Do Teens With Severe Substance Problems Benefit From Brief Interventions?

Do Teens With Severe Substance Problems Benefit From Brief Interventions?Researchers from the University of Minnesota Medical School have assessed the potential effectiveness of brief interventions for teenagers involved in the serious misuse of alcohol or marijuana, concluding that brief interventions are more effective for mild to moderate instances of substance abuse than for severe cases. 

Brief intervention is the general name for a group of techniques designed to quickly identify and deter involvement in a pattern of drug or alcohol use that increases current or future risks for the onset of substance use disorder (substance abuse and/or addiction). These techniques frequently work for relatively minor cases of drug/alcohol misuse, but may not work for more serious cases.

Brief Intervention for Drugs or Alcohol

Doctors and other trained health practitioners use brief interventions to quickly distinguish individuals who are engaged in patterns of substance intake that could lead to the onset of a diagnosable case of substance use disorder, or patterns of substance intake that indicate current problems with substance abuse/addiction.

During a brief intervention, a practitioner will tell a patient/client about the potential or current impact of his or her substance intake, put forward the idea of changing to a less harmful pattern of intake or halting substance use altogether, underscore the patient’s/client’s responsibility for enacting any desired changes and give advice on specific next steps to make the idea of change an actual reality.

Techniques employed for brief alcohol and/or drug interventions come from change-oriented psychotherapy, including approaches such as cognitive behavioral therapy and motivational interviewing. Depending on the individual and the specific methods used by a health professional, an intervention can last anywhere from five minutes to half an hour or longer. Common settings for an intervention include doctors’ offices, clinics and emergency rooms.

Severity of Substance Problems

Under guidelines established by the American Psychiatric Association in 2013, the substance use disorder diagnosis covers all symptoms of non-addicted substance abuse and substance addiction, whether those symptoms appear separately or simultaneously in a single individual. A minimally affected person has at least two symptoms of abuse and/or addiction within a 12-month timespan, while a maximally affected person has 11 symptoms.

When making a diagnosis, doctors use the number of symptoms present as a gauge of the seriousness of their patients’ substance issues. Mild cases of substance use disorder involve two or three symptoms, while moderate cases involve either four or five symptoms. The threshold for severe cases of the disorder is six symptoms.

Does Brief Intervention Help Teens With Severe Substance Abuse?

In a study published in January 2015 in the journal Drug and Alcohol Dependence, the University of Minnesota researchers assessed the effectiveness of a specific brief intervention, called Teen Intervene, for adolescents affected by relatively severe problems with alcohol use or marijuana use.  Teen Intervene is aimed at preteens and teenagers between the ages of 12 and 19 and relies on a series of three hour-long sessions to encourage at-risk people in this age group to reduce and end their substance intake. Normally, health professionals use the intervention on individuals who have started using drugs or alcohol relatively recently.

During their project, the researchers reanalyzed data they had previously gathered from a group of teenagers involved in the consumption of alcohol and/or marijuana. As part of this reanalysis, they looked at factors that included the number of potentially diagnosable symptoms of abuse/addiction present in each individual at the beginning of the project and the number of potentially diagnosable symptoms present in each individual half a year and a full year after receiving the Teen Intervene brief intervention. The researchers took steps to separate the alcohol-related outcomes of the intervention from the marijuana-related outcomes.

After completing their analysis, the researchers concluded that, in terms of both the ability to reduce substance intake and the ability to avoid substance intake altogether, the Teen Intervene brief intervention works relatively well for teenagers with mild or moderate cases of diagnosable substance use disorder. However, by the same criteria they also concluded that the intervention is substantially less successful for teens affected by severe cases of the disorder.

The study’s authors believe their findings reinforce the usefulness of brief interventions for teenagers dealing with mild or moderate effects of substance use disorder. However, they also believe their findings underscore the fairly limited usefulness of brief interventions for teenagers severely affected by substance problems. Teens in this last category commonly need assistance above and beyond the scope of a mere intervention.