Long-Term Outcomes of Adolescents in Drug Treatment

说明：(申请人提供)尽管最近在青少年药物滥用治疗研究方面取得了令人印象深刻的进展，包括以理论为基础的干预措施的手册和评估，以及对这些治疗如何产生治疗中和治疗后收益的初步了解，但对针对青少年的药物滥用治疗的长期影响几乎一无所知。这项申请提出了对两种最先进的、常用的青少年药物滥用治疗模式--一名门诊患者和另一名住院患者--进行的第一项长期受控研究。迈阿密大学青少年药物滥用治疗研究中心的研究人员正在进行一项仍在进行的比较临床试验，对这些治疗方法进行测试。这项正在进行的研究是第一个随机试验，比较了任何门诊方法和家庭青少年药物治疗的治疗效果和相对收益-成本。令人印象深刻的跟踪数据捕获率，这项试验有希望的12个月结果初步结果，以及缺乏经验证据来指导研究人员、从业者或政策制定者青少年药物治疗的长期结果，这些都支持我们研究这些干预措施的长期影响的目标。这项拟议的长期跟踪研究将跟踪140名青少年及其父母，他们被随机分为门诊或住院治疗。青少年及其父母/监护人将在2年、3年和4年的随访期内接受一系列药物使用、家庭和心理社会功能以及经济评估措施的评估。这项研究有三个目的：1)比较住院治疗和门诊、家庭治疗在改善双重诊断青少年的药物使用、共病症状和犯罪率方面的长期效果。2)检查四年吸毒期内的预测因素(即家庭功能、同伴、教育/职业功能和参与治疗后服务的药物使用)与结果变量(即药物使用、共病症状和犯罪行为)之间的关系。3)比较住院治疗和门诊家庭治疗的总和净长期经济收益。

DESCRIPTION: (provided by applicant)Despite impressive recent advances in adolescent drug abuse treatment research, including the manualization and evaluation of theory-based interventions and a preliminary understanding of how these treatments create in-treatment and post-treatment gains, almost nothing is known about the long-term effects of adolescent-specific drug abuse treatment. This application proposes the first controlled long-term study of two state-of-the-science, commonly-practiced treatment modalities -- one outpatient and the other residential -- for adolescent drug abuse. These treatments are being tested in a still active comparative clinical trial being conducted by investigators at the University of Miami Center for Treatment Research on Adolescent Drug Abuse. This ongoing study is the first randomized trial comparing the therapeutic effects and relative benefit-costs of any outpatient approach with a residential adolescent drug treatment. Impressive follow-up data capture rates, promising preliminary 12-month outcome findings from this trial, and the absence of empirical evidence to guide researchers, practitioners or policy makers on the long-term outcomes of adolescent drug treatment all support our aim to study the longer-term impacts of these interventions. The proposed long-term follow-up study will follow 140 adolescents and their parents randomized to either outpatient or residential treatment. Youth and their parents/guardians will be assessed at 2, 3, and 4-year follow-up periods on a range of drug use, family and psychosocial functioning, as well as economic evaluation measures. The study has three aims: 1) To compare the long term effectiveness of residential treatment with outpatient, family-based treatment in ameliorating drug use, co-morbid symptoms, and criminality among dually diagnosed adolescents. 2) To examine the relationships among predictors (i.e., family functioning, peer, educational/vocational functioning and involvement in post-treatment services drug use) and outcome variables (i.e., drug use, co-morbid symptoms, and criminal behavior) during the four-year post intake period. 3) To contrast the total and net long-term monetary benefits of the residential treatment and the outpatient family based treatment.