Addiction (1995) 90, 627-635
RESEARCH REPORT
Withdrawal and dependency symptoms among
adolescent alcohol and drug abusers
DAVID G. STEWART' & SANDRA A. BROWN'
'San Diego State University/University of Califomia, San Diego Joint Doctoral Program in
Clinical Psychology & ^Veterans Administration Medical Center, San Diego and University of
Califomia, San Diego, USA
Abstract
Due to differences in duration, intensity and topography of alcohol and drug use pattems, the withdrawal and
dependency symptoms of adolescent substance abusers may differ from those of adult substance abusers. To
explore these potential differences, 166 adolescents recruited from inpatient alcohol and dmg treatment
programs in the USA were assessed for alcohol and other drug withdrawal and dependency symptoms. Teens
were administered the Customary Drinking and Drug Use Record following 2 weeks of abstinence and
evaluated for recent (< 3 months) DSM-III-R psychoactive substance withdrawl and dependency symptoms.
Adolescents were all multiple substance users with a life-time average of 4.27 drugs used in addition to alcohol.
Amphetamines were the most frequently used drug (50% of sample) and the most prevalent withdrawal
symptoms were those associated with central stimulant use. However, the number of different withdrawal
symptoms (M.= 11.27) was greater than expected for uncomplicated stimulant withdrawal or withdrawal
from any single substance. On average, panicipants reponed dependency symptoms more than DSM-III-R
criteria for the diagnosis of alcohol dependency (M. = 3.30), as well as dependency on their two most frequently
used drugs. Heavy alcohol and cigarette use were found to exacerbate withdrawal symptoms of other drugs.
These findings highlight the imponance of assessing adolescent substance abusers for withdrawal from and
dependency on multiple substances.
Introduction Schwartz & Hoffman, 1989; Smith, Schwartz &
Adolescents receiving treatment for alcohol and Martin, 1989). Polysubstance abuse is common
drug problems differ in length, intensity and among adults in treatment samples but less
topography of psychoactive substance use com- prevalent than among teens, ranging from 0 to
pared with clinical samples of adults. The 55% (Hesselbrock, Meyer & Keener, 1985;
propensity of American adolescents in treatment Gawin & Kleber, 1986; Sellers et al, 1991). As
to use multiple substances has been well docu- noted by others (e.g. Pandina, 1986) polysub-
mented. Between 70 and 98% of adolescents in ^^^'^'^^ "^e by adolescents complicates the diag-
treatment for substance abuse are polysubstance '^°^^^ °^ ^1*=°^°^ "^^ disorders,
abusers (Brown, Vik & Creamer, 1989; Estroff, ^^^"^ differences in clinical samples of
adolescent and adult alcohol and drug abusers
can be understood as age-related characteristics
Correspondence to: Sandra A. Brown, San Diego Psychology ,r,., j r. i, o <-. .• ,«.^«N T-I
Service(116B),VAMedicalCenter,3350LaJollaVillageDrive, (Fllstead, Parella & Conlm, 1988). Due tO
San Diego, CA 92161, USA. restrictions in age range, clinical adolescent
0965-2140/95/050627-09 © 1995, Society for the Study of Addiction to Alcohol
and other Drugs