Does drug treatment for juveniles increase recidivism?

Back in January I reported on the bizarre finding that Texas Youth Commission inmates who went through drug treatment had higher recidivism rates than addicted youth who didn't receive those services, according to a legislatively mandated report (pdf). As mentioned then, the agency's "chemical dependency treatment was a flat-out failure, actually increasing recidivism compared to youth assessed as having chemical dependency who received no treatment." The problem had been going on for years. In 2007, the Dallas News ran a story declaring, "The Texas Youth Commission's drug treatment program produces graduates who are more likely to re-offend after release than addicted inmates who did not participate."

TYC has recently changed the treatment curriculum and it's too soon to analyze results from the new program, but these startling data left me scratching my head.

Then Time magazine ran a feature July 16 asking, "Does teen drug rehab cure addiction or create it?," and now I'm wondering if TYC's treatment curriculum was merely flawed, or if the whole concept of drug treatment for teens should be reconsidered. Reports Time:

Increasingly, substance-abuse experts are finding that teen drug treatment may indeed be doing more harm than good. Many programs throw casual dabblers together with hard-core addicts and foster continuous group interaction. It tends to strengthen dysfunctional behavior by concentrating it, researchers say. "Just putting kids in group therapy actually promotes greater drug use," says Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA).

The exposure can be especially dangerous for impressionable youngsters. "I've known kids who have gone into inpatient treatment and met other users. After treatment, they meet up with them and explore new drugs and become more seriously involved in drug use," says Tom Dishion, director of research at the Child and Family Center at the University of Oregon, who has documented such peer influence in scientific studies.

In academic terms, the problem is known as deviancy training, or the negative impact of friends on teen behavior — what parents would simply call a bad influence. In one 2000 study, in which researchers measured how much time teens spent together and how much they encouraged their peers' misbehavior, Dishion found that social exposure to delinquent peers at age 14 accounted for 53% of adolescents' life problems five years later — including criminal convictions, sexual promiscuity, relationship issues and drug use. ...

In addition, researchers find, the harm of many teen drug-treatment programs may come not only from the negative influence of new relationships but also from the degradation of positive bonds with family. In a 2003 paper, Jose Szapocznik, chair of the epidemiology and public-health department at the University of Miami, found that teens who used marijuana but still had healthy relationships with their families saw those relationships deteriorate — and their drug habits increase — when they were assigned to peer-therapy groups. Among these teens, who were in treatment for a minimum of four weeks, 17% reduced their marijuana habit, but 50% ended up smoking more. "In group, the risk of getting worse was much greater than the opportunity for getting better," Szapocznik says, adding that in contrast, 57% of teens who were assigned to family therapy showed a significant decrease in drug use, while 19% used more.

Maybe the problem with TYC's drug treatment program wasn't a bad curriculum. Perhaps, if these assessments are accurate, intensive drug treatment may be a misguided approach for juveniles altogether, however successful the tactic may be for seriously addicted adults.