Characteristics of relapse to substance use in comorbid adolescents

This study examined the factors associated with the relapse process for substance use disordered (SUD) youth with comorbid psychiatric disorders. Temporal and situational characteristics as well as psychiatric symptoms, self-efficacy, and developmentally relevant experiences preceding first relapse after treatment were evaluated as part of a youth focused addiction relapse model. Method: Adolescents (N=81) with a DSM-III-R substance use disorder (SUD) and another Axis 1 psychiatric disorder were recruited from inpatient Substance abuse and psychiatric treatment. Face-to-face interviews were conducted while youth were in treatment and monthly telephone interviews were conducted in the six months following treatment to ascertain length of time to first substance use episode and characteristics of the episode. Results: Youth who relapsed within the first month were more likely to report use of drugs other than alcohol or marijuana in their first use, while use among late relapsers was more often preceded by direct social pressure to use. Those relapsing in the first 3 days after treatment were less likely to view substance use as a problem and less likely to report passive emotional states (e.g., boredom) prior to use. Psychiatric symptoms were associated with relapse in conflict/life stress, negative emotional states and active emotional states. Self-efficacy was related to relapse among youth with conflict/life stress, and when youth were experiencing a desire to use in the two weeks prior to relapsing. Conclusions: Findings highlight some of the factors that are most important in understanding the process of relapse in comorbid adolescents. Research and treatment implications are discussed. (c) 2005 Elsevier Ltd. All rights reserved.