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Considerations for Adolescents

According to the Centers for Disease Control and Prevention's Youth Risk Behavior Survey, in 2017, 14.0% of high school students reported that they have used an illicit drug. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), research has shown a correlation between having an adverse childhood experience (ACE) and developing a substance use disorder (SUD). ACEs can include living in a house with individuals who exhibit SUD behaviors. Rural SUD programs implementing a multigenerational approach to treatment should consider how SUD behaviors affect children and adolescents living in the home. Close collaboration with social services organizations and schools can help rural SUD programs address the needs of all family members.

Prevention and early treatment of substance misuse during adolescence is critical because the brain undergoes substantial changes during this period, which may have major implications for healthy cognitive and emotional development. In general, the earlier the age of initiation of drug and alcohol use, the higher the likelihood of developing SUD later in life. Multiple factors contribute to adolescent substance misuse, including:

  • Parental substance use behavior
  • Peer influences
  • Media messaging and marketing
  • Availability
  • Other environmental and cultural factors

Research has found that therapies to treat SUD are often designed for adults and may not be as effective in adolescent populations. Adolescent treatment typically involves family members and requires parental consent. The National Institute on Drug Abuse created Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide, which describes adolescent substance use, principles of treatment, and evidence-based approaches for adolescents with SUDs.

Providers who treat adolescents with SUD need to consider the legal considerations surrounding confidentiality and privacy. Adolescents are more likely to seek SUD treatment if they believe services will be confidential. Laws and statutes surrounding consent for and confidentiality of SUD treatment for adolescents vary from state-to-state. Providers should be aware of legal and ethical aspects and implications of admitting adolescents into treatment programs and communicating with their parents and caregivers in a way that does not violate the minor's privacy.

Resources to Learn More

Perceived Ease of Access to Alcohol, Tobacco and Other Substances in Rural and Urban US Students
Document
Examines the differences in perceived ease of access to both legal and illegal substances for adolescents in rural and urban areas of Georgia. Provides statistics with breakdowns by substance, rural/urban, and middle versus high school students.
Authors: Warren, J., Smalley, K., & Barefoot, K.
Citation: Rural and Remote Health, 15(4), 3397
Date: 10/2015