Substance Abuse

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Substance Abuse

According to the Center on Addiction (2011), adolescent substance abuse is the United States' number one public health problem. In 2011, approximately 46% of high school students in the U.S. reported using addictive substances. An estimated 12% of these individuals met the criteria for clinical addiction (Center on Addiction, 2011). According to the National Institute of Drug Abuse (2016), 80-90% of incarcerated adolescents have a substance abuse disorder. Substance abuse often begins in adolescence (National Institute on Drug Abuse, 2014). A research study performed by Wimberly and Engstrom (2017) demonstrated that stressful experiences contribute to substance abuse by challenging individuals' emotional and physical wellbeing. Substance abuse is often a maladaptive coping strategy for managing and coping with chronic stress to attempt at alleviating negative feelings (Wimberly & Engstrom, 2017).

According to Mericle et al. (2015), a high number of adolescents have substance abuse disorder, but few receive appropriate treatment. Approximately 7-9% of adolescents in the U.S. met the criteria for substance abuse disorder but less than 2% received treatment in the past year. The National Institute on Drug Abuse (2014) also found that 52% of rehabilitation facilities admit adolescents. However, only 32% of these facilities offer programs for adolescents specifically. This statistic indicates a gap in treatment. Many adolescents are not seeking substance abuse treatment, and those who do seek treatment are not receiving individualized treatment.



According to Wimberly & Engstrom (2017), reentry programs addressing substance abuse are essential in today's society. Reintegration can be stressful leading to an increased risk for substance abuse. Approximately 40% of individuals reentering society after substance abuse treatment use drugs or alcohol within eight to ten months of being released. Preparing individuals for successful reintegration can lead to decreased rates of substance use and reincarceration. Research shows that successful reintegration programs should address basic needs such as housing, employment, case management services, and insurance (Wimberly & Engstrom, 2017).

Another study by Wimberly & Engstrom (2017), supported the use of mindfulness alongside yoga for a successful reintegration program. Research has shown that this leads to stress reduction and reduced substance use. The practice of meditation has been associated with positive outcomes in substance abuse treatment programs. This has also been linked with improved self-esteem, decreased hostility and mood disturbance (Wimberly & Engstrom, 2017). 

Effective substance abuse treatment programs involve developing personal responsibility and accountability (National Institute on Drug Abuse, 2018). Effective substance abuse treatment programs should also include a transition program. According to the AOTA (n.d.), transition is described as movement from one stage to the next. It can include changes in daily life, functional abilities, or environment. Ju & Tang (2016) state that transition outcomes can be improved with transition planning and implementation. Positive transition outcomes are considered living independently to the maximum extent, having meaningful employment, or attending further education. Effective transition programs should teach a variety of skills, including academic, functional, social, behavioral, and occupational skills (Ju & Tang, 2016).   


Addiction can be studied using an occupational approach because it affects an individual's occupations, environmental roles, routines, and occupational performance (AOTA, 2017). Addiction is defined as repetitive behaviors that involve genetic, developmental, educational, psychological, environmental, and cultural elements by Rojo-Mota, Pedrero-Perez, and Huerta-Hoyas (2017). OTs have the expertise and knowledge to treat mental illness and improve an individual's well-being and quality of life (Rojo-Mota et al., 2017).


According to Gardner et al. (2019) individuals with a substance abuse disorder often report difficulty with managing finances and rank improvement in financing as one of their top priorities. In a concurrent mixed-methods study, 128 participants were interviewed about their participation in financial management sessions. Interview results demonstrate that after participating in the financial management program, individuals reported improvements in overall quality of life, wellbeing, self-determination, confidence, security, and self-esteem (Gardner et al, 2019).

According to Gardner et al. (2019) individuals with a substance abuse disorder often report difficulty with managing finances and rank improvement in financing as one of their top priorities. In a concurrent mixed-methods study, 128 participants were interviewed about their participation in financial management sessions. Interview results demonstrate that after participating in the financial management program, individuals reported improvements in overall quality of life, wellbeing, self-determination, confidence, security, and self-esteem (Gardner et al, 2019).


Substance abuse disorder left untreated can result in school failure, incarceration, problems with social relationships, impaired memory, risky sexual behavior, loss of interest in meaningful activities, and risk of overdose (National Institute on Drug Abuse, 2014). It can also contribute to an increased risk of motor vehicle accidents, violent events, and mental health disorders such as major depressive disorder, anxiety disorders, conduct disorders, and attention deficit hyperactivity disorder (CITE?). These risky behaviors contribute to the high incarceration rates of adolescents (Van der Put, et al., 2014).

Unfortunately, a significant number of individuals who are fortunate enough to receive aftercare treatment have been shown to continue experiencing decreased self-esteem and increased internalized stigma and anxiety (Birtel et al., 2017). Anxiety and low self-esteem often contributes to poorer health and wellbeing, decreased sleep, and reduced socialization (Birtel et al., 2017). Perceived social support is one of the only factors that result in higher self-esteem, lower levels of depression, and better sleep (Birtel et al., 2017).

Factors impacting transition to community life include survival from abuse, poverty, substance abuse, and lack of resources. These circumstances can lead to anxiety, depression, and posttraumatic stress disorder complicating reintegration into society (Nymathi et al., 2018).