Adolescent Substance Abuse: Etiology, Treatment, and Prevention.

The aim of Adolescent Substance Abuse is to define the complex problem of teenage substance abuse and practical solutions to curtail its effects. A compendium of researched articles by qualified professionals, this manual offers assistive guidance to families, practitioners and educators working with high-risk youth populations. The preface states that "substance abuse among adolescents is a multi-faceted problem that must be approached from many perspectives. "This volume addresses specific social theories, groups, behaviors and prevention programs, and treatments for adolescents abusing substances.

This book is divided into five parts, covering etiology, treatment considerations, specific programs related to substance abuse, targeted populations, and prevention strategies. A descriptive summary of chapter materials is found at the beginning of each section. A summary section, index and suggested readings appendix is included in the back of the book. Part I, "Etiology," consists of five chapters, covering causes of alcohol and drug abuse, environmental contributors, theories of social learning, and an Eriksonian rationale for expressed behaviors. Chapter Two, "Adolescence: A Physiological, Cultural, and Psychological No Man's Land" treats the scope of use, warning symptoms and assessment factors for treatment. Chapter Four concentrates on intergenerational studies and connections within familial alcoholism. The editors remark that although arguments exist for a disease model of substance abuse, they "prefer to look at adolescent substance abuse as a behavior, and to look at those who are involved in this behavior on a regular basis as having a condition with physical, social and psychological aspects that need to be addressed in treatment and prevention programs."

Part II focuses on effective treatment models for teenagers and their families in the resolution of substance problems. Chapter Six covers assessment tools and techniques that improve diagnosis of severity in teenage abusers. Chapter Seven offers an overview of a model hospital-based intervention program in the Los Angeles region. Two chapters contain advantages and outcomes of group psychotherapy and peer counseling. Chapters Ten and Eleven discuss clinical therapy with families and methods of home treatment. Additional chapters of interest include urine drug screening, "twelve-step" benefits and hypnotic suggestion.

Part III features coexisting conditions responsible for, or found in substance abuse. Chapters Sixteen and Seventeen draw correlations between alcohol/drug abuse and suicide and incest. Self-destructive behaviors, assessment and prevention of suicide is discussed. Also, the dynamics of incest, stages of accomodation by adolescents, and related sexual disorders are described. The drug abuse profile of youth gangs "originates in numerous social, cultural, psychological, and environmental influences; parental neglect; lack of positive role modeling; peer pressure; low self-esteem; the attraction of gang support; structure and drug profits; and the need for acceptance and identity," is the theme of Chapter Eighteen.

Other thought-provoking chapters include the occult, steroid use, adolescent pregnancy, AIDS, and relationships between juvenile delinquency and vision disorders. Chapter Twenty-Two, "Eating Disorders in Adolescents," proposes diagnostic factors, definitions for, and incidence of Anorexia Nervosa and Bulimia in teenage females.

Part IV shifts to special groups with substance abuse dilemmas, and preventative measures. Chapter Twenty Six targets Native American youth and variables involved in treatment and cause. A compact, but persuasive section on "Adolescents in Alcoholic Families" is incorporated into the book, as well as chapters on two widely-abused substances, cocaine and methamphetamine.

The editors of Adolescent Substance Abuse comment that "we continue to fund research to find a biological or genetic 'marker' that would predict which people will become substance abusers; however, the chances of creating a vaccine against substance abuse are slim." They also argue that past attempts (e.g., Prohibition) were unsuccessful in validating a "blanket approach" to prevention. Part V offers various prevention models that appear effective. Chapter Thirty provides suggestions for the development of health promotion programs. Other chapters view public school programs, AIDS education, and prevention assistance for Native American and African American youth. Chapter Thirty Three, "New Skills for Parents of Teens," is a parent's guide to developmental tasks in adolescence, relationship building skills, and power/authority approaches.

Adolescent Substance Abuse is edited by Gary W. Lawson and Ann W. Lawson, with chapter contributors from the fields of psychology, substance abuse, research, education, social work and employment assistance programs. Dr. Gary Lawson is Director of Graduate Studies in Chemical Dependency at the School of Human Behavior, United States International University in San Diego, California. Dr. Ann Lawson is an Associate Professor of Marriage and Family Therapy at the School of Human Behavior, United States International University.

Adolescent Substance Abuse is replete with current information and research on causes, treatment and prevention of adolescent substance abuse. It is a well-documented, fascinating magnifier of teenage alcoholism and drug use. This book should be a valuable addition to the resource libraries of practitioners, educators and parents, who provide direction and guidance to youth caught in the vicious cycle of substance abuse.

J. Gordon Swensen, M.S., CRC Division of Rehabilitation Salt Lake City, Utah