Teen Alcohol and Drug Abuse
Finding the Right Treatment for Your Teen
Most teens do not make a conscious decision to quit abusing a substance before they go into treatment for substance use problems. So it is very important that treatment be based on a thorough assessment and fit the teen's level of substance use.
Appropriate treatment for level of use
- If your teen has started experimenting with alcohol, cigarettes, inhalants, or drugs, education about the harmful effects of substances through a school or community program may be all that is needed. Some schools have programs for students with alcohol and drug use problems that provide support and drug education. At this level of substance use, encouraging your teen to be involved in healthy activities (such as sports, hobbies, or church), spend time with the family, and participate in a healthy peer group may help him or her develop the skills needed to avoid substance abuse. You can also pay attention to your teen's activities and peers who might be using substances. It can help to set up clear rules about the use of substances. For example, if your teen continues to use drugs or alcohol, you could take away privileges such as driving.
- If your teen is abusing a substance regularly (at least weekly), some form of treatment is usually needed. At this level of substance use, it is important to pay close attention to your teen's concerns, which may be related to emotional or self-esteem problems. Finding activities that your teen can substitute for substance use is important for him or her to be able to remain alcohol- and drug-free. Treatment in an adolescent outpatient or hospital program is recommended. The focus of treatment should be on helping the teen gain motivation to stop using and skills to refuse drugs in the future. Because substance abuse problems affect the whole family, family counseling should also be a part of treatment.
- If your teen is dependent on alcohol or drugs, he or she will need treatment in a structured program and may need medical attention for withdrawal symptoms. For example, if your child is addicted to heroin or another opiate, he or she may be referred to a methadone treatment program. These programs use the medicines methadone, buprenorphine, or antidepressants such as bupropion (Wellbutrin) to help people cope with the withdrawal symptoms caused by opiate use. Also, a teen needs to learn coping skills to deal with the anger, frustration, sadness, and disappointment that are often associated with substance abuse and recovery. Again, family involvement is important to your teen's success in remaining substance-free.
- If your teen is dependent on cigarettes or other tobacco products, he or she needs to quit to prevent serious health problems. For more information, see the topic Quitting Smoking.
Types of programs
There are several types of teen substance abuse treatment programs.
- Inpatient programs are highly structured, closely supervised programs located within a hospital or treatment facility. The teen stays day and night during treatment, which normally lasts about 4 weeks. These programs usually have an aftercare program that provides support and encouragement after treatment.
- Inpatient programs provide education and individual, family, and group counseling. They are often based on the principles of Alcoholics Anonymous and Narcotics Anonymous.
- Another type of inpatient program is the therapeutic community, which is not based in a hospital. In a therapeutic community program, the teen accomplishes a series of tasks with constant feedback from his or her peers. Therapeutic community programs may last as long as 2 years, and some teens choose to stay and work in the program after treatment.
- Wilderness challenge programs combine a wilderness experience and some form of treatment to help troubled teens communicate better with their family, control their anger, and build healthy relationships. A variety of programs are available, and their quality varies greatly. Wilderness challenge programs are expensive and tend to limit contact with parents. Talk with a health professional, and ask him or her questions if you are considering sending your teen to a wilderness program.
- Outpatient programs range from very structured programs with psychotherapy and family therapy to drop-in centers.
- Outpatient day treatment programs require that the teen spend 8 hours or more during the day at the facility, but the teen is home at night. Day treatment programs usually have the same components (individual, group, and family counseling) as inpatient programs, but day treatment normally costs less.
- Less intensive outpatient programs are designed for young people who do not need residential, hospitalization, or intensive day treatment. Treatment includes individual or group counseling and family therapy, and some settings use 12-step programs. Programs vary in how many days and hours a week are required.
Whatever type of treatment program you choose, it should consider teen developmental issues and characteristic problems, such as peer pressure and the need to test the limits. The treatment also needs to provide a way for your teen to continue his or her education. Some teens need remedial help to return to school after treatment. It may boost your teen's self-confidence and self-esteem if he or she can accomplish even small academic tasks during treatment. Your teen should be involved in an aftercare program following treatment.
Substance abuse affects all family members. Often family counseling is part of the treatment program, but family members may want to attend support group meetings such as Al-Anon, Nar-Anon, Alatot, or Alateen meetings as well. These support groups can help you and your family deal with how your teen's substance use has affected the family and how each family member can stop contributing to the teen's use.
What to do if your teen relapses
Getting a teen to stop using alcohol, cigarettes, or other drugs is only the first step. Substance use fills an emotional need. Identifying and satisfying that need in a healthy way is crucial to the teen being able to stay off the substance.
Returning to substance use (having a relapse) after treatment is common and is not considered a treatment failure. Most relapses occur within the first 3 months after treatment. Most often, teens need to go through treatment more than once and follow a long recovery process to remain substance-free.
Your teen is less likely to relapse if:
- The treatment program helps the teen develop motivation to stop using, and skills needed to deal with drug cravings, high-risk situations, and relapse.
- Your teen can commit to being substance-free for 12 to 24 months.
- Your teen has or finds a healthy hobby or interest. He or she may replace time formerly spent using the substance with time for the new activity.
- Your teen receives treatment for any other psychiatric conditions, such as attention deficit hyperactivity disorder (ADHD), depression or long-term depressed mood (dysthymia), post-traumatic stress disorder, or an anxiety disorder. This will help prevent him or her from using the substance to treat the symptoms of the condition.
- Your teen is involved in an aftercare program or case management.
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| Author: | Caroline Rea, RN, BS, MS Jeannette Curtis | Last Updated: August 27, 2008 |
| Medical Review: | Michael J. Sexton, MD - Pediatrics Yifrah Kaminer, MD - Child and Adolescent Psychiatry | |
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