Do improvements in substance use and mental health symptoms during treatment translate to long-term outcomes in the opposite domain?
Open accessAbstract
Providers who treat adolescents with co-occurring substance use and mental health issues may prioritize treatment of one set of symptoms believing that improvements in one domain will result in improvements of the other. However, limited empirical data for adolescents provide evidence of such "spillover effects." Using data from 2900 youth in an outpatient treatment, we examined whether during-treatment changes in substance use or mental health symptoms predicted 12-month outcomes in the analogous and opposite domains. There was very little evidence of spillover effects, only that youth with no internal distress at 0 and 3 months reported lower levels of substance use problems at 12-months relative to youth with internal distress that stayed the same from 0 to 3 months. These findings suggest that providers treat both sets of substance use and mental health symptoms in an integrated manner given that these symptoms commonly co-occur among youth with either set.
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The youth SUD treatment literature has not shown that treating only one co-occurring mental health or SUD condition produces benefits for the other.
“youth SUD treatment literature has not found “spillover benefits” from treating only one co-occurring MH or SUD condition [22]”
From Interventions for prevention and treatment of substance use in youth with traumatic childhood experiences: a systematic review and synthesis of the literature (2024) · cites this paper as [22]
The Discussion (page unavailable) reports little evidence that improvement in one domain during adolescent substance-use treatment predicted better 12-month outcomes in the other. But the Introduction (page unavailable) notes some evidence that effective mental-health treatment may prevent subsequent substance-use disorders. The claim’s categorical statement that the youth literature has found no spillover benefits overstates the source. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIntegrated or at least coordinated simultaneous treatment is recommended for most cases.
“recommending integrated, or at least coordinated simultaneous treatment in most cases [22, 23]”
From Interventions for prevention and treatment of substance use in youth with traumatic childhood experiences: a systematic review and synthesis of the literature (2024) · cites this paper as [22]
The Discussion recommends treating both substance-use and mental-health symptoms in an integrated manner and describes treatment planning and care coordination as a possible approach. But the recommendation concerns youth with co-occurring symptoms; the paper does not establish that it applies to most cases generally. (LLM, conf=0.84)
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References 41 · Cited by 18
- Authors
- Ramchand, R., Griffin, B. A., Slaughter, M. E., Almirall, D., & McCaffrey, D. F.
- Affiliations
- RAND Corporation (US)
- University of Michigan (US)
- Corresponding author
- Ramchand, Rajeev
- Venue
- Journal of Substance Abuse Treatment
- Publisher
- Elsevier BV
- Published
- 2014-11
- Volume
- 47
- Issue
- 5
- Pages
- 339-346
- ISSN
- 0740-5472 (ISSN-L)
- PMC
- PMC4175419
- OpenAlex
- W1985874377
- Cited by
- 18
- References
- 41
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 1 · 2020: 4 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 1
- FWCI
- 0.76
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Substance Abuse Treatment (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Public Health Service (27007-0191, 2702003-00006)
- National Institute on Drug Abuse (R01DA017507, P50DA010075, R01DA015697)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- spillover effects, substance use, psychiatric symptoms, adolescents, co-occurring disorders, outpatient care, treatment outcomes, integrated treatment
- MeSH terms
- Adolescent, Mental Disorders, Child, Community Mental Health Services, Female, Humans, Male, Mental Health, Psychotherapy, Treatment Outcome, Diagnosis, Dual (Psychiatry), Substance-Related Disorders, Young Adult
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