Trends in Therapeutic Services Participation among U.S. Adolescents Affected by Substance Use, 2002-2017.

Objective: Substance use continues to pose threats to adolescent health and development in the United States (U.S.). Despite evidence of effectiveness, little is known about adolescent participation in self-help groups (e.g., Alcoholic Anonymous, Alateen) and individual/group counseling for coping with own and another family member's substance use. This study provides new information on the prevalence and trends of adolescent participation in self-help groups and counseling for substance use using a nationally-representative sample. Methods: Data was derived from the 2002-2017 National Survey on Drug Use and Health, which include cross-sectional samples of U.S. adolescents aged 12-17 (n=243,618). Specifically, year-by-year prevalence of program participation was estimated, and then the trends were tested using logistic regression analyses while controlling for sociodemographic factors. Results: We found that U.S. adolescents' participation in self-help groups and counseling for substance use decreased from 5.6% in 2002 to 3.4% in 2017, a 39 percent decline that was significant while controlling for sociodemographic confounds (AOR = 0.969, 95% CI = 0.963-0.974). The decreases were most notable among low-income (-39%) and Hispanic (-49%) adolescents. Conclusion: Findings suggest that barriers to therapeutic service use and potential unmet needs among U.S. adolescents, especially low-income and Hispanic adolescents affected by own and family member's substance use, need to be alleviated to promote healthy recovery.