Associations between childhood risk factors and alcohol treatment outcomes in adolescence

<b>Background:</b> Early onset alcohol use, mental health problems, familial alcohol use and adverse childhood experiences (ACEs) increase the likelihood of persistent alcohol-use disorders later in life. This study aimed to determine the relative influence of such risk factors when predicting adolescent alcohol treatment outcomes, an area overlooked in prior research. <br/><br/><b>Methods:</b> Retrospective cross-sectional analysis using the National Drug Treatment Monitoring System (NDTMS) incorporating data from all publicly funded community alcohol services in England. The study included adolescents (aged 11 – 17) whose alcohol treatment took place between 1st April 2018 and 31st March 2023 (n = 2,621). Logistic regression models tested for associations between predictors and key outcomes, including treatment non-completion and being non-abstinent at treatment completion. Predictors included demographics, treatment information, alcohol use, ACEs, psychological and socioeconomic factors.<br/><br/><b>Results:</b> Significant predictors of not completing treatment: increased age; increased monthly drinking days; year of exit 2020/21; Not in Education, Employment or Training (NEET) status and being plan on a child protection plan. NEET adolescents had double incomplete treatment rate compared to the general cohort. Significant predictors of non-abstinent completion: increased age; monthly drinking days; units per drinking day; mental health treatment need; early onset use; affected by other’s substance use; and illicit substance use. <br/><br/><b>Conclusions: </b>Adolescents with higher alcohol or illicit substance use at treatment start, NEET status and/or exposure to ACEs (indicated by a child protection plan) have worse alcohol treatment outcomes. These groups are highlighted for tailored interventions which consider psychological and environmental challenges adolescents may be experiencing.<br/>