While some exploration of drugs and alcohol is normative during adolescence, most adults with substance abuse disorders report beginning use during adolescence, making early intervention important. Substance use disorders range from problematic use to addiction; research indicates that even teens who are not addicted to substances can benefit from behavioral treatment. Though not direct indicators of a substance abuse disorder, warning signs can include: changes in eating or sleeping patterns, unexplained personality changes, sudden changes in relationships, groups of friends, or favorite hangouts, declining school or work attendance and/or performance, or deterioration in personal grooming. Many adolescents with untreated mental health conditions begin to use substances as a form of self-medication, creating a cycle of emotional avoidance that inhibits the opportunity to learn and practice new, more adaptive coping skills.
Effective treatment plans for substance abuse in adolescents begin with a careful assessment to identify the function, extent, and impact of the substance abuse, along with underlying mental health symptoms and environmental and relational stressors. In some cases, referral to a higher level of care is indicated, such as a detoxification or residential treatment program. Evidence-based treatment plans may involve some combination of the following: Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy for Substance Abuse (DBT), referral to 12-step programs, and/or referral for psychopharmacology.