Substance abuse and criminal involvement are two of the most serious problems among today's youth. Substance abuse is common among juvenile offenders with an estimated 82% of youth committed to the Juvenile Rehabilitation Association (JRA) in Washington defined as being either dependent on, or abusing, alcohol or other drugs (JRA, 1997). A recent report prepared for the Washington State Division of Alcohol and Substance Abuse on adolescent drug treatment reported that following treatment 36% of treated youth had remained abstinent for six months (New Standards Inc., 1995). Similar post-treatment relapse rates for adolescents have been noted elsewhere (Brown, 1990). In order to better meet the needs of juvenile offenders by providing interventions which research has demonstrated to be effective in reducing substance use and criminal behavior, the legislature approved HB 3900 (Sec 26-28) which requires the development, implementation, and evaluation of the CDDA program.

While drug treatment is at the core of CDDA, it is essential that other issues which contribute to the problems these adolescents face, and in turn the crimes they commit, be addressed concurrent with treatment for chemical dependency. Mental health problems, for instance, are extremely common among adolescents who abuse drugs. A study of 192 adolescents who received inpatient chemical dependency treatment in Washington during 1996 found that 65% of the youth had received mental health services and 45% were taking prescription medication for mental health problems (Peterson, 1997).

A. Adults Versus Adolescents

Prior to 1985 most substance abuse treatment programs for adolescents were the same or very similar to those for adults. In fact, adolescents were frequently treated in the same physical settings as adults (Brown, 1990). Research has since demonstrated that it can not be assumed that salient factors in the establishment, maintenance, and treatment of substance abuse and to a lesser degree, delinquency, are the same for adults and adolescents. Compared to adults, adolescents have shorter periods of substance abuse, greater involvement with alcohol and marijuana, are more likely to be poly-drug abusers, and have shorter criminal histories. The need for family support and educational assistance is more significant for adolescents in substance abuse treatment compared to adults (Friedman, 1986).

A recent study by Martin (1995) reveals further differences between adults and adolescents. In this study of 181 adolescent drinkers, half of whom were males, Martin found that the severity and pattern of alcohol use differed for adults and adolescents. Adolescents had fewer formal symptoms of alcohol abuse or dependence as measured by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), than did adults, as well as fewer difficulties in occupational functioning. Adolescents had more difficulties in meeting obligations in the home, family, and school domains compared to adults, and were half as likely to report alcohol withdrawal symptoms. With respect to gender differences, adolescent males with alcohol abuse or dependence reported more legal problems, physical fights, and hazardous use of alcohol compared to females with alcohol abuse or dependence. Compared to males, females reported more difficulty maintaining their grades, more impact on their involvement in social activities and more continued alcohol use despite psychological problems as a result of drinking. No racial differences were revealed in the symptom patterns related to alcohol abuse or dependence. It is worth noting, however, that there were a disproportionate number of African Americans who received no diagnosis of alcohol abuse or dependence.