Course of Problems in Adolescent Drug Treatment Intakes

描述（由申请人提供）： 本提案是对NIDA 2001年5月21日关于药物滥用卫生服务研究的方案公告PA-01-097的回应。它检查了3年和5年的过程中的问题，在“意图治疗”样本的400名青少年摄入量在4个管理式护理药物滥用治疗网站，并评估药物滥用问题和治疗的关系，医疗利用和成本。收集了基线、6个月和12个月随访数据。拟议的研究建立在纵向和治疗结果的文学青少年药物滥用，并确定了5年的时间路径的物质使用模式和问题的决定因素。药物使用的时间路径或“轨迹”在理论上和应用上都与青少年药物治疗领域有关，在青少年药物治疗领域，药物滥用问题日益被视为慢性和复发性问题，与此同时，许多人“成熟”后不再有问题。分析借鉴了潜在曲线分析技术，以比较药物使用轨迹的形状及其决定因素。我们研究了人口特征、问题严重程度（即，物质使用类型和严重程度、医学和精神病合并症、社会问题和生活压力），治疗（即，开始治疗和索引治疗的停留时间，和再入院），和“额外治疗”（例如，同伴影响、家庭功能、十二步参与）因素对5年问题进程的影响。另一个重要的贡献，建议的研究，对青少年药物滥用的纵向文献是检查共病的医疗条件，以及它们之间的关系，青少年药物滥用的过程。我们还在每一波研究中采访了一位家长，并通过药物测试检查了间接报告和自我报告的有效性。健保办事处一直有计算机化的数据，列明每次治疗的日期和住院时间，以及所接受的所有精神科和医疗服务，以及有关费用。我们从青少年和家长那里收集了关于健康计划不包括的治疗和医疗服务利用的自我报告数据。我们跟踪青少年在关键的“成为年轻人”期间的5年，当许多人“成熟”的问题，这使我们能够检查个人，环境和服务因素，这一过程的基础，对于那些成功的人和那些不。

DESCRIPTION (provided by applicant): This proposal responds to NIDA's Program Announcement, PA-01-097, of 5/21/01, on Drug Abuse Health Services Research. It examines the 3- and 5-year course of problems in an "intent to treat" sample of 400 adolescent intakes in four managed care substance abuse treatment sites, and assesses the relationship of substance abuse problems and treatment to medical utilization and cost. Baseline, 6- and 12-month follow-up data have been collected. The proposed study builds on the longitudinal and treatment outcome literature on adolescent substance abuse, and identifies the determinants of 5-year time paths of substance use patterns and problems. Time paths, or "trajectories" of substance use are of both theoretical and applied relevance to the adolescent drug treatment field, where substance abuse problems are increasingly viewed as chronic and relapsing, and at the same time, many individuals "mature out" of problems. Analyses draw on latent curve analysis techniques to compare the shape of trajectories of substance use and their determinants. We examine the influences that demographic characteristics, problem severity (i.e., substance use type and severity, medical and psychiatric comorbidities, social problems, and life stressors), treatment (i.e., starting treatment and length of stay of index treatment, and readmissions), and "extra-treatment" (e.g., peer influences, family functioning, twelve-step participation) factors have on the 5-year course of problems. Another important contribution of the proposed study to the longitudinal literature on adolescent substance abuse is the examination of co-morbid medical conditions, and their relationship to the course of adolescent substance abuse. We have also interviewed a parent at each wave of the study, and we examine collateral reports and validity of self-report through drug testing. The HMO has on-going computerized data on the dates and length of stay of treatment episodes and all psychiatric and medical services received, as well as their costs. We collect self-report data from teens and parents on treatment and medical service utilization not covered by the health plan. We follow adolescents for 5 years during the crucial "becoming young adult" period when many individuals "mature out" of problems, which allows us to examine the individual, environmental, and service factors that underlie this process, for those who succeed and those who do not.