Center for Adolescent Substance Abuse Research (CASAR)

The Center for Adolescent Substance Abuse is dedicated to conducting research that will help adolescents, young adults, and their families address their alcohol and other drug use, problem gambling, and other addictions or harmful behaviors. Aim to reduce the harmful effects of these behaviors and promote a healthy way of life.

Previous Projects

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Study Complete: Home-Based Brief Intervention

This study will develop and test a new, innovative version of a brief intervention (BI) for parents with a teenager aged 12-17 who has already started to use drugs. The BI will be home-based rather than implemented by a counselor in a clinical setting. Stage I (2011) activities will involve the development of the parent training manual and the BI "home" program manual, and a small feasibility study; Stage II (2012-2014) work involves a formal controlled research study.

Study Procedures

Questionnaires and interviews will be administered at baseline and at 3-, 6- and 12-months post-baseline. We hypothesize that the home-based intervention will be beneficial in reducing adolescent substance use and improving parenting skills.
We will examine mediators that may contribute to post-intervention drug use outcomes among adolescents. We expect response to the intervention by the adolescent to be mediated by motivation, cognitions, problem-solving, peer drug use, parenting skills and parent self-efficacy.


Effectiveness of Recovery High Schools as Continuing Care

This project will examine the efficacy of Recovery High Schools on improving academic outcomes for adolescents with drug abuse problems (2011-2015). The study will be conducted in cooperation with multiple drug abuse treatment facilities and Recovery High Schools in the greater Minneapolis-Saint Paul, Minnesota area. The purpose of this study is to find ways to enhance school environments in order to provide a healthy and supportive learning environment for students. We hope to learn more about how high schools and other factors impact a young person who recently attended a drug treatment program.

Study Procedures

Approximately 914 adolescents will be recruited from a drug abuse treatment facility or a Recovery High School and followed up through 12 months after they have left treatment.

Data will be used to assess whether students attending Recovery High Schools exhibit better academic and drug use outcomes after drug treatment than those attending non-Recovery High Schools.

Recruitment has ended. Follow-up only.


The Brief Intervention (BI) study assessed 12-19 year old adolescents who were experiencing mild to moderate problems due to alcohol and/or drug use, such as an alcohol or drug-related infraction in school or in the community, a concerned teacher or parent, or referred by a clinic or other agency.

This study compared two levels of BI therapy with a comparison group. The first BI group consisted of a therapist meeting with the adolescent for two 60-minute sessions. The second BI group also received the same two adolescent sessions with a therapist, but also included a session in which the therapist met individually with the parent/s. The comparison group did not meet with a therapist, but all 3 groups received questionnaire and interview assessments at 4 time points.

Summary of the Results

Summary of the results, as reported by the National Institute on Drug Abuse (NIDA Notes, January 2, 2013).


Phase 1

This research effort actually began in approximately 1990, at which time the project was called the Minnesota Competence Enhancement Project (MNCEP) in collaboration with Gerry August, Ph.D. and George Realmuto, M.D. The original study compared two large groups of youth: one group showed signs of having Attention Deficit Hyperactivity Disorder (ADHD) during childhood, whereas the other group did not show signs of ADHD during childhood.

The follow-up study was conducted in three different waves - in roughly 2000, 2002, and 2005 - with the intent of seeing how those individuals with and without a history of ADHD symptoms during childhood would compare on various aspects of life as young adults.

Summary of Results 

Brief participant summary of the results

Phase 2 - Environmental and Genetic Risk Factors in Drug Use

This study continues the longitudinal assessment of participants from previous studies and examines the developmental pathways of drug and alcohol use among young adults with the purpose of better understanding the genetic and environmental risks for substance use and mental health concerns among young adults.

Study Procedures

  • Participants complete an interview and questionnaire to help us examine the environmental risk factors, as mentioned above. 
  • Participants are also asked to provide a DNA sample via a saliva sample. This portion helps us understand the genetic risk factors involved in the development of substance use and mental health concerns.

Summary of the Results

Results are currently being analyzed. We will post a summary of the results as they become available.


This research study examined the life events of 3 groups of adolescents: 1) those who were treated at a local inpatient substance treatment program, 2) those on a waiting list for treatment, and 3) those who were not seeking treatment for substance abuse (comparison group). The purpose of this research effort was to study adolescent alcohol and other drug use and problems resulting from drug and alcohol use over a 5-year period. Participants in this study completed questionnaires and interviews at treatment intake, 3-months posttreatment, 6-months posttreatment, 1-year posttreatment, 4-years posttreatment, and 5 ½ -year posttreatment.

Summary of the Results

Brief participant summary of the results


Adolescent Substance Use Publications

Botzet, A.M., McIlvaine, P.W., Winters, K.C., Fahnhorst, T., & Dittel, C. (2014).  Data collection strategies and measurement tools for assessing academic and therapeutic outcomes in recovery schools.  Peabody Journal of Education, 89, 197-213.

Botzet, A., Winters, K. C., & Stinchfield, R. (2006). Gender Differences in Measuring Adolescent Drug Abuse and Related Psychosocial Factors. Journal of Child and Adolescent Substance Abuse, 16, 91-108.

Breyer, J. L., Lee, S., Winters, K. C., August, G. J., & Realmuto, G. M. (2014). A longitudinal study of childhood ADHD and substance dependence disorders in early adulthood. Psychology of Addictive Behaviors28(1), 238.

Brown, S.A., McGue, M., Maggs, J., Schulenberg, J., Sher, K., Winters, K.C., & Lowman, C. (2008). A developmental perspective on alcohol and youth ages 16 - 20. Pediatrics, 121, S290-S310.

Dembo, R., Wareham, J., Schmeidler, J., Briones-Robinson, R., & Winters, K. C. (2014). Differential Effects of Mental Health Problems Among Truant Youths. The journal of behavioral health services & research, 1-26.

Gans, J., Falco, M., Schackman, B., & Winters, K.C. (2010). An in-depth survey of the screening and assessment practices of highly regarded adolescent substance abuse treatment programs. Journal of Child & Adolescent Substance Abuse, 19, 33-47.

Kaminer, Y. & Winters, K.C. (2011). Clinical manual of adolescent substance abuse treatment.

Latimer, W. W., Newcomb, M., Winters, K. C., & Stinchfield, R. D. (2000). Adolescent substance abuse treatment outcome: The role of substance abuse problem severity, psychosocial, and treatment factors.Journal of Consulting and Clinical Psychology, 68, 684-696.

Lee, C-Y. S., Winters, K. C., & Wall, M. (2010). Trajectories of substance use disorders in youth: Identifying and predicting group membershipsJournal of Child & Adolescent Substance Abuse, 19, 135-157.

Realmuto, G., Winters, K.C., August, G.J., Botzet, A., Lee, S., & Fahnhorst, T. (2009). Drug use and psychosocial functioning of a community derived sample of adolescents with childhood ADHD. Journal of Child and Adolescent Substance Abuse, 18, 172-192.

Stinchfield, R. (1997). Reliability of adolescent self-reported pretreatment alcohol and other drug use.Substance Use and Misuse, 32, 425-434.

Stinchfield, R., Niforopulos, L., & Feder, S. H. (1994). Follow-up contact bias in adolescent substance abuse treatment outcome research. Journal of Studies on Alcohol, 55, 285-289.

Tanner-Smith, Emily E., et al. "Can Brief Alcohol Interventions for Youth Also Address Concurrent Illicit Drug Use? Results from a Meta-analysis." Journal of youth and adolescence (2015): 1-13.
Winters, K. C., Lee, S., Botzet, A., Fahnhorst, T., & Nicholson, A. (2014). One-year outcomes and mediators of a brief intervention for drug abusing adolescents. Psychology of Addictive Behaviors28(2), 464.

Whitten, L (2013, January 2). Brief intervention helps adolescents curb substance use. NIDA Notes

Winters, K., Lee, S., & Symmes, A. (2014). The association between adhd and nicotine in a prospective sample of youth. Drug & Alcohol Dependence140, e243.

Winters, K.C. (2009, Fall). Adolescent brain development and alcohol abuse. The Journal of Global Drug Policy and Practice, 3.

Winters, K.C. & Arria, A (2011). Adolescent brain development and drugs. Prevention Research, 18 (2), 21-24.

Winters, K.C., Arria, A, & Catalano, R. (in press). Prevention and early interventions for at risk children and adolescents. Journal of the Academy of Child and Adolescent Psychiatry.

Winters, K.C., Botzet, A.M., Fahnhorst, T., Baumel, L., & Lee, S. (2009). Impulsivity and its relationship to risky sexual behaviors and drug abuse. Journal and Child and Adolescent Substance Abuse, 18, 43-56.

Winters, K.C., Fahnhorst, T. & Botzet, A. (2007). Adolescent substance use and abuse. In E.J. Mash & R.A. Barkly (Eds.), Assessment of childhood disorders (4th ed. pp. 184-209). New York: The Guilford Press.

Winters, K.C., Fahnhorst, T., Botzet, A., & Stinchfield, R. (2009). Assessing adolescent substance use. In R.K. Ries, D.A. Fiellin, & R. Saitz (Eds.), Principals of addiction medicine (4th ed. pp. 1429-1443).Philadelphia: Lippincott Williams & Wilkins.

Winters, K.C., Fahnhorst,T., Botzet, A., Lee, S., & Lalone, B. (2012). Brief intervention for drug-abusing adolescents in a school setting: Outcomes and mediating factors. Journal of Substance Abuse Treatment, 42, 279–288.

Winters, K.C., & Kaminer, Y. (2008). Screening and assessing adolescent substance use disorders in clinical populations. Journal of the Academy of Child and Adolescent Psychiatry, 47, 740-744.

Winters, K.C., Latimer, W.W., Stinchfield, R.D., & Henly, G.A. (1999). Examining psychosocial correlates of drug involvement among drug clinic-referred youth. Journal of Child & Adolescent Substance Abuse, 9(1), 1-17.

Winters, K.C., & Lee, S. (2008). Likelihood of developing an alcohol and cannabis use disorder during youth: Association with recent use and age. Drug and Alcohol Dependence, 92, 239-247.

Winters, K.C., Lee, S., Botzet, A.M., Fahnhorst, T., Realmuto, G. & August, G.J. (2011). A prospective examination of the association of stimulant medication history and drug use outcomes among community samples of ADHD youth. Journal of Child & Adolescent Substance Abuse, 20, 314-329.

Winters, K.C., Lee, S., Stinchfield, R.D., & Latimer, W.W. (2008). Interplay of psychosocial factors and the long-term course of adolescents with a substance use disorder. Substance Abuse, 29, 107-119.

Winters, K.C., & Leitten, W. (2007). Brief interventions for moderate drug abusing adolescents.Psychology of Addictive Behaviors, 21, 151-156.

Winters, K.C., Leitten, W., Wagner, E., & O’Leary Tevyaw, T. (2007). Use of brief interventions in a middle and high school setting. Journal of School Health, 77, 196-206.

Winters, K. C., Stinchfield, R., & Bukstein, O. G. (2008). Assessing Adolescent Substance Abuse. In Y. Kaminer & O. G. Bukstein (Eds.), Adolescent Substance Abuse: Psychiatric Comorbity and High Risk Behaviors (pp. 53-85). Binghamton, NY: Haworth press.

Winters, K. C., Stinchfield, R., Fulkerson, J., & Henly, G. A. (1993). Measuring alcohol and cannabis use disorders in an adolescent clinical sample. Psychology of Addictive Behaviors, 7, 185-196.

Winters, K. C., & Stinchfield, R., & Henly, G. A. (1993). Further validation of new scales measuring adolescent alcohol and other drug abuse. Journal of Studies on Alcohol, 54, 534-541.

Winters, K. C., Stinchfield, R. D., Latimer, W. W., & Lee, S. (2007). Long term outcome of substance dependent youth following 12-step treatment. Journal of Substance Abuse Treatment, 33(1), 61-69.

Winters, K. C., Stinchfield, R. D., Latimer, W. W., & Stone, A. (2008). Internalizing and externalizing behaviors and their association with the treatment of adolescents with substance abuse disorder.Journal of Substance Abuse Treatment, 35, 269-278.

Winters, K. C., Stinchfield, R., Lee, S. & Latimer, W. W. (2008). Interplay of psychosocial factors and the long-term course of adolescents with a substance use disorder. Substance Abuse, 29(2), 107-119.

Winters, K.C., Stinchfield, R.D., Opland, E., Weller, C., & Latimer W. W. (2000). The effectiveness of the Minnesota Model approach in the treatment of adolescent drug abusers. Addiction, 95, 601-612.

College Age Substance Use Publications

Botzet, A. M., Winters, K., & Fahnhorst, T. (2008). An Exploratory Assessment of a College Substance Abuse Recovery Program: Augsburg College’s StepUP program. Journal of Groups in Addiction and Recovery, 2, 257 - 270

Laudet, A. B., Harris, K., Winters, K., Moberg, D., & Kimball, T. (2014). Nationwide survey of collegiate recovery programs: Is there a single model?.Drug & Alcohol Dependence140, e117.

Laudet, A. B., Harris, K., Kimball, T., Winters, K. C., & Moberg, D. P. (2014). Characteristics of Students Participating in Collegiate Recovery Programs: A National Survey. Journal of substance abuse treatment.

Nelson, T.F., Toomey, T., Lenk, K.M., Erickson, D.J., & Winters, K.C. (in press). Implementation of NIAAA College Drinking Task Force Recommendations: How are colleges doing 6 years later?Alcoholism: Clinical and Experimental Research.

Winters, K.C., Toomey, T., Nelson, T.F., Erickson, D., Lenk, K. & Miazga, M. (2011). Screening for alcohol problems among 4-year colleges and universities. Journal of American College Health, 59 (5), 350 — 357.

Gambling Publications

Back, Ki-Joon, Lee, Choong-Ki, & Stinchfield, R. (in press). Gambling motivation and passion: A comparison study of recreational and pathological gamblers. Journal of Gambling Studies.

Breyer, J. L., Botzet, A. M., Winters, K. C., Stinchfield, R., August, G., & Realmuto, G. (2009). Young adult gambling behaviors and their relationship with the persistence of ADHD. Journal of Gambling Studies, 25, 227-238.

Hodgins, D. C., & Stinchfield, R. (2008).Gambling Disorders. In J. Hunsley and E. Mash, (Eds.). A Guide to Assessments that Work (pp. 370-388). New York: Oxford University Press.

Jimenez-Murcia, S., Alvarez-Moya, E., Stinchfield, R., Fernandez-Aranda, F., Granero, R., Aymami, M.N., Gomez-Pena, M., Jaurrieta, N., Bove, F., & Menchon, J. M. (in press). Age of onset in Pathological Gambling: Clinical, therapeutic and personality correlates. Journal of Gambling Studies.

Jimenez-Murcia, S., Stinchfield, R., Alvarez-Moya, E., Jaurrieta, N., Bueno, B., Granero, R., Aymami, M.N., Gomez-Pena, M., Gimenez-Martinez, R., Fernandez-Aranda, F., & Vallejo, J. (2009). Reliability, validity and classification accuracy of a Spanish translation of a measure of DSM-IV diagnostic criteria for pathological gambling. Journal of Gambling Studies,25(1), 93-104.

Kessler, R., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N. Winters, K.C., & Shaffer, H. (2008). The prevalence and correlates of DSM-IV pathological gambling in the National Comorbidity Survey Replication Study. Psychological Medicine, 38, 1351-1360.

Lakey, C. E., Goodie, A. S., Lance, C. E., Stinchfield, R., & Winters, K. C. (2007). Examining DSM-IV criteria for Pathological Gambling: Psychometric properties and evidence from cognitive biases. Journal of Gambling Studies, 23(4), 479-498.

Stinchfield, R. (2000). Gambling and correlates of gambling among Minnesota public school students.Journal of Gambling Studies, 16, 153-173.

Stinchfield, R. (2001). A Comparison of Gambling among Minnesota Public School Students in 1992, 1995 and 1998. Journal of Gambling Studies, 17, 273-296.

Stinchfield, R. (2002). Reliability, Validity, and Classification Accuracy of the South Oaks Gambling Screen (SOGS). Addictive Behaviors, 27, 1-19.

Stinchfield, R. (2002). Youth Gambling: How Big a Problem? Psychiatric Annals, 32 (3), 1-7.

Stinchfield, R. (2003). Reliability, validity, and classification accuracy of a measure of DSM-IV diagnostic criteria for Pathological Gambling. American Journal of Psychiatry, 160, 180-182.

Stinchfield, R. (2004). Demographic, Psychosocial, and Behavioral Factors Associated with Youth Gambling and Problem Gambling. Derevensky, J., & Gupta, R. (Eds.), Gambling problems in youth: Theoretical and applied perspectives (pp. 27-39). New York: Kluwer Academic/Plenum Publishers.

Stinchfield, R. (2007). Gender, Age are most important clues for teen gambling behavior: A summary of “A comparison of gambling by Minnesota public school students in 1992, 1995, and 1998". In Increasing the Odds Volume 1 Youth and College Gambling (pp. 4-7). 

Stinchfield, R. (2010). A critical review of adolescent problem gambling assessment instruments.International Journal of Adolescent Medicine and Health, 22(1), 77-93.

Stinchfield, R. (in press). Gambling among Minnesota public school students from 1992 to 2007: Declines in youth gambling. Psychology of Addictive Behaviors.

Stinchfield, R. & Winters, K. C. (2001). Outcome of Minnesota’s Gambling Treatment Programs. Journal of Gambling Studies, 17, 217-245.

Stinchfield, R., & Winters, K. C. (2004). Adolescents and young adults. In J. E. Grant & M. N. Potenza (Eds.), Pathological gambling: A clinical guide to treatment (pp. 69-81). Washington, DC: American Psychiatric Publishing, Inc.

Stinchfield, R., Govoni, R., & Frisch, R. G. (2004). Screening and assessment instruments. In J. E. Grant & M.N. Potenza (Eds.), Pathological gambling: A clinical guide to treatment (pp. 207-231). Washington, DC: American Psychiatric Publishing, Inc.

Stinchfield, R., Govoni, R., & Frisch, R. G. (2005). DSM-IV diagnostic criteria for Pathological Gambling: Reliability, validity, and classification accuracy. American Journal on Addictions, 14, 73-82.

Stinchfield, R., Govoni, R., & Frisch, G. R. (2007). A review of screening and assessment instruments for problem and pathological gambling. In G. Smith, D. C. Hodgins, & R. Williams (Eds.), Research and Measurement Issues in Gambling Studies (pp. 179-213). New York: Academic Press.

Stinchfield, R., Hanson, W. E., & Olson, D. H. (2006). Problem and pathological gambling among college students. In G. S. McClellan, T. W. Hardy, & J. Caswell (Eds.), Gambling on Campus: New Directions for Student Services (No 113, pp. 63-72). San Francisco: Jossey Bass.

Stinchfield, R., Kushner, M., & Winters, K. C. (2005). Alcohol use and substance abuse treatment in pathological gambling treatment patients: A clinical follow-up study. Journal of Gambling Studies, 21, 273-297.

Stinchfield, R., Winters, K. C., Botzet, A., Jerstad, S., & Breyer, J. (2007). Development and psychometric evaluation of the Gambling Treatment Outcome Monitoring System (GAMTOMS).Psychology of Addictive Behaviors, 21(2), 174-184.

Strong, D. R., Lesieur, H., Stinchfield, R., Breen, R., & Lejuez, C. W. (2004). Using the Rasch model to examine the utility of the South Oaks Gambling Screen across clinical and community samples.Addictive Behaviors, 29, 465-481.

Winters, K. C., Stinchfield, R. D., Botzet, A., & Anderson, N. (2002). A prospective study of youth gambling behaviors. Psychology of Addictive Behaviors, 16, 3-9.

Winters, K. C., Stinchfield, R. D., Botzet, A., & Slutske, W. S. (2005). Pathways of youth gambling problem severity. Psychology of Addictive Behaviors, 19, 104-107.

Other Publications

Stinchfield, R., & Burlingame, G. (1991). Development and use of the Directives Rating System in group therapy. Journal of Counseling Psychology, 38, 251-257.

Stinchfield, R., Owen, P., & Winters, K. (1994). Group therapy for substance abuse: A review of the empirical research. In A. Fuhriman & G. Burlingame (Eds.), Handbook of group psychotherapy (pp. 458-488). New York: Wiley.

Willenbring, M., Ridgely, S., Stinchfield, R., & Rose, M. (1991). Application of case management in alcohol and drug dependence: Matching techniques and populations (DHHS Publication No. ADM 91-1766). Rockville, MD: National Institute on Alcoholism and Alcohol Abuse.