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8 Core Principles When Treating Addiction in Adolescents

8 Core Principles When Treating Addiction in Adolescents

  • The principal goal of treatment of substance abuse disorders (SUDs) in adolescents is achieving and maintaining abstinence and improving functioning. This slideshow presents 8 core principles for the clinical management of adolescents with SUDs.

  • SUDs in adolescents have multifactorial etiologies and treatment requires integrated and concurrent approaches for both substance use and any co-occurring psychiatric disorders. Be aware of stages of development and use developmentally-informed approaches (ie, meeting adolescents “where they are”).

  • Know the level of care you as a provider are comfortable managing and the referral sources in your community for higher levels of care (ie, residential/inpatient, intensive outpatient services).

  • One behavioral intervention is to involve parents and family in the treatment process. This will help to improve family functioning and parent-teen relationships. Changing parental monitoring, limit setting, and substance use beliefs can improve outcomes. A comprehensive diagnostic evaluation that includes the patient and his or her parents is used to characterize developmental history, risk and protective factors, current and lifetime psychiatric symptoms and disorders, and substance use and related disorders.

  • Use evidence-based behavioral interventions as your treatment backbone. There is strong evidence for the efficacy of psychosocial or behavioral interventions in the treatment of adolescent SUDs. This will help to fine-tune and solidify approaches to treatment.

  • Evaluate patients for co-occurring psychiatric disorders (eg, ADHD, conduct disorder, depression, PTSD) and provide integrated and concurrent treatment if necessary. Evidence-based psychosocial and pharmacotherapy approaches are used concurrently to treat psychiatric disorders when present.

  • Adjunctive pharmacotherapy may be used for the treatment of withdrawal symptoms and craving in youth that have failed behavioral interventions.

  • Incorporate urine drug screening, in a systematic way, as part of the initial screening and maintenance phases of treatment. Using a contingency management approach that provides awards for negative UDSs can improve outcomes.

  • Twelve step programs, such as Alcoholics or Narcotics Anonymous (AA/NA), especially those with a teen focus, may be helpful when added to (but not in place of) the above described integrated treatment approaches.

  • For more on this topic, see Treatment Strategies for Substance Use Disorders in Adolescents, by Christopher J. Hammond, MD, PhD and Pravesh Sharma, MD, on which this slideshow is based.


View the slides in PDF format.


Great topic here...where can I get more information for a post I am currently working on this subject exactly. My audience is late adolescents and young adults and I try to make the blog posts a bit more interactive for them to read...thank you ahead of time! - Dr. Hector

Hector @

Interesting: I can read the slides by clicking on the image and on the PDF format. I use Safari

barry @

I can view the slides on the Google Chrome browser but not on Safari. I can't view the slides in PDF format with either browser. On Google Chrome I received the following message:

This site can’t be reached

http’s server DNS address could not be found.
Search Google for http images ubm medica psychiatric times pdfs 2017 Jul AdolescentSUDs PDF

Peter @

I had the exact same error message. July 9

Haydn @

How do these apply to adolescents who have fetal alcohol spectrum disorder? Is it necessary for those treating addicted adolescents to have training in FASD?

barry @

Prevention strategies by our social "networks". (And I use that term loosely), are lacking. We should be bombardimg them at every opportunity, in the schools, on television , video games and apps, on the internet. By the time they enter treatment, the damage is already done.

Brenda E @

Pax GBG used in elementary schools reduced substance abuse by 50% in one study and reduced heroin use by 69% in another. For true prevention, research Pax GBG. For starters see:

NIDA Notes. “Behavior Game Played in Primary Grades Reduces Later Drug-Related Problems.” Volume 23, Number 1, April 2010. National Institute on Drug Abuse.

NIDA Notes. “Good Behavior Game Wins 2012 Mentor International Best Practice Award.” November 2012. National Institute on Drug Abuse.

Bates, Mary. “Calm Down Boys, Adolescent Girls have ADHD, too.” Psychology Today, June 2012. http://www.psychologytoday.com/articles/201206/diagnosis-calm-down-boys

SAMHSA National Registry of Evidence-based programs and Practices (NREPP) Good Behavior Game.

SAMHSA National Registry of Evidence-based programs and Practices (NREPP) Pax Good Behavior Game.

David-Ferdon C, Simon TR. Preventing Youth Violence: Opportunities for Action. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 2014. p. 27

Washington State Institute for Public Policy

or go to www.goodbehaviorgame.org

also reduces many other negatives e.g. smoking, depression, suicide, delinquency, conduct disorders, truancy, drop outs...

Richard @

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