A brief history and some current dimensions of adolescent treatment in the United States.

Abstract

Resources for the treatment of adolescent substance use disorders have increased over the past century in tandem with the increased visibility and cultural alarm regarding adolescent substance-related problems. The United States now has a multi-branched and growing system of adolescent treatment services that spans public and private sectors and offers services in both specialty and non-specialty service settings. Most adolescents are entering treatment due to alcohol and/or cannabis-related problems (and, to a lesser degree, other illicit drugs), but present with a wide array of co-occurring problems and obstacles to recovery. Multiple levels of specialized care are available but most adolescents being treated via outpatient counseling. The number and methodological rigor of adolescent treatment outcome studies have increased dramatically in recent years. The findings of these studies suggest the need for earlier systems of problem identification and intervention, a model of sustained recovery support for adolescents presenting with high problem severity and complexity, and sustained interventions with the adolescent's post-treatment family and social environment. In the opening decade of the twenty-first century, the treatment of adolescent substance use disorders is itself maturing into a professionalized and science-guided service arena.