Treatment

A variety of substance-use treatment programs are available. Many children and adolescents experiment with alcohol and drugs, but those who develop serious problems require professional help.

All treatments are not the same. When choosing a treatment plan, parents are encouraged to consult a mental health professional to ensure that the program serves the needs of the child or adolescent. Generally, the type of treatment is based on the severity of the problem. For example, if a teenager has developed a chemical dependence, a hospital setting may be necessary to monitor detoxification. On the other hand, for occasional binge drinking, a 12-Step Alcoholics Anonymous teen program may be a useful part of the treatment plan. Based on greater to lesser severity, mental health professionals recommend the following treatment settings:

  • Inpatient, such a hospital or rehab center
  • Residential, such a group home for teens
  • Partial hospitalization or day treatment
  • Outpatient, such as 12-Step self-help programs, individual and/or family therapy, or school-based counseling

Special recreational opportunities, such as wilderness experiences, with supervised activities in a drug-free environment

Abstinence

Stop alcohol and drug use. The treatment goal is to stop all substance use. Substance abuse is a chronic problem, with the potential to recur, and total abstinence is crucial. If a person is chemically dependent, detoxification is the first step. Medical supervision is necessary. If depressant drugs such as alcohol or sedatives are stopped abruptly, a person may be at risk for life-threatening withdrawal. Patience and support are important. The more subtle effects of withdrawal may continue for weeks or months. Teenagers should avoid social settings that may trigger the craving, such as parties where others are using the substances.

Rehabilitation

Getting off drugs is the first step, changing behavior is the next. Successful treatment includes good follow-up, family involvement, and a drug-free lifestyle. Coexisting disorders, such as anxiety, depression, or ADHD, should also be treated. These disorders can play a strong role in the development of substance disorders. A few treatment options for substance disorders are described below.

  • Self-help, group, and family therapy
    12-Step programs can be an important part of many treatment programs for adolescents. There are Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) groups for teenagers. Positive role models, socialization, and support are important. Studies show family involvement increases treatment success. The goals are to reestablish parental influence and improve communication among family members.
  • Cognitive and behavioral therapy.
    These types of therapy help participants develop skills to avoid relapse. They are taught to identify self-esteem issues, social triggers, negative environments, and risky behaviors that contribute to their substance use. Other issues include problem-solving skills, anger control, and leisure-time management.
  • Medication
    Generally, for adolescents, medication is used only for severe cases, such as treating withdrawal effects. For example, methadone is a medication that may be given as a substitute for heroin dependence. Occasionally, medication may be prescribed to counter withdrawal effects. In addition to treating the substance disorder, medication may helpful for treating underlying disorders such as depression, ADHD, aggressive behavior, or anxiety.

Maintenance: Prevent relapse. Long-term support is the key to success. Relapses may occur, but they are to be expected and do not constitute failure. Parents should make sure there are treatment services available for continued support and follow-up assessment. Be aware that the risk of relapse is higher for some drugs, such as nicotine, cocaine, and opioids. Support positive social relationships, and be mindful of these predictors of relapse:

  • Thoughts, feelings, and cravings for drugs
  • Less involvement in school or work
  • Less satisfactory leisure-time activities

And remember: The longer a child or teenager goes drug-free, the less chance for relapse. But don't forget that remission isn't a cure. When a person has a substance disorder, moderation may not be a choice.