Substance Use Disorder Treatment Can Reduce Symptoms of Another Common Disorder
When parents seek treatment for a teen with an alcohol use disorder or a substance use disorder (AUD/SUD), their primary goal is to help their teen stop using alcohol or drugs. They understand that substance use and addiction can lead to a wide range of significant negative physical, emotional, behavioral, and social consequences. Those are the things they want to avoid, and for good reason: addiction, when untreated, can escalate and the negative consequences can last for decades, hinder typical development, and degrade overall quality of life and well-being.
That’s why treatment for an alcohol or substance use disorder diagnosed during adolescence is essential. It can mitigate, and in some cases, totally eliminate, many of the negative consequences of alcohol or drug addiction.
A study published in the Journal of the American Academy of Child & Adolescent Psychiatry includes data that show treatment for substance use disorder can also improve the symptoms of another mental health disorder that’s common in adolescents. Before we give you the big reveal, and talk about which mental health disorder SUD treatment can help, we’ll offer a quick review of the negative consequences of alcohol and drug use among adolescents – because it’s important to remember that adolescent alcohol and substance misuse is a serious problem that can significantly disrupt the life of a teenager.
Why Seek Treatment for Teen Addiction?
The earlier a person develops an addiction disorder, the more damaging the consequences – if left untreated.
We’ll start with the physical consequence of alcohol and drug use. Evidence shows that alcohol and illicit drugs, including marijuana, opiates, and amphetamines, can damage the:
Alcohol and drugs can impair typical development, reduce brain size, and negatively impact brain areas that control rational decision making, impulse control, emotional control, and reward.
Excess alcohol and drug use increase risk of heart disease, including stroke, heat failure, and arrhythmia.
Smoking any drug damages lung tissue and increases risk of lung disease and chronic bronchitis.
Liver, Kidneys, Pancreas
While there is no evidence marijuana use has a negative impact on these organs, the use of alcohol, amphetamines, and opiates can cause significant damage, up to and including kidney and liver failure, which may lead to death. In addition, excess alcohol use can lead to pancreatitis, which can be fatal.
While all drugs of abuse and misuse can impact overall health, which degrades immune function, the prolonged use of opiates suppresses immune function and leads to a high rate of developing infectious disease.
Now let’s look at the emotional consequences of alcohol and drug use. The misuse or abuse of intoxicants during adolescence can increase:
Now let’s look at the behavioral consequences of teen addiction. When a teen develops a substance use disorder, the following things may occur:
- Increase in risky behavior
- Decrease in academic performance
- Volatile behavior, such as anger outbursts
- Decrease in personal hygiene
- Withdrawal from previously loved or favorite activities
- Decrease in meaningful interaction with family
- Increase in family conflict
Finally, let’s look at the social consequence of teen alcohol or drug use. When a teen develops and addiction or substance use disorder, they may:
- Completely change their friend/social group
- Completely change their social activities
- Withdraw from long-time friends
- Cease all social activity in favor of alcohol or drug use
- Experience turbulent and rocky friendships and romantic relationships
When viewed as a whole, the consequences of teen addiction can impact life satisfaction, overall. When left untreated and unresolved, all the issues listed above can attenuate the successful transition to adulthood, and reduce chances of academic achievement, gainful employment, stable relationships, and overall well-being.
Those are all compelling reasons for parents of teens with addiction problems to get their teen into an evidence-based based treatment program for substance use disorder as soon as possible. And now, a new study shows that treatment for substance use disorder – without additional treatments – can also reduce the symptoms of one of the most common mental health disorders among teens: depression.
Addiction Treatment and Depression: The New Data
In the study Adaptive Treatment for Youth With Substance Use and Depression: Early Depression Response and Short-term Outcome published last year, researchers posed an interesting question that, to our knowledge, previous researchers had never asked:
What is the effect on depressive symptoms of cognitive behavioral therapy for alcohol or substance use disorder (CBT) on teens with co-occurring AUD/SUD and depressive symptoms?
Here’s how the lead researcher on the study described the need to an experiment with this design:
“The combination of alcohol or cannabis use and depression is a significant problem in adolescents and young adults. In addition to the negative outcomes associated with substance use…those with both conditions tend to have longer episodes of depression, more substance-related problems, and, most importantly, an increased risk for suicidal behavior. Yet there is no standard approach to treating them, and they are often treated in two separate systems of care.”
To address this gap in knowledge and this treatment need, and to answer the question above, the research team recruited 95 teens and young adults (14-21) in treatment at two different locations who met the following criteria:
- Diagnosed with AUD or history of alcohol use
- Diagnosed SUD or history of cannabis use
- Displayed depressive symptoms
Before they initiated treatment for AUD/SUD with CBT, researchers administered surveys to determine baseline levels of:
- Alcohol use
- Cannabis use
- Depressive symptoms
Treatment involved up to 12 sessions of cognitive behavioral therapy over 14 weeks. Clinicians measured treatment progress – using the same surveys they used to establish baseline levels – at four subsequent time intervals:
- 4 weeks
- 9 weeks
- 14 weeks
After the four-week progress check, the group was divided into three new sub-groups:
- Teens who show early depression response (EDR) continued as they had for the first four weeks. Clinicians define EDR as “…a 50% reduction of depressive symptoms in the first month of treatment.”
- Half the remaining teens participated in enhanced treatment as usual (ETAU)
- The other half received cognitive behavioral therapy for depression (CBT-D)
The purpose of this second subdivision was to measure outcomes for teens in three similar, but specialized, treatment regimens for co-occurring AUD/SUD and depression.
Let’s take a look at what they learned.
CBT for SUD: Does it Work for Depression?
Here are the results for depressive symptoms, alcohol use, and cannabis use:
- 35% of adolescents displayed EDR, or a reduction of depressive symptoms by 50% within 4 weeks
- Researchers identified two factors associated with EDR:
- Fewer days of cannabis use at baseline
- Absence of conduct disorder (CD)
- From weeks 4-14, depressive symptoms decreased significantly for all groups:
- EDR group
- ETAU group
- CBT-D group
Alcohol and Cannabis Use:
- For the EDR, ETAU, and CBT-D groups:
- Frequency of drinking decreased
- Heavy drinking decreased
- Cannabis use decreased
- The EDT group showed lowest cannabis use
When we read those results, we’re intrigued – and we don’t say that often. For one, it verifies the efficacy of treatment for substance use and depression in general, which is our work – so that validates the work we do. Second, it shows the efficacy of an approach to treatment we use – CBT – so that validates the techniques we use. Third, it hints at information on a topic that’s always interested us, but the study authors don’t address: the conundrum of crossover between depressive symptoms and symptoms of the disordered use of substances, i.e. addiction.
The conundrum is the chicken-egg question: does depression lead to substance use or does substance use cause the symptoms of depression? This data seems to imply that in some cases, some depressive symptoms are indeed the result of the misuse of substances.
That’s good information for us to have – but that’s not the only interesting thing about the study.
The Benefits of an Adaptive Approach
In treatment for mental health disorders or substance use disorders, the best treatment plans change as the person in treatment changes. In fact, an adaptable treatment plan and approach is a hallmark of a highly regarded adolescent treatment center. This study shows the benefits of embracing this model of treatment. If a teen with a substance use disorder and depressive symptoms shows a reduction in depressive symptoms after a month of treatment – an EDR, in the language of this study – but continued symptoms of an substance use disorder, then clinicians can tailor the treatment plan to emphasize treatment for the SUD, rather than the depression.
On the other hand, if a teen with a substance use disorder and depressive symptoms shows a reduction in SUD symptoms but not a reduction in depressive symptoms after a month of treatment, they can tailor the treatment plan to emphasize treatment for the depression, rather than the SUD. And in either case, an adaptable treatment plan allows for the return of any treatment modality to address and resolve the reappearance of either depressive symptoms or symptoms of SUD.
That’s what an adaptable plan is meant to do: change as the person in treatment changes. That’s another reason this article intrigues us. We specialize in adaptable plans and the ability to treat adolescents with a wide range of treatment modalities. We’re pleased to see new evidence that shows that the treatment community – which we’re part of – is on the right track. An integrated treatment model with adaptable plans and a variety of therapies and techniques helps target treatment and support for teens and leads to efficient and positive outcomes.
One Last Thing: About CBT
Parents reading this article might think, “CBT sounds like good treatment. I want to know more.” For a complete description of CBT, please read our CBT Treatment Page. For a quick primer on CBT, without as many details, please read on.
Here’s how the National Alliance on Mental Illness (NAMI) describes the CBT process:
“By exploring patterns of thinking that lead to self-destructive actions and the beliefs that direct these thoughts, people with mental illness can modify their patterns of thinking to improve coping.”
Perhaps we should back up one step. CBT is a type of talk therapy, or psychotherapy. During CBT, a trained CBT therapist directs a patient through the process described in the NAMI quote above. It’s easy to see how CBT can help teens with substance use and depression, because at its core, it explores the relationship between patterns of thought and patterns of behavior.
During CBT therapy, a CBT therapist helps an adolescent understand how thought affects emotion and emotions affects behavior. CBT helps teens change behavior by teaching them how to identify counterproductive patterns of thought and replace them with productive patterns of thought. This, in turn, helps teens replace life-interrupting behaviors with life-affirming behaviors. This empowers teens to manage their mental health disorder – whether it’s depression, substance abuse, or something else – and live life on their terms, dictated not by the symptoms of their disorder, but by their choices, values, and aspirations.
Finding Help: Resources
If you’re seeking treatment for your teen, please navigate to our page How to Find the Best Treatment Programs for Teens and download our helpful handbook, A Parent’s Guide to Mental Health Treatment for Teens.
In addition, the American Academy of Child and Adolescent Psychiatry (AACAP) is an excellent resource for locating licensed and qualified psychiatrists, therapists, and counselors in your area. Both the National Institute of Mental Health (NIMH) and the National Alliance on Mental Illness also provide and high-quality online resources, ready and waiting for you right now.
Angus is a writer from Atlanta, GA. He writes about behavioral health, adolescent development, education, and mindfulness practices like yoga, tai chi, and meditation.