ADOLESCENT SUBSTANCE USE
Weekly Sessions
Week
1
Application
 Personal beliefs, professional practices
 Sociocultural influences
2
 Neurobiological research on addiction
 Lecture, discussion,
power point, video, and
 Limitations of the disease model
 Handouts
 Assessment using the DSM IV TR
 Lecture, discussion,
power point, role plays
 Standardized screening tools
 Handouts
 Epidemiology of comorbidity
 Lecture, discussion,
 Linking substance abuse and trauma
5
power point, video, and
 Handouts
 Adolescents versus adults
4
 Lecture, discussion,
 Multiple conceptions of addictive behavior
 Effects on brain structure and function
3
Methods
power point, youth
 Integrated treatment
 Handouts
 Developmental Assets Theory: Policy/Practice
 Lecture, discussion,
 Child Welfare & Juvenile Justice – Dual
Jurisdiction
power point, and
 Handouts
 Best Practices and Adolescents
6
 Public Health - Policy and Practice
 Fabled War on Drugs
 Environmental strategies
9 CEUS/CMEs: LCSWs, MDs, MFT, and Psychologists
Evaluation: pre-tests/ post-tests; comments/suggestions
 Lecture, discussion,
power point, and
 Handouts
Week 1
Application
 Personal beliefs, professional practices
 Sociocultural influences
Methods
 Lecture, discussion, power
point, video, and
 Multiple conceptions of addictive behavior
 Handouts
 Purpose of the course
 Goals and Objectives
 Presenter’s experience and qualifications
 Video: Reefer Madness
 Expectation of participants
 Biopsychosocial Theory
 On time for sessions
 Actively participate in discussions
 Don’t dominate, listen too
 Participate in evaluation
 Explore beliefs/explore experiences
 A Disease Like Any Other?
 Liver Transplantation for ALD
 National Survey(MTF)
 NIAAA Scope
 Give up a habit for 6 weeks
 12 step meetings optional
 Addiction as immoral conduct, a disease, or
maladaptive behavior?
 Stigma – how do we contribute to it?
 Scope of the problem – adolescent substance use
References
Adult Addictions Services Branch, Alcohol and Drug Services British Columbia Ministry for Children and
Families May 1996, Biopsychosocial Theory of Addiction.
Anantharaju, A. and Van Thiel, D. (2003) Liver Transplantation for Alcohol Liver Disease. NIH, Alcohol
Research & Health, Vol. 27, No. 3, 2003.
Hooked: Illegal Drugs and How They Got That Way (2008) A & E American History Channel (DVD)
Monitoring the Future (2011) National Results on Adolescent Drug Use, Overview of Key Findings 2010.
National Institute on Drug Abuse, National Institutes of Health.
National Institute on Alcohol Abuse and Alcoholism (2005). The Scope of the Problem. Retrieved on July
12, 2011 from http://pubs.niaaa.nih.gov/publications/arh283/111-120.htm
Pescosolido, et.al. (2010) “A Disease Like Any Other?” Am J Psychiatry 167:11, November 2010.
Thombs, Dennis. (2006) Introduction to Addictive Behaviors, 3rd Edition, Gilford Press.
Week 2
Application
 Neurobiological research on addiction
Methods
 Lecture, discussion, power point,
 Effects on brain structure and function
video, and
 Limitations of the disease model
 Handouts
 Controversy surrounding disease model
 New Prohibitionists
 Free Will and Decision Making
 The Controlled Drinking Debates
 The Neurobiology of Addiction
 Decision Making and Free Will: A
Neuroscience Perspective
 A Syndrome Model of Addiction
 The Role of Emotion in Decision Making
 Substance Use and the Adolescent Brain

Video – Medical Aspects of Chemical
Dependency, the Neurobiology
 Toward a Syndrome
 Substance Use and the Adol. Brain
References
Bickel, W. et.al. (2007) Behavioral and Neuroeconomics of Drug Addiction: Competing Neural Systems
and Temporal Discounting Processes. NIH Public Access Drug Alcohol Depend. 2007 Sept: 90 (Suppl 1:
S85-S91)
Burns, K. and Bechara, A. (2007) Decision Making and Free Will: A Neuroscience Perspective. Behav.
Sci. Law 25: 263-280. Wiley InterScience.
Hazelden (2003) Medical Aspects of Chemical Dependency, the Neurobiology of Addiction (2003) DVD,
Hazelden, ISBN-10: 1592852912.
Hersey, Brook (2001) The Controlled Drinking Debates: A Review of Four Decades of Acrimony.
Addiction, Pain, & Public Health website – www.doctordeluca.com/
Lubman, Dan et.al. (2007) Substance use and the adolescent brain: A toxic combination? Journal of
Psychopharmacology 21(8) (2007) 792–79.
NIH Publication (2010) Teenage Brain: A Work In Progress (Fact Sheet). Publication No. 01-4929.
Peele, Stanton. (2011) The New Prohibitionists, retrieved 7/11 from http://www.peele.net/lib
Shaffer, H. et. Al. (2004) Toward a Syndrome Model of Addiction: Multiple Expressions, Common
Etiology, Harv Rev Psychiatry November/December 2004
Naqvi, N., Shiv., B., Bechara, A. (2006) The Role of Emotion in Decision Making A Cognitive
Neuroscience Perspective. Association for Psychological Science Volume 15- Number 5, pages 260264.
Week 3
Application
 Assessment using the DSM IV TR
 Adolescents versus adults
Methods
 Lecture, discussion, power point,
and practice vignettes
 Screening tools
 Handouts
 Fears of “labeling” as a result of diagnosing
 Continuum of Use
 What about chronic pain?
 Abuses versus Dependence
 Unique Factors of Adolescent Use
 Managing Addiction as a Chronic Condition
 Minor Consent Laws in California
 Standardized tools for youth
 Drug testing & Zero Tolerance: National
Policies / Current Debates
 Challenges in Using Opioids to Treat Pain
 Addiction and the Treatment of Pain
Chronic Pain
 California Family Code Sections 6920-29
 Newsletter by Goetz
 CRAFFT, AUDIT
 Beyond Zero Tolerance
References
American Psychiatric Association. (2004) DSM IV TR. Washington, D.C. 4th Edition, Text Revision.
Budney, A. et al. (2007) Marijuana Dependence and Its Treatment, NIDA, Addiction Science & Clinical
Practice, December 2007.
Cheatle, Martin et. al. (2006) Chronic Pain and Comorbid Mood and Substance Use Disorders:
A Biopsychosocial Treatment Approach Current Science Inc. 2006, 8:371–376
Dennis, M. and Scott, C. (2007) Managing Addiction as a Chronic Condition NIDA, Addiction Science &
Clinical Practice, December 2007.
Goetz, Kristi (2009) Adolescent Substance Abuse Newsletter HD202 November 2009.
Savage, S. et. al (2008) Challenges in Using Opioids to Treat Pain in Persons with Substance Use
Disorders. Addiction Science & Clinical Practice (June, 2008).
Skager, Rodney, PhD. (2007) Beyond Zero Tolerance: A Reality-Based Approach to Drug Education &
School Discipline. Drug Policy Alliance, www.drugpolicy.org.
Ziegler, P. (2005) Addiction and the Treatment of Pain. Substance Use & Misuse, 40:1945–1954, Taylor
& Francis Inc.
Week 4
Application
 Epidemiology of Co-Occurring Disorders
 Linking substance abuse and trauma
Methods
 Lecture, youth presentation,
discussion
 Integrated services & welcoming systems
 Handouts
 Data on prevalence
 Epidemiology - SAMHSA
 Connecting trauma and substance use in youth
 Comorbidity
 Neurological Effects of Stress
 Contention: mental health and addiction recovery
 NTCSN Making the Connection
 Why we need genuine “integrated services”
 Non-Traditional Service Settings
 Re-traumatizing youth by our systems of care
 Developing Welcoming Systems

What are “youth friendly, trauma informed services”?
 Dual Dx Enhanced Programs
 COD Youth Practice Guidelines
References
Addressing Co-Occurring Disorders in Non-Traditional Service Settings, (2006) US Department of Public
Health and Human Services, COCE SAMHSA’s Co-Occurring Center of Excellence.
Brady, K. and Shinha, Rajita (2005) Co-Occurring Mental and Substance Use Disorders: The
Neurobiological Effects of Chronic Stress. (Am J Psychiatry 2005; 162:1483–1493).
Co-Occurring Joint Action Council Youth Committee, California (2011). Practice Guidelines for Youth with
Co-Occurring Disorders.
Center for Substance Abuse Treatment. The Epidemiology of Co-Occurring Substance Use and Mental
Disorders. COCE Overview Paper 8. DHHS Publication No. (SMA) 07-4308. Rockville, MD: Substance
Abuse and Mental Health Services Administration, and Center for Mental Health Services, 2007.
Minkoff, K. (2008) Dual Diagnosis Enhanced Programs. Journal of Dual Diagnosis, Vol. 4(3), 2008.
Minkoff, K. and Cline, C. (2004) Developing Welcoming Systems for Individuals with Co-Occurring
Disorders: The Role of the Comprehensive Continuous Integrated System of Care. Model Journal of Dual
Diagnosis, Vol. 1(1) 2004. The Hawthorn Press, Inc.
National Child Traumatic Stress Network (2008) Making the Connection: Understanding the Links
Between Adolescent Substance Use and Trauma, June 2008. Toolkit.
NIDA (2010) Comorbidity: Addiction and Other Mental Illnesses. Research Report Series No. 10-5771
van Dernoot Lipskey, Laura (2009) Trauma Stewardship An Everyday Guide to Caring for Self While
Caring for Others. Berrett-Koehler Publishers ISBN-13: 978-1576759448.
Week 5
Application
 Developmental Assets Theory – Policy & Practice
 Child Welfare & Juvenile Justice – Dual Jurisdiction
Methods
 Lecture, discussion,
power point, media clips
 Best Practices and YOUTH
 Handouts
 Prevention versus Promotion: Origins of Positive
 PYD So Far
Youth Development & Current Research
 40 Developmental Assets; The 5 Cs
 Crossing from Dependency to Delinquency Courts
 PYD in the U.S.
 40 Developmental Assets
 Child Welfare, Juvenile
Justice Sides of the Same
 Values and principles of ROSC with adolescents
 Chapman, What Works
 Advocating for change in adolescent behavioral health
 Life Beyond Treatment:
Focusing on ROSC
care settings, especially substance abuse treatment
References
Benson, P. et. al. (2006) Positive Youth Development So Far Core Hypotheses and Their Implications for
Policy and Practice. Search Institute, Insights and Evidence, November, 2006, Vol.3, No. 1.
Chapman, Charlotte and Rokutani, Laurie (2003) Adolescents and Substance Abuse: What Works and
Why? Article 9.
Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation,
the National Institute of Child Health and Human Development, and the Social Development Research
Group at the University of Washington. Positive Youth Development in the United States. Retrieved on
August 5, 2011 from http://aspe.hhs.gov/hsp/PositiveYouthDev
Federal Advisory Committee on Juvenile Justice (2010) Annual Report. http://www.facjj.org
Heaps, M. et al. (2009) Recovery Oriented Care for Drug Abusing Offenders. NIDA, Addiction Science &
Clinical Practice, April 2009.
Nash, M. and Bilchik, S. (2009) Child Welfare and Juvenile Justice – Two Sides of the Same Coin
Juvenile and Family Justice Today, Winter 2009.
White, W. et. al. (2011) The Recovery Revolution: Will it include children, adolescents, and transition age
youth? NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services
Recovery/Resilience, System of Care and Person-Centeredness in Services for Youth and Their
Families- Supplemental Reading, January 2011. http://www.ncdhhs.gov/mhddsas/cabha/training
Week 6
Application
 The “War on Drugs”
 Harm Reduction and Public Policy
Methods
 Lecture, discussion,
power point, video, and
 Health Care Reform
 Handouts
 Who’s winning the “war”?
 Drug Prohibition
 What exactly is “harm reduction”?
 Brief History War on Drugs
 San Francisco’s Harm Reduction Policy
 Harm Reduction and Abstinence are Not Mutually
Exclusive
 SBIRT – Primary Care Public Health Model
 Prevention & Los Angeles County (SAPC)
 Implications for Primary Care and Behavioral Health in
 Principles of Harm Reduction
 Integrating HR + abstinence
 Beyond Harm Reduction
 Evidence for Harm Reduction
 HR and risky health
behaviours in adolescents
 Commission on Drug Policy
 Screening Works Update
Working with Adolescents
References
Canadian Paediatric Society (2008) Harm reduction: An approach to reducing risky health behaviours in
adolescents. Paediatr Child Health Vol 13 No 1 January 2008.
Drucker, Ernest, PhD. (1999) Drug Prohibition. Public Health Reports, January, Volume 114.
Futterman, R., Lorente, M. & Silverman, S. (2004). Integrating harm reduction and abstinence-
based substance abuse treatment in the public sector. Substance Abuse, 25 (1), 3-7.
Futterman, R., Lorente, M. & Silverman, S. (2005) Beyond Harm Reduction: A New Model of Substance
Abuse Treatment Further Integrating Psychological Techniques Journal of Psychotherapy Integration
2005, Vol. 15, No. 1, 3–18
International Harm Reduction Development Program (2004) Evidence for Harm Reduction. Open Society
Institute November 2004.
Skager, Rodney, PhD. (1998). A Public Health Perspective on High-Risk Youth Behavior: Harm
Reduction in Prevention Policy. Community Alcohol and Other Drug Prevention, DADP.
Suddath, Claire (2009) BRIEF HISTORY The War on Drugs. Time Magazine, Time Inc. March 25, 2009.