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Continued Decline in Youth Substance Abuse

Current illicit drug use among teens is continuing to decline, according to a new report by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) released today. The study also shows positive signs that teens are seeing the dangers of abusing prescription drugs and methamphetamine and are pushing back. Among youth ages 12-17, the 2007 National Survey on Drug Use and Health (NSDUH), the Nation's largest substance use survey, shows that the significant decline in overall past month illicit drug use that began in 2002 continued through 2007, from 11.6 percent to 9.5 percent.

The survey, released at the start of the 19th Annual National Alcohol and Drug Addiction Recovery Month, shows that the reductions in youth drug use occurred for nearly every type of illicit drug including marijuana, cocaine, hallucinogens, LSD, and Ecstasy. The survey also shows dramatic declines in meth use, down by 67 percent (from 0.3% to 0.1%) and prescription drug abuse among teens, which declined overall by 18 percent, from 4 percent to 3.3 percent between 2002-2007.

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Evaluate addiction with an underlying trauma or grief issue

Columns - Assessment Tools

Monday, 31 May 1999

The following is an assessment tool that counselors can use in evaluating addiction with an underlying trauma or grief issue.

Clinical Interview

History/comprehensive psychosocial-medical history
Presenting problem
Why are you here, what is it that brings you here?
What kind of problem are you having?
What I am interested in here is the client stating in his/her own words the difficulty — I want to know how he/she conceptualizes it as well as the level of insight and understanding of what is happening.
History of presenting problem
How long have you been having this problem and how is it affecting your life?
Past personal history and current psychological functioning psychosocial history and current functioning
occcupational history/current functioning
Past psychiatric history
Substance abuse history and current status
Family history (psychosocial, psychiatric, medical, substance abuse)
Obviously red flag these if there is a history of major thought disorder, mood disorder, or behavior or substance abuse disorder.

As noted above, the mental status observations can be made concurrently, paying attention to:

appearance
level of psychomotor activity
speech and language
mood and affect
thought process and content
insight and judgment
symptoms of anxiety, depression, psychosis
difficulty with impulse control
indicators for substance abuse, speech, needle marks, unusual
mannerisms, skin color, pupils, etc.

Risk Factors

Again, if psychosis, severe substance abuse, i.e., need for detox, suicide or homicide surface as issues they must be dealt with and that determines the course and direction of the rest of the interview. Assessment now beccomes intervention.

Assessment domains

The primary feature of assessment is finding out who the person is we may be treating or at least evaluating.

coping skills
ego functioning
frustration tolerance, impulsivity
repeated scripts and themes in life
self-image, self-esteem
personality dynamics and conflicts
relationship patterns — dependent, ambivalent, distant, paranoid, angry, anxious
strength, assets, coping abilities, internal resources
specific vulnerabilities, weaknesses, liabilities

Concurrent Life Stressors

Any recent losses, deaths, life changing events?
Nature of loss, circumstances, secondary losses
Tell me about what happened.
How did it affect you?
How did it change your life?
Are you now having difficulty with it?
How have you tried to deal with it? What has worked, what has not?
Any previous trauma, loss or history of abuse?
What type of support do you have in your life?
Compared to previous times in your life how are you coping now?
Do you have any important spiritual beliefs or affiliations which help you cope with your life difficulties?
What is it you expect to gain from seeking help?
What would normal look like for you?
Expectations for recovery and image of desired life.
Is there anything else you would like to tell me about yourself that we haven’t discussed?

Course of treatment, direction of intervention is all based on discovery of (1) problem, (2) premorbid conditions and predisposing factors, (3) concurrent stressors, and (4) current level of individual psychological functioning of person. As always, treatment is subject to less than ideal circumstances, i.e. client’s ability to pay, mental health resources in the community, and client’s ability to cooperate with and benefit from recommended intervention plan.

This assessment tool was developed by Gary W. Reece, PhD. Dr. Reece is a therapist, author, educator, lecturer and consultant. He is author of The Stepcare Recovery Guide for Substance Abuse, and The Hero’s Journey, A Course on Self-Esteem. He is founder and executive director of the Stepcare Institute in Sierra Madre, California. For more information contact Dr. Reece at 626-355-2407 or by email: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it .

In each issue, Assessment Tools provides effective, functional information designed to supplement and enhance the assessment process. We look forward to your input, and we encourage you to send in assessment tools and instruments of your own. Please send your ideas and suggestions to Professional Counselor, Assessment Tools, 3201 SW 15th St., Deerfield Beach, FL 33442; or fax to (954) 360-0034.