Substance Use Disorder: Treatment for Teens

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KEY POINTS

• If your teen has a problem with alcohol or drugs, it won't go away without treatment. If you suspect a substance use disorder, seek help from your healthcare provider, a mental health professional, or local treatment center.
• Short-term methods, lasting less than 6 months, include individual, group, and family therapy, day treatment, and medicine.
• Residential therapy often lasts much longer than 6 months. Your teen will live at the residential treatment home.

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What is a substance use disorder?

A substance use disorder is a pattern of using alcohol or drugs that leads to serious personal, family, and health problems. The more of these statements that apply to your teen, the more severe the substance use disorder is.

1. Your teen uses more or use the substance for longer than planned.
2. Your teen wants to cut down or quit but is not able to do so.
3. Your teen spends a lot of time and energy getting drugs, using drugs, and getting over the effects.
4. Your teen craves alcohol or drugs so much that your teen has trouble thinking about anything else.
5. Your teen has problems at work or school.
6. Your teen has relationship problems because your teen doesn’t keep promises, or your teen argues or gets violent with other people.
7. Your teen stops doing things that used to matter to him or her, such as sports, hobbies, or spending time with family members or friends, because of the substance use.
8. Your teen uses alcohol or drugs even when it is dangerous such as while driving or operating machinery.
9. Your teen keeps using substances even though your teen knows that it is hurting his or her physical or mental health.
10. Your teen needs to use more of the drug or alcohol or use it more often to get the same effects. This is called tolerance.
11. Your teen has withdrawal symptoms when your teen stops using.

Substance use disorder may also be called drug or substance dependence or addiction.

Substances commonly abused by teens include alcohol, marijuana, K2, Spice, amphetamines, cocaine, prescription pain medicines, cough medicine, and others.

How is substance use disorder treated?

There are many kinds of treatment that may be recommended for your teen. The type of treatment depends on whether your teen:

• Is at risk for withdrawal symptoms
• Has other mental or physical health problems
• Wants to stop using drugs or alcohol
• Is at risk for going back to using substances (relapse)
• Will be supported in efforts to stop using by family members, friends, and other people

Short-term methods, lasting less than 6 months, include outpatient therapy, day treatment, and medicine.

• Outpatient therapy may involve individual, group, and family therapy. Outpatient therapy may be done 1 to 3 times week.
  • Individual therapy can help teens learn new ways to act and think so they can avoid drugs and alcohol in the future.
  • Twelve step groups can also be helpful. Twelve Step programs do not use professional counselors or therapists. Meetings are led by group members who have been addicted and can help other who are currently addicted. They can provide the support your teen needs to recover.
  • Family therapy treats all members of the family rather than working with one person alone. It helps the whole family understand each other better and make changes. Teens who improve family relationships, become more involved in their school, and make new friends who do not use alcohol or drugs are more successful in their recovery.
• Day treatment programs are a special kind of school where your teen goes to classes as well as 4 to 6 hours of therapy up to 5 days per week. While attending day treatment your teen usually lives at home. It is helpful when your teen's behavior is so out of control that your teen can no longer be in a regular school setting.
• Medicines may be prescribed to help teens who are depressed or anxious. Some medicines decrease the cravings for alcohol or drugs, and some make you sick when you drink. This may reduce the chances that your teen will abuse drugs or alcohol in the future.

If your teen is likely to have severe withdrawal symptoms, your teen may need to stay in a hospital or treatment center. This is often called detox, and usually takes 5 to 7 days. Your teen will need another type of treatment after the medical detox is completed.

Residential therapy often lasts much longer than 6 months. Your teen will live at the residential treatment home. Residential treatment programs are also used for teens that have gone back to using substances after treatment, or who have been in trouble with the law. Random urine tests are often part of these programs.

How do I find the right treatment for my teen?

• Often the first step is to bring your teen to your healthcare provider. Your provider will evaluate your teen for substance use disorder and related health conditions and recommend treatment.
• Find a therapist who has experience working with teens who abuse substances.
• If your teen needs residential treatment, it helps if the treatment center is nearby so that your family can be involved. Family therapy can help you learn how to help your teen.
• A good treatment program will allow your teen to keep up with schoolwork, while also learning how to live without abusing substances. Some programs are also able to treat depression, anxiety, and other mental health problems.
• Get an idea of how long this phase of treatment will last, and what kind of ongoing treatment your teen should have.
• Make sure that you understand the costs of treatment, and whether those costs are covered by your insurance.

What can I do to help my teen?

Talk to your teen about your suspicions and listen to what they tell you. Follow your instincts. If your teen has a problem with alcohol or drugs, it won't go away without treatment. If you suspect a problem, seek help from your healthcare provider, a mental health professional, or local treatment center.

Other things you can do to help your teen include:

• Teach your teen how to make good choices about alcohol and drugs. Teach in a way that fits your teen's age and ability to understand.
• Listen to your teen's feelings and concerns, so that your teen feels comfortable talking with you.
• Be prepared for your teen to ask you about your own drug or alcohol use. If you have never used drugs, let your teen know this and explain why. If you have used drugs, be honest, but explain what you learned and why you stopped. Make your family position on drugs clear. For example, "In our family, we don't use drugs and the children are not allowed to drink alcohol." Set a good example. Your teen is much more likely to use smoke, drink, or use drugs if you smoke, drink, or use drugs, even if you tell them not to.
• Talk about what makes a good friend. Peer pressure is a big part of why kids get involved with drugs and alcohol. Help your teen understand that friends who pressure them to drink or use drugs aren't friends at all. Role-play ways for your teen to say no to drugs, for example:
  • Say, “no, thanks” and walk away.
  • Suggest something else to do such as playing a video game.
  • Use humor, such as "No thanks. I don’t want to fry my brain."
• Build self-esteem. Teens who feel good about themselves are much less likely to turn to drugs. Offer lots of praise for a job well done. If you need to criticize or discipline your teen, talk about the action, not the teen. For example, instead of saying "you should know better" try saying, "what you're doing is not safe." Set aside time every day to talk, play a game, or take a walk with each of your children.

When someone has a substance use disorder, it is up to them to stop using drugs or alcohol. You didn’t cause it and you don’t have the power to do it for them. However, there are some things you can do that might help:

• Make sure your home is free from alcohol and drugs.
• Offer rides to treatment and support groups.
• Involve your teen in fun and relaxing activities that don’t involve drinking or drugs. Help your teen avoid places and situations that might trigger substance use.
• Encourage your teen to stay in treatment. Your teen will need to learn new ways to cope with daily life. This takes time and a lot of work.
• Understand that many people try more than once to quit using substances before they succeed. Support your teen if he needs to try again.

Get emergency care if your child or teen has thoughts of suicide or self-harm, violence, or harming others.

For more information, contact:

• The National Drug and Alcohol Treatment Referral Routing Service
  800-662-4357
  https://findtreatment.samhsa.gov/
• The American Society of Addiction Medicine
  301-656-3920
  https://www.asam.org/