Subtypes of adolescent sedative and anxiolytic misusers in drug treatment

Individualized treatment plans are extremely beneficial for adolescents in drug treatment because specific programs can be created to allow adolescents to work through problems of anxiety and depression. In an alternative to AA, individuals can use evidence based addiction treatment plans to reduce anxiety.

Adolescent drug treatment and prevention programs tend to focus on illicit drugs and alcohol. However, the misuse of prescription medication is also a major problem among adolescents, especially those who have high levels of anxiety. Researchers at the University of Kentucky, University of North Carolina at Chapel Hill, and University of Michigan employed latent profile analysis to identify three distinct classes of adolescent sedative and anxiolytic misusers (Hall, Howard & McCabe, 2010).

The researchers interviewed 723 Missouri adolescents who were in a residential care program for antisocial behavior. Of the 723 youth, 247 were classified as sedative/anxiolytic misusers. The average age of sedative/anxiolytic misusers was 15.8 years. Seventy percent of the sedative/anxiolytic misusers were white, 83.3 percent were male, and 53.8 percent resided in rural/small town areas. Interviews included questions to assess substance use, traumatic life experiences, and antisocial traits and behaviors.

The results of the latent profile analysis identified three classes of adolescent sedative/anxiolytic misusers. The first class included 59.1 percent of the sedative/anxiolytic misusers, and individuals in this class had “significantly lower levels of currently distressing psychiatric symptoms, fewer lifetime traumatic experiences, less problematic substance use histories, less frequent antisocial behavior, and less impulsivity than youth in Classes 2 and 3.” Class 2 consisted of 11.3 percent of the youth, and individuals in this class had high levels of psychiatric symptoms of more frequent antisocial behavior compared to those in class 1 and class 3. Class 3 consisted of 29.5 percent of the sedative/anxiolytic misusers, and individuals in this class had intermediate levels of psychiatric and behavioral problems. The frequency of sedative/anxiolytic misuse was significantly higher in classes 2 and 3 compared to class 1. Individuals in classes 2 and 3 also showed the highest level of symptoms for which these medications are commonly prescribed.

“Adolescents who misused prescription sedatives/anxiolytics evidenced significant heterogeneity across measures of psychiatric and behavioral dysfunction,” the authors concluded. “Youth with comparatively high levels of anxiety and depression reported significantly more intensive sedative/anxiolytic misuse than their counterparts and may be at high risk for sedative/anxiolytic abuse and dependence.”

Adolescents who are exposed to sedatives and anxiolytics through prescription use are more likely to misuse such medications. Thus, adolescents with high levels of anxiety are more likely to be exposed to anxiolytics and more likely to misuse and abuse anxiolytics. Because use of these medications may lead to drug dependence, adolescent use of prescription anxiolytics should be monitored closely. Further, prescription medication should not be the first line of defense against anxiety for adolescents. Adolescence in an anxiety-ridden time of life for nearly all individuals, but all adolescents do not need medication. There are other methods of anxiety reduction — such as exercise and talk therapy — that do not carry risk of drug dependence.

Hall MT, Howard MO, McCabe SE. Subtypes of adolescent sedative/anxiolytic misusers: a latent profile analysis. Addictive Behaviors. 2010; 35(10): 882-889.

http://www.sciencedirect.com/science/article/pii/S0306460310001462