Substance Use Disorders
Introduction to Substance Use Disorders (Teens)
Substance use disorder (SUD) is when alcohol or drug use causes real problems in daily life—at home, at school, or with health and safety. Teens may use alcohol, nicotine (including vaping), cannabis, prescription medicines, or other drugs. Many teens try substances, but some develop patterns that harm their health and put them at risk for overdose and injuries. In recent CDC data, 15% of high-school students reported ever using select illicit or injection drugs, and 14% reported misusing prescription opioids. Early evaluation helps prevent harm.
Common signs: secrecy about use, changes in friends or activities, falling grades, skipping school, cravings or withdrawal, and using before or during school or driving. Co-occurring depression or anxiety is common and needs care too.
Safety note:
If your child talks about suicide or has a plan to harm themselves or others, call 911 or go to the nearest ER. In the U.S., you can also call or text 988.
Causes and Risk Factors
- Family and peers: family history of substance use, parental use, low monitoring, and friends who use.
- School context: low school connectedness and poor performance increase risk; strong school ties protect.
- Stress and adversity: trauma or abuse raise risk. Supportive family relationships help protect.
- Mental health conditions: anxiety, depression, and other concerns often occur together and can drive use.
Treatment and Management
Care at Texas Pediatric Mental Health Services (Houston) starts with a confidential, teen-friendly evaluation. We review health, substance use, and mental health. With your consent, we coordinate with your pediatrician and school. Pediatric guidelines support SBIRT (Screening, Brief Intervention, and Referral to Treatment) in youth care. publications.aap.org+1
What helps
- Family-based therapies (e.g., MDFT/FFT) improve communication, monitoring, and teen outcomes. PMC
- Cognitive behavioral therapy and motivational interviewing teach coping, reduce use, and support change; contingency management can boost results. PMC
- Medication (when appropriate). For opioid use disorder, medications like buprenorphine (FDA-approved for patients ≥16 years) may be used under specialist care; methadone or naltrexone can also be considered in specific programs. We also discuss naloxone for overdose reversal where risk exists. PMC
- School supports and safety. We plan for safe transportation, monitor for relapse, and coordinate school accommodations when needed.
- Treat co-occurring conditions (anxiety, depression, ADHD) alongside SUD for best results. Child Mind Institute
Our team sets clear goals, tracks progress, and adjusts the plan with your family.