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Treating Mental Health and Substance Use Disorders in Adolescents: What Is on the Menu?

  • Substance Use and Related Disorders (F Levin and E Dakwar, Section Editors)
  • Published:
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Abstract

Specific treatments targeting adolescents with substance use disorders (SUDs) have been developed over the last couple of decades. Despite these developmentally tailored treatments, long-term abstinence rates remain relatively low among adolescents receiving care. Research over the last decade has increasingly focused on adolescents with comorbid substance use and psychiatric disorders, in recognition of the barriers caused by inadequate treatment of co-occurring psychiatric disorders. Treatments targeting dually diagnosed youth are now regarded as essential to improving SUD treatment outcomes, but remain underutilized. A variety of treatment modalities such as behavioral therapy, family therapy, 12-step groups, motivational interviewing, contingency management, and combinations of these interventions have been modified for adolescents. In this article, we review the research on these treatments, as they apply to dually diagnosed youth. Furthermore, we explore the evidence for various treatments targeting comorbid SUD, specific to the presence of externalizing or internalizing disorders. The current evidence base supports the importance of integrated treatment targeting both SUD and psychiatric disorders simultaneously. High-quality treatment programs offering combinations of behavioral and family therapy, particularly with motivational interviewing and contingency management, are particularly well supported. In addition, we review various psychotropic medication treatments that have also been studied in conjunction with adolescent SUD treatment. Finally, we review research on post-treatment, supportive care that has been shown to improve long-term SUD outcomes. Recently conceptualized modular treatments, which offer personalized combinations of evidence-based treatments for specific disorders, have been proposed as a means of improving outcomes. Future research on modular programs must test the efficacy of individualized treatments when applied to combinations of psychiatric and SUDs in adolescents.

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Authors and Affiliations

  1. Department of Psychiatry, Indiana University School of Medicine, 705 Riley Hospital Drive, Room 4300, Indianapolis, IN, 46202, USA

    Stanley Brewer & Leslie A. Hulvershorn

  2. Chestnut Health Systems, 448 Wylie Dr., Normal, IL, USA

    Mark D. Godley

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  1. Stanley Brewer
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  3. Leslie A. Hulvershorn
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Correspondence to Leslie A. Hulvershorn.

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Funding

Leslie A. Hulvershorn’s effort for the writing of this manuscript was funded by the National Institute of Drug Abuse (5K12 DA 357–15).

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Stanley Brewer and Leslie A. Hulvershorn declare that they have no conflict of interest.

Mark D. Godley reports grants from the National Institute on Alcohol Abuse and Alcoholism, during the conduct of the study.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Substance Use and Related Disorders

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Brewer, S., Godley, M.D. & Hulvershorn, L.A. Treating Mental Health and Substance Use Disorders in Adolescents: What Is on the Menu?. Curr Psychiatry Rep 19, 5 (2017). https://doi.org/10.1007/s11920-017-0755-0

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