? ? This proposal responds to NIDA's Program Announcement, PA-01-097, of 5/21/01, on Drug Abuse Health Services Research. It examines the 3- and 5-year course of problems in an """"""""intent to treat"""""""" sample of 400 adolescent intakes in four managed care substance abuse treatment sites, and assesses the relationship of substance abuse problems and treatment to medical utilization and cost. Baseline, 6- and 12-month follow-up data have been collected. The proposed study builds on the longitudinal and treatment outcome literature on adolescent substance abuse, and identifies the determinants of 5-year time paths of substance use patterns and problems. Time paths, or """"""""trajectories"""""""" of substance use are of both theoretical and applied relevance to the adolescent drug treatment field, where substance abuse problems are increasingly viewed as chronic and relapsing, and at the same time, many individuals """"""""mature out"""""""" of problems. Analyses draw on latent curve analysis techniques to compare the shape of trajectories of substance use and their determinants. We examine the influences that demographic characteristics, problem severity (i.e., substance use type and severity, medical and psychiatric comorbidities, social problems, and life stressors), treatment (i.e., starting treatment and length of stay of index treatment, and readmissions), and """"""""extra-treatment"""""""" (e.g., peer influences, family functioning, twelve-step participation) factors have on the 5-year course of problems. Another important contribution of the proposed study to the longitudinal literature on adolescent substance abuse is the examination of co-morbid medical conditions, and their relationship to the course of adolescent substance abuse. We have also interviewed a parent at each wave of the study, and we examine collateral reports and validity of self-report through drug testing. The HMO has on-going computerized data on the dates and length of stay of treatment episodes and all psychiatric and medical services received, as well as their costs. We collect self-report data from teens and parents on treatment and medical service utilization not covered by the health plan. We follow adolescents for 5 years during the crucial """"""""becoming young adult"""""""" period when many individuals """"""""mature out"""""""" of problems, which allows us to examine the individual, environmental, and service factors that underlie this process, for those who succeed and those who do not.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA015803-03
Application #
6858740
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Flanzer, Jerry
Project Start
2003-04-25
Project End
2008-03-31
Budget Start
2005-04-01
Budget End
2006-03-31
Support Year
3
Fiscal Year
2005
Total Cost
$446,111
Indirect Cost
Name
University of California San Francisco
Department
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Lui, Camillia K; Sterling, Stacy A; Chi, Felicia W et al. (2017) Socioeconomic differences in adolescent substance abuse treatment participation and long-term outcomes. Addict Behav 68:45-51
Campbell, Cynthia I; Sterling, Stacy; Chi, Felicia W et al. (2016) Marijuana use and service utilization among adolescents 7 years post substance use treatment. Drug Alcohol Depend 168:1-7
Chi, Felicia W; Sterling, Stacy; Campbell, Cynthia I et al. (2013) 12-step participation and outcomes over 7 years among adolescent substance use patients with and without psychiatric comorbidity. Subst Abus 34:33-42
Chi, Felicia W; Campbell, Cynthia I; Sterling, Stacy et al. (2012) Twelve-Step attendance trajectories over 7 years among adolescents entering substance use treatment in an integrated health plan. Addiction 107:933-42
Ramirez, Rhonda; Hinman, Agatha; Sterling, Stacy et al. (2012) Peer influences on adolescent alcohol and other drug use outcomes. J Nurs Scholarsh 44:36-44
Sterling, Stacy; Chi, Felicia; Hinman, Agatha (2011) Integrating care for people with co-occurring alcohol and other drug, medical, and mental health conditions. Alcohol Res Health 33:338-49
Sterling, Stacy; Weisner, Constance; Hinman, Agatha et al. (2010) Access to treatment for adolescents with substance use and co-occurring disorders: challenges and opportunities. J Am Acad Child Adolesc Psychiatry 49:637-46; quiz 725-6
Balsa, Ana I; Homer, Jenny F; French, Michael T et al. (2009) Substance use, education, employment, and criminal activity outcomes of adolescents in outpatient chemical dependency programs. J Behav Health Serv Res 36:75-95
Chi, Felicia W; Kaskutas, Lee A; Sterling, Stacy et al. (2009) Twelve-Step affiliation and 3-year substance use outcomes among adolescents: social support and religious service attendance as potential mediators. Addiction 104:927-39
Sterling, Stacy; Chi, Felicia; Campbell, Cynthia et al. (2009) Three-year chemical dependency and mental health treatment outcomes among adolescents: the role of continuing care. Alcohol Clin Exp Res 33:1417-29

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