a previous in-depth collaborative study of MPSOC and recovery among people with substance use problems who received help and services from Norwegian municipalities. Findings: The findings suggest that multiple communities (geographical, relational and ideal) and senses of communities (within and outside treatment) simultaneously can influence individual recovery processes from problematic substance use in both positive as well as negative ways. As such, these community dimensions are of central importance to include in mapping and assessing of patients’ social situations, as well as in the promotion of MPSOC through clinical pathways. Conclusions: The suggested tool and approaches can increase the likelihood of achieving key aims of the national clinical pathways. Most important, mapping, assessing and promoting MPSOC through clinical pathways may promote long-term recovery processes and positive recovery capital for persons with substance use problems.

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