Diagnosis and treatment of adolescent substance abuse

Robert L. DuPont, M.D., the founding director of the National Institute on Drug Abuse and former president of the American Council for Drug Education, made the following comments regarding this monograph: In terms of thinking about treatment, there are several principles that underlie all successful approaches: (1) First is the use of education. They tell drug-dependent youth and their families what is wrong and what to do about the problem. This is in dramatic contrast to the traditional psychotherapy approach, which relies on such techniques as "Tell me what you think." (2) Successful programs insist on drug-free living without compromise. (3) They involve the family actively in the treatment, reinforcing the health of the family rather than focusing on its pathology. Often this is done in family groups. (4) They have substantial duration and intensity. They are not brief or casual. (5) They reinforce prosocial, community-based values and lifestyles (love, duty, hard work, caring for others, etc.). (6) They have structure--a beginning, a middle, and an end (or "steps" or "stages"). Treatment of drug use will vary depending on stage of involvement, community resources, and desired goals of therapy. The bottom line in the evaluation of any treatment plan is its long-range effectiveness in reaching desired goals. What seems least conservative in therapy may, in fact, be the most conservative if less rigorous approaches lead to failure or delay of recovery.