Fernando Ellis is a 15-year-old young man of Latino heritage who was referred to the local health/substance abuse agency after he attempted to jump out of his father’s moving vehicle during a verbal argument. Fernando had been using and was high on drugs at the time. He was skipping school, using marijuana on a daily basis, and had numerous drug-related police contacts and charges. He was also on probation for selling drugs on school grounds. Fernando’s father worked long hours and drank to excess when he was at home. He introduced his son to alcohol and drugs at an early age, and offered little supervision or guidance. Fernando’s mother was killed in an accident when Fernando was 12 years old, leaving his father to care for him and his three older siblings. In addition, Fernando was born with a birth defect that had often resulted in teasing by other children. At times, it was difficult to understand his speech and he walked with a significant limp. It appeared Fernando was trying to fit in, “be cool,” and gain acceptance by engaging in criminal activity. At the juvenile court hearing, Fernando was ordered to complete community service and individual counseling, and was referred to the community mental health center for an alcohol and drug assessment, as well as a suicide risk assessment. He reluctantly cooperated with the order to avoid a more serious disposition. Fernando’s assessments indicated that although he did try to jump out of a moving car, he did not appear to be a suicide risk. He was under the influence at the time and in a very heated argument with his father. There was concern about his daily use of drugs and alcohol, and Fernando was referred to an outpatient drug treatment program at the center. In addition, Fernando met weekly with his counselor for individual counseling. They worked on his drug and alcohol issues, changing his behavior and habits, and the grief and loss issues related to the sudden death of his mother. This loss was a turning point for Fernando. Up to that time, he had been a good student who was not involved with drugs. Everything changed when his mother was killed. Over the course of his work with his counselor, Fernando began to process this loss, as well as make positive changes in his life. A team of professionals, including his teachers, probation officer, drug and alcohol counselor, and a mentor provided by the school, all worked with Fernando to help him realize his goals. He began to attend school on a more regular basis and worked to improve his relationships with his father and siblings. Fernando continued to occasionally use alcohol but eliminated his drug use. He also struggled with his home situation and sometimes ran away from home to stay with friends. Overall, Fernando significantly reduced his criminal activity, although he remained on probation for the duration of the court order. 

There is little question that adolescent substance abuse and its association with delinquency is a vexing problem. Almost every city, town, and village in the United States has confronted some type of teenage substance abuse problem. Self-report surveys indicate that just under half of high school seniors have tried drugs and two-thirds (66 percent) have used alcohol.1 Adolescents at high risk for drug abuse often come from the most impoverished communities and experience a multitude of problems, including school failure and family conflict.2 Equally troubling is the association between drug use and crime.3 Research indicates that between 5 and 8 percent of all juvenile male arrestees in some cities test positive for cocaine.4 Self-report surveys show that drug abusers are more likely to become delinquents than are nonabusers.5 The pattern of drug use and crime makes teenage substance abuse a key national concern. This chapter addresses some important issues involving teenage substance abuse, beginning with a review of the kinds of drugs children and adolescents are using and how often they are using them. Then we discuss who uses drugs and what causes substance abuse. After describing the association between drug abuse and delinquent behavior, the chapter concludes with a review of efforts to prevent and control the use of drugs in the 

 

 

 

 

Although there was progress in the case, involved team members continued to have concerns for Fernando and his siblings.

critical thinking: Discuss what could have been done to address these concerns, including whether Fernando (and his siblings) should have been removed from his parental home. Make sure to weigh the advantages and disadvantages over both the short and long term

 

 

Understanding why young people take drugs is not always straightforward, and Fernando’s situation was no different. 

critical thinking: Based on the information you read in this chapter, make a list of the reasons why Fernando may have abused alcohol and drugs. For example, what were the significant family factors that may have played a role?

 

 

 

Critical Thinking:  If you were going to use a multisystemic treatment approach with Fernando, identify whom would you involve and what issues you would address. Do you think this approach could be successful in the case? Discuss why or why not.