Adolescent and Young Adult Heroin and Non Heroin Users: A Quantitative and Qualitative Study of Experiences in a Therapeutic Community

Abstract

Admissions to treatment for heroin abuse have increased in recent years among the adolescent and young adult population, yet few studies have described whether, and to what extent, young heroin users differ from their non heroin-using peers. This exploratory study presents quantitative and qualitative data obtained from lifetime heroin and non heroin-using adolescents and young adults in a long-term, step-down therapeutic community. Self-report data from the Global Appraisal of Individual Needs (GAIN) were obtained from 22 lifetime heroin and 33 non heroin users on admission to residential treatment and 12 months later. Ethnographic interviews (n = 27) were conducted with heroin users at all stages of treatment. Results indicate that lifetime heroin users had greater polysubstance use and lower self-efficacy scores (i.e., confidence to resist relapse) on admission to treatment than non heroin users, and though improved, heroin users' self-efficacy scores remained lower than those of non heroin users at the 12 month follow-up. Ethnographic data suggested that adolescents who had used heroin "hit bottom" before entering treatment and credited treatment with providing the opportunity to change their lives. The overall comparability of treatment outcomes between the heroin and non heroin using groups shows that adolescents and young adult heroin users can achieve similar outcomes in an age-appropriate therapeutic community treatment setting.

Self-Control as a Predictor of Relapse and Recidivism in Adolescent Therapeutic Community Treatment

“…Effectiveness studies show that TCs help adolescents to reduce their substance use (Hawke et al, 2000;Perry & Duroy, 2004). Adolescent TCs also help to improve psychological functioning and lower criminal recidivism (Morral et al, 2004;Gordon et al, 2000).…”

“…At this time, however, there are very few empirically supported treatment programs available to meet this demand (McWhirter, 2008). Overall, research shows that adolescents who receive substance user treatment, 1 when compared with those who do not, have lower rates of long-term substance use and other related problems (Hawke, Jainchill, & De Leon, 2000;Jainchill et al, 1999;Latimer et al, 2003;Liddle et al, 2001;Mosher & Phillips, 2006;Perry & Duroy, 2004). One of the most effective modalities of treatment for this age group is the Therapeutic Community 158 S. ABDEL-SALAM (TC) (Hawke et al, 2000;Morral, McCaffrey, & Ridgeway, 2004;Perry & Duroy, 2004).…”

“…Overall, research shows that adolescents who receive substance user treatment, 1 when compared with those who do not, have lower rates of long-term substance use and other related problems (Hawke, Jainchill, & De Leon, 2000;Jainchill et al, 1999;Latimer et al, 2003;Liddle et al, 2001;Mosher & Phillips, 2006;Perry & Duroy, 2004). One of the most effective modalities of treatment for this age group is the Therapeutic Community 158 S. ABDEL-SALAM (TC) (Hawke et al, 2000;Morral, McCaffrey, & Ridgeway, 2004;Perry & Duroy, 2004). Therapeutic communities have been shown to reduce substance use and delinquency in adolescents and to help them develop the skills required to succeed in life (Gordon, Moriarty, & Grant, 2000;Morral et al, 2004).…”

Young Heroin Users in Baltimore: A Qualitative Study

“…A few recent ethnographic studies (11,14,15) are available. Some more information recently has become available from Substance Abuse and Mental Health Services Administration (SAMHSA)-Center for Substance Abuse Treatment (CSAT) Adolescent Treatment Models (ATM) initiative (16,17). These studies include subjects in the 13-21 years age group, in residential treatment, reporting lifetime heroin use.…”

The Role of Drinking Severity on Sex Risk Behavior and HIV Exposure among Illicit Drug Users

“…This gap is of some concern when we note that alcohol is among the most misused substances in the world and is of particular danger of being misused among IDUs, 30,31 where studies have indicated rates of alcohol use or misuse as high as 91%. 32 As such, a case can be made to investigate problematic alcohol consumption as a contributor to sex risk …”