Young Cannabis Users in Residential Treatment: As Distressed as Other Clients

Abstract

Doubt remains about the need for residential substance user treatment for young cannabis users. Using a series of validated clinical tools, this study compared 1,221 primarily cannabis-, psychostimulant-, alcohol-, or opioid-dependent young people admitted to an urban/rural Australian residential treatment program between 2001 and 2007. Multinomial logistic regression revealed that the cannabis user group had poorer mental health than the opioid group, poorer social functioning than the alcohol drinking group, and comparably poor functioning otherwise but remained in treatment longer than the psychostimulant and opioid user groups. Residential treatment for primarily cannabis-dependent young people with complex and multiple needs can be supported.

RÉSUMÉ

Titre: Les jeunes usagers de cannabis en traitement résidentiel: aussi affligé que d'autres clients?

Un doute persiste quant à la nécessité pour le traitement residential d'utilisation de substance pour jeunes consommateurs de cannabis. Grâce à une série d'outils cliniques validés, cette étude a comparé 1,221 juenes que utiliseront principalement du cannabis, psychostimulants, alcool ou des opioïdes admis dans un du programme de traitement résidentiel dans les zones urbaines ou rurales de l'Australie entre 2001 et 2007. Régression logistique multinomiale a révélé que le groupe de cannabis avaient une moins bonne santé mentale que dans le groupe opiacés, les plus pauvres du fonctionnement social que le groupe de l'alcool, et comparablement le fonctionnement plus pauvres autrement, mais il est resté dans le traitement plus longtemps que les groups des psychostimulants et des opiacés. Le traitement résidentiel pour le jeunes principalement dépendant au cannabis avec des complexes et multiples besoins peut être supporté.

Mots-clés: cannabis, traitement résidentiel, les jeunes, la santé mentale, le fonctionnement psychosocial

RESUMEN

Título: Jóvenes consumidores de cannabis en tratamiento residencial: tan afligidos como los otros clientes?

Persisten dudas acerca de la necesidad de tratamiento residencial para el consumo de sustancias psicoactivas por parte de jóvenes consumidores de cannabis. Utilizando una serie de instrumentos clínicos validados, éste estudio comparó principalmente a 1,221 jóvenes dependientes al cannabis, a los psicoestimulantes, al alcohol, o a los opiáceos, admitidos a un programa de tratamiento residencial australiano en área urbana/rural, entre los años 2001 y 2007. El análisis de regresión logística multinomial reveló que el grupo con dependencia al cannabis tenía peor salud mental que la del grupo de los opiáceos, peor adaptación social que la del grupo del alcohol, y por el contrario comparativamente pobre funcionamiento, aunque permanecieron por mayor tiempo en tratamiento que los grupos dependientes a los psicoestimulantes y opiáceos. El tratamiento residencial principalmente para jóvenes dependientes al cannabis con necesidades complejas y múltiples puede ser apoyado.

Palabras clave: cannabis, tratamiento residencial, jóvenes, salud mental, funcionamiento psicosocial.

Keywords :

• cannabis
• residential treatment
• young people
• mental health
• psychosocial functioning

THE AUTHORS

Dr. Anthony J. Arcuri holds a doctorate in counseling psychology. He has worked for a number of years conducting research in the areas of psychotherapy and substance use and young people, in both university and nongovernment settings. He has taught undergraduate drug and alcohol studies, personality, and postgraduate qualitative methods. Currently, Anthony works as a counseling and clinical psychologist in a private practice, where he has a special interest in psychodynamic treatment.

Dr. John Howard is a Senior Lecturer with the National Cannabis Prevention and Information Centre, as well as the University of New South Wales’ National Drug and Alcohol Research Centre's international research activities with a focus on young people. He has worked in schools, juvenile justice, adolescent mental health and drug treatment, and universities. John is a registered Clinical Psychologist and his major clinical, teaching, and research areas include adolescent substance use and “street youth,” comorbidity, depression and suicide in young people, working with marginalized youth and those with multiple and complex needs, adolescent psychotherapy, same-sex attracted youth, HIV infection in adolescents, resilience, youth treatment capacity-building and developing “youth friendly” harm reduction. International work has taken him to Nepal, China, Thailand, Vietnam, Lao PDR, India, Philippines, Egypt, and South Africa.

Dr. Melissa Norberg is the National Clinical Services and Evaluation Manager at the National Cannabis Prevention and Information Centre (NCPIC). She is a registered clinical psychologist and maintains a small practice at the CBT Clinical Psychology Centre. She obtained an M.S. and Ph.D. in clinical psychology from the University of Wisconsin-Milwaukee. Dr. Norberg's primary clinical and research interests are in the psychopathology and cognitive-behavioral treatment of comorbid anxiety and substance use disorders and in extending treatment outcome to include quality of life assessment.

Professor Jan Copeland is the Director of the National Cannabis Prevention and Information Centre and an Assistant Director of the National Drug and Alcohol Research Centre at the University of New South Wales. She is a registered psychologist and has a Ph.D. in community medicine and public health. Her research interests include the treatment of cannabis dependence in adults and adolescents and the measurement of service utilization and treatment outcome. She has more than 200 publications and given over 270 papers including keynote addresses at national and international conferences. Dr. Copeland is involved in a number of community agencies and is currently Chair of the Drug and Alcohol Multicultural Education Centre and on the Board of Odyssey Houses’ McGrath Foundation. She is a member of a number of national and international advisory groups on a range of clinical and policy issues. She is an assistant editor of Addiction, Research Notes, and the Journal of Substance Abuse Treatment and a member of the US College on Problems of Drug Dependence.

Barbara Toson is a biostatistician with National Drug & Alcohol Research Centre (NDARC). Previously, she has worked as a project manager for the Population Research and Evaluation team at Statistics New Zealand and as a senior researcher at the Office for National Statistics in the UK where she maintained and analyzed a database of drug poisoning deaths in England and Wales. Barbara also attended short courses in basic and advanced epidemiology at the London School of Hygiene and Tropical Medicine (LSHTM) in 2003 and 2004.

Notes

3 The reader is referred to Hills's criteria for causation that were developed in order to help assist researchers and clinicians determine if risk factors were causes of a particular disease or outcomes or merely associated. (Hill, A. B. (1965). The environment and disease: associations or causation? Proceedings of the Royal Society of Medicine, 58, 295–300.) Editor's note.

4 The reader is asked to consider that a critical issue for determining whether a specific treatment ideology, model, technique, etc. is indicated or contra-indicated is related to the underpinnings for its selection criteria: theory, evidence-informed, “principles of faith”, tradition, budget, policies, law, etc. Editor's note.