Treatment Outcomes Among Youth

Research Update

The following is a Research Update excerpt from the Butler Center for Research. Download the PDF to read the entire Update.

A substantial number of teenagers and young adults engage in abuse of alcohol or other drugs, and many of these individuals are in need of formal addiction treatment. In a recent report of youth, the Substance Abuse and Mental Health Services Administration (SAMHSA) reported that 21% of young adults aged 18 to 25 needed treatment for alcohol or illicit drug use. In addition, 96% of those who needed treatment did not perceive the need to attend treatment.1

Does treatment for youth work?

A number of studies support the effectiveness of alcohol/drug treatment for adolescents and young adults. A recent collaborative study between the State of Wisconsin Bureau of Mental Health and Substance Abuse Services and six adolescent treatment centers examined outcomes of 128 adolescents (aged 12–18) attending several different modalities of treatment, including residential, day treatment, and intensive outpatient. Compared to a period of time before treatment, the rate of abstinence among adolescents who met dependence criteria for alcohol and/or drugs increased by 39% during the first six months following treatment. The average number of overall substance use days after treatment was significantly lower than before treatment. In addition, the adolescents experienced a 21% improvement in family problems pre- to post-treatment.2

Hazelden routinely tracks outcomes for adolescents and young adults attending residential treatment at the Hazelden Center for Youth and Families in Plymouth, Minnesota. The following graph shows two outcomes measures for a group of young women (aged 18–23) attending residential treatment in 2006. The first outcome is percent days abstinent (PDA) from alcohol and represents the percentage of days during the 12 month period after treatment discharge that patients abstained from alcohol. The second measure is percent days abstinent (PDA) from marijuana and represents the percentage of days during the 12 month follow up period that patients abstained from marijuana:

 Youth Treatment Outcomes

Compared to the 90 day period prior to admission to treatment, patients had significantly higher PDA from both alcohol and marijuana during the 12 months following treatment. In addition to improvements in substance use, young women experienced statistically significant improvement in a number of other life areas. For example, in the year before treatment, young women reported spending an average of 3.93 days in the hospital for problems related to alcohol/drug use. In the year following treatment the average decreased to .67 days. In terms of job or school performance, young women were absent from school or work an average of 34.21 days before treatment and only 4.58 days after treatment. As a whole, the Hazelden data and findings from a number of other research studies suggest that the majority of adolescents and young adults show dramatic improvement in substance use and other areas of life functioning after attending treatment.

The role of Twelve Step affiliation in enhancing treatment outcomes

Most programs that treat adolescents and young adults, even those that do not use a Twelve Step model per se, recommend ongoing Twelve Step meeting attendance after treatment as a way to maintain treatment gains. Research studies suggest that youth engage with Twelve Step fellowships after treatment and those who attend meetings regularly have better substance use outcomes. Chi et al. (2009) examined three year outcomes for a sample of 13- to 18-year-olds who attended intensive outpatient treatment. At the three year follow up, 19% reported attending at least one meeting in the last six months. Meeting attendance at three years was significantly related to the likelihood of being abstinent from drugs and alcohol at three years.3 Kelly et al. (2008) examined both Twelve Step attendance and substance use outcomes among a sample of adolescent inpatients for a period of eight years after discharge from treatment. At the eight year follow up, Twelve Step attendance continued to be a significant predictor of substance use outcomes even when controlling for other factors such as pretreatment substance use severity and mental health diagnoses.4 In a more recent study of young women (aged 18–23) who attended residential treatment at Hazelden, Klein and Slaymaker (in press) found that meeting attendance was a significant predictor of post-treatment alcohol use days among women and engagement in other prescribed Twelve Step activities (such as getting a sponsor and sponsoring others) was a significant predictor of alcohol use days among a comparison group of young men.5

Other predictors of treatment outcome among youth

In addition to Twelve Step involvement, a number of studies have identified other predictors of treatment outcomes among adolescents. Hsieh and Hollister (2004) examined a sample of over 2,000 adolescents admitted to residential treatment. During the six month period following treatment, Twelve Step meeting attendance, substance abuse severity before treatment, parental participation in treatment, and length of stay in treatment were significantly related to abstinence among male patients. Among female patients, Twelve Step meeting attendance, pretreatment substance use severity, and legal involvement were significantly related to abstinence. For both groups of patients, Twelve Step attendance was more strongly related to abstinence status than any other factors.6


As a whole, research findings from a number of different studies suggest that alcohol and drug treatment is effective for young people with substance use disorders. Compared to the period of time before treatment, youth experience dramatic improvement in substance use and other areas of life functioning after receiving treatment. The findings also suggest that youth who engage with Twelve Step fellowships after treatment are more likely to experience positive outcomes than youth who do not engage with these fellowships.

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