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Access to Treatment

Young people usually don't get treatment for alcohol and other drug use disorders until their drinking has gotten them in trouble with the law. In fact, 44 percent of young people in treatment have been referred by the criminal justice system.

Other sources of referral include:

  • School/Community Agency (22%)
  • Self/Family (17%)
  • Other Substance Abuse Treatment Agency (5%)
  • Other Health Care Provider (5%)
  • Other (16%)

The nation's health care system doesn't identify or treat young people with alcohol and other drug use problems any better than it does adults. Because of longstanding relationships with their young patients, pediatricians and family practice physicians are ideally positioned to observe the changes in behavior and health that occur as a result of drinking and drug use. But while the American Medical Association recommends that health professionals ask their young patients about their alcohol and drug use on an annual basis, fewer than 50 percent of physicians screen these patients for this purpose.13

Unique Treatment Needs

Treatment for alcohol and other drug use disorders among young people has advanced considerably in the past several years. Within the next year or two, clinicians will be able to choose among a dozen therapies whose effectiveness and cost benefits have been established by research.14 This progress has been stimulated in part by necessity: during the 1990s, the number of young people seeking drug treatment rose by 50 percent.15

Researchers learned that treating young people in programs for adults didn't work. In some cases, it may even have caused their drug use to escalate once they were discharged.16

Acknowledging the considerable differences between adolescent and adult drug use disorders was the first step in developing age appropriate treatment:

  • The patterns of drug use among young people differ: they drink more alcohol and smoke more marijuana than adults. They also are more likely to binge drink or get high whenever an opportunity arises.
  • Young people have higher rates of mental health disorders and get into trouble more often than adults. They require more careful assessment for mental health disorders which, if present, must be treated appropriately.
  • Young people are increasingly influenced by their peers and shaped by the pressures encountered in social institutions such as school and the criminal justice and welfare systems. These influences and pressures contribute not only to the development of serious alcohol problems, but also have a profound impact on treatment.
  • The gains young people make during treatment may be undercut when they are return to an unhealthy atmosphere at home, in their neighborhoods or at school. They do not always have access to age-appropriate support groups. This explains why they have higher relapse rates than adults and typically require three or four treatment episodes before achieving recovery.


13 Physician Leadership for National Drug Policy. 2002.

14 Dennis, M.L. 2002. Treatment Research on Adolescent Drug and Alcohol Abuse: Despite Progress, Many Challenges Remain. Connection, a publication of the Academy for Health Services Research and Health Policy.

15 Physician Leadership for National Drug Policy. 2002.

16 Physician Leadership for National Drug Policy. 2002.