SUD Program Implementation Considerations for Youth and Adolescents

Substance use among youth and adolescents in rural areas presents unique challenges that necessitate tailored approaches for prevention and treatment. Substance use among youth and adolescents includes the misuse of prescription drugs and the use of illicit drugs such as cocaine, heroin, methamphetamines, inhalants, hallucinogens, or ecstasy. Adolescents in rural communities may face distinct risk factors contributing to substance use disorders (SUD), including peer influences, cultural acceptance, availability of substances, and poor academic achievement.

Adverse Childhood Experiences and SUD
Adverse childhood experiences (ACEs) are a significant risk factor for developing SUD. ACEs include experiences such as abuse, neglect, and household dysfunction, including living with family members who exhibit SUD behaviors. Research has shown a strong correlation between ACEs and the development of SUD later in life. Rural SUD programs implementing multigenerational treatment approaches should consider how parental or familial substance use behaviors impact adolescents. Close collaboration with social services organizations and schools can help rural SUD programs address the needs of all family members.

Prevention and Early Intervention
Addressing substance use among adolescents is crucial, as early initiation is associated with a higher likelihood of developing SUD later in life. The adolescent brain undergoes significant development, and substance misuse during this period can interfere with cognitive and emotional growth. Improving infrastructure for the implementation of evidence-based prevention programs in schools and community centers can educate adolescents about the risks associated with substance use.

For more information about prevention programs for youth, see Module 2.

Treatment Approaches and Confidentiality
Effective treatment for adolescents often differs from adult-oriented programs. Psychosocial treatments, such as family-based therapy, cognitive behavioral therapy, and multicomponent approaches, have shown effectiveness in treating adolescent SUD. The National Council for Mental Wellbeing created Best Practices for Effective Adolescent Substance Use Disorder Services, a resource guide describing adolescent substance use, principles of treatment, and evidence-based approaches for adolescents with SUD.

Providers who treat adolescents with SUD need to consider the legal considerations surrounding privacy, as confidentiality is an important factor in encouraging adolescents to seek treatment. Laws regarding consent and confidentiality for SUD treatment vary by state, and providers must navigate these regulations carefully. Ensuring that adolescents understand their privacy rights can increase their willingness to participate in treatment.

Recovery high schools may be an option for students in recovery from SUD. According to the Association of Recovery Schools, recovery high schools are institutions that meet state requirements for awarding a secondary school diploma while supporting students through a program of recovery from SUD or co-occurring disorders.

Medications for Substance Use Treatment
The American Academy of Pediatrics (AAP) recommends the use of medications for adolescents and young adults with opioid use disorder (OUD). Despite evidence of effectiveness, access to medication for OUD remains limited for this age group. Barriers include the limited number of trained and waivered physicians authorized to prescribe these medications. Rural programs can address this gap by providing training opportunities for healthcare providers and establishing referral networks to ensure adolescents can receive comprehensive care.

Resources to Learn More

Adverse Childhood Experiences and the Role of Substance Misuse Prevention
Document
Provides information for prevention professionals about ACEs, covering their definition, prevalence, effects on substance use and behavioral health, and ways to incorporate ACE-related strategies into current prevention efforts.
Organization(s): Strategic Prevention Technical Assistance Center, Substance Abuse and Mental Health Services Administration
Date: 10/2024