WISCONSIN UNITED
for MENTAL HEALTH

Since the early 1990s there has been a “sharp resurgence” in the misuse of alcohol and other drugs by adolescents. According to the National Comorbidity Study, 41 to 65 percent of individuals with a lifetime substance abuse disorder also have a lifetime history of at least one mental disorder, and about 51 percent of those with one or more lifetime mental disorders also have a lifetime history of at least one substance use disorder. The rates are highest in the 15- to 24-year-old age group. The cross-sectional data on association do not permit any conclusion about causality or clinical prediction, but an appealing theory suggests that a subgroup of the population abuses drugs in an effort to self-medicate for the co-occurring mental disorder. Little is actually known about the role of mental disorders in increasing the risk of children and adolescents for misuse of alcohol and other drugs. Stress appears to play a role in both the process of addiction and the development of many of the comorbid conditions.

A meta-analysis and literature review concluded that family-oriented therapies were superior to other treatment approaches and enhanced the effectiveness of other treatments. Multi-systemic family therapy, discussed elsewhere in this chapter, is effective in reducing alcohol and other substance use and other severe behavioral problems among adolescents.