A Blended Strategy for Adolescent Males: Aspects of Both Abstinence-Based and Harm Reduction Approaches Can Benefit Youths

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According to a 2011 study conducted by the National Center on Addiction and Substance Abuse (CASA) at Columbia University, substance use by teens is the most significant public heath problem in the United States. The CASA study found that 46% of all high school students are currently using addictive substances (i.e., nicotine, alcohol and other drugs), and 1 in 3 of those students meet criteria for addiction.

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Probably not surprising to front-line practitioners in the substance abuse treatment field, the CASA report revealed that 90% of adult Americans with addiction began using substances prior to age 18. Addiction as a progressive brain disease has its origins in adolescence, related in large part to the vulnerability of the developing brain during that period.

In addition to the significant increase of risk for addiction, substance use during adolescence has numerous negative consequences and costs, including fatal and nonfatal injuries due to motor vehicle accidents; unintended overdose; sexually risky practices and unwanted pregnancies; and increased risk for medical and mental illnesses. Early identification of, and effective intervention for adolescents with, substance use problems can prevent the disease's progression from abuse to addiction and, for teens already addicted, the possibility of recovery before incurring the increasingly severe damage and losses tragically associated with adult addiction.

But for intervention to be effective, it is crucial, especially for adolescents, to distinguish between drug abuse and drug addiction. This distinction provides an opportunity for more individualized and effective treatment. A diagnosis of substance abuse essentially involves impairment in role functioning and repeated harmful consequences without the physiological cravings, tolerance, or withdrawal associated with addiction. …