Treating Teens for Substance Abuse

What is substance abuse?

Substance abuse is an unhealthy pattern of using substances that causes problems in school, work, or home. Substances commonly abused include Ecstasy, marijuana, cocaine, prescription medicines, alcohol, and others. Teenagers who abuse drugs and alcohol are at increased risk of serious drug use later in life. Substance abuse may also cause school failure and poor judgment that puts kids at greater risk for accidents, violence, unplanned and unsafe sex, and suicide.

Some people abuse substances but do not become dependent on them. A person who has to have more of a drug to get an effect and has withdrawal symptoms when they stop using is chemically dependent. Treatment is more intensive for teens who are chemically dependent than for teens who are substance abusers. This means treatment will:

• take longer
• require more frequent group or individual treatment sessions
• involve monitoring such as urinalysis

It may require residential treatment away from the teen's home.

How common is teen substance abuse or dependence?

An estimated 2 million youth between the ages of 12 and 17 are dependent on alcohol or drugs. Over 25% of high school seniors have tried a drug such as heroin, cocaine, or inhalants.

Over 80% of high school seniors have tried alcohol. Teens who start drinking alcohol at age 13 are 4 times more likely to develop an alcohol abuse problem than if they had started drinking alcohol at age 20.

Why do teens abuse substances?

Teens whose parents abuse substances are at increased risk for substance abuse. Teens with close friends who abuse alcohol or drugs are also at high risk.

Alcohol and drugs dull emotional pain. This is why treatment for substance abuse must address the underlying issues that led to the abuse. Teens who abuse substances often struggle with:

• mental health issues such as depression or anxiety
• physical or sexual abuse
• troubled relationships at home
• learning disabilities or school problems

How is substance abuse treated?

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

• Outpatient therapy involves individual, group, and often family therapy. Cognitive behavioral therapy may help teens learn new ways to act and think so they can avoid drugs and alcohol in the future. Random urine tests are often part of these treatments. Family therapy can be one of the most effective parts of treatment. 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.
• Medicines may be prescribed to help teens who are depressed or anxious. There are also medicines which decrease craving for alcohol or drugs and there is medicine that makes people sick when they drink. This may reduce the chances that the teen will abuse drugs or alcohol in the future.
• Day treatment removes teens from their regular school, yet allows them to return home each night.

Residential therapy often lasts much longer than 6 months. It involves removing the teen from their home to a residential treatment program. Residential treatment programs are also used for teens that are chemically dependent on substances, have relapsed after outpatient treatment, or who have been in trouble with the law. These treatment programs also usually involve being locked up.

What can I do if my teen is abusing substances?

Talk to your child about your suspicions and listen to what they tell you. Follow your instincts about your child. If you think there is reason for alarm, seek help. If your child has a problem with alcohol, illegal drugs, or prescription medicines, it is not likely to get better without treatment. If you suspect a problem, seek help from your child's healthcare provider, a mental health professional, or local treatment center.

How do I find the right treatment for my child?

Find a therapist who has experience working with teens who abuse substances. Ask questions such as:

• How much experience do you have with teens?
• What type of treatments do you offer?
• How often will urine tests be done?
• How much information will be shared with parents?

Be willing to become involved in family therapy. It helps to work on improving the relationship between you and your teen and other family members.

If residential treatment is advised, ask questions about the program such as:

• What does the program include?
• Will a psychiatric evaluation be done?
• Is this treatment program specifically for children and teens?
• How qualified is the staff to treat teen substance abuse?
• What is your success rate?
• How do you involve family in treatment?
• How is confidentiality handled?
• How do you match a treatment plan with the severity of the abuse?
• How will my child be able to keep up with schoolwork?
• What will treatment cost? Are the costs covered by my insurance or health plan?
• What happens if we can't afford the treatment our child needs?
• What can family members do to make our child's treatment successful?
• How long will this phase of the treatment process last?
• What types of ongoing treatment will be needed? (Going back to abusing drugs and alcohol is common.)

For more information, contact The National Drug and Treatment Referral Routing Service at 800-662-4357. You may also want to check the National Institute on Drug Abuse (NIDA) Web site: http://www.drugabuse.gov.