Thirty-month relapse trajectory cluster groups among adolescents discharged from out-patient treatment.
OBJECTIVE
To identify adolescent relapse trajectory groups following discharge from out-patient substance abuse treatment.


METHODS
Adolescents aged 12-18, who were assigned randomly to one of five out-patient interventions (n = 563) in four United States communities and followed-up 3, 6, 9, 12 and 30 months post-intake.


METHODS
Self-report measures of days using any alcohol or other drugs (AOD), days of alcohol use, days of cannabis use, days of heavy use, days of crack/cocaine use, days of heroin/opiate use, days AOD use interfered with responsibilities and days in a controlled environment.


RESULTS
Adolescents can be grouped empirically into five relapse trajectories over 30 months following out-patient treatment: (a) low AOD use with limited days in a controlled environment; (b) low AOD use with high days in a controlled environment; (c) moderate/decreasing AOD use; (d) increasing AOD use; and (e) consistently high AOD use.


CONCLUSIONS
There was considerable heterogeneity in the relapse trajectories, varying by the initial response to treatment, the stability (versus increase/decrease) of the response and an interaction with time in a controlled environment. Cannabis and alcohol were the two main substances involved, although the two groups with the poorest trajectories had increasing levels of cocaine, opiate and other substance use at the 30-month follow-up. This study demonstrates the chronicity of substance use even among a subgroup of adolescents and the importance of studying more complex longitudinal patterns of recovery.
Godley
Susan H
SH
Chestnut Health Systems, Bloomington, IL 61701, USA. sgodley@chestnut.org
Dennis
Michael L
ML
Godley
Mark D
MD
Funk
Rodney R
RR
D000293:Adolescent; D016000:Cluster Analysis; D006801:Humans; D010044:Outpatient Clinics, Hospital; D010351:Patient Discharge; D012008:Recurrence; D019966:Substance-Related Disorders / Q000628:therapy*