Adolescence and Substance Abuse

Data from the National Survey of Adolescents (PDF) and other studies indicate that one in four children and adolescents in the United States experience at least one potentially traumatic event before the age of 16, and more than 13% of 17-year-olds—one in eight—have experienced posttraumatic stress disorder (PTSD) at some point in their lives.

Many of these young people also have access to psychoactive substances that can both dull the effects of stress and place teens at increased risk of experiencing trauma. It is estimated that 29% of adolescents—nearly one in three—have experimented with illegal drugs by the time they complete eighth grade, and that 41% have consumed alcohol.

The NCTSN has developed tools and materials to help mental health clinicians, substance abuse treatment providers, parents, caregivers, and youth address the complex needs of this population.

Page Contents:

For Mental Health and Substance Abuse Treatment Providers

Understanding the Links Between Adolescent Trauma and Substance Abuse: A Toolkit for Providers (2nd Edition) 
This toolkit explores the complex connections between traumatic stress and substance abuse, and provides guidelines for identifying, engaging, and treating adolescents suffering from these co-occurring problems. The entire toolkit can be downloaded as a single PDF file. The individual fact sheets that comprise the toolkit can also be downloaded individually; see list and descriptions below.

The Role of Trauma Among Families Struggling with Substance Abuse Speaker Series Learning Center
This series of webinars from the Trauma and Substance Abuse Committee focuses on a range of issues and approaches related to substance abuse treatment and trauma response.

Adolescent Trauma and Substance Abuse Online
This course was developed to educate mental health clinicians, substance abuse treatment providers, parents, caregivers, and youth on the complex interrelationship between psychological trauma and co-occurring substance abuse and dependency.

Fact Sheets
Making the Connection: Trauma and Substance Abuse — Fact Sheet 1 (2008) (PDF)
Explores links between trauma and substance abuse and addresses how to overcome challenges to care.

Understanding Traumatic Stress in Adolescents: A Primer for Substance Abuse Professionals — Fact Sheet 2 (2007) (PDF)
Defines traumatic stress and its impact on adolescent development and behavior, and discusses its implications for substance abuse treatment.

Understanding Substance Abuse in Adolescents: A Primer for Mental Health Professionals — Fact Sheet 3 (2008) (PDF)
Describes the scope and nature of substance abuse among adolescents

Treatment for Youth with Traumatic Stress and Substance Abuse Problems — Fact Sheet 4 (2008) (PDF)
Outlines validated traumatic stress and substance abuse assessment tools and describes evidence-based interventions that address both disorders.

Engaging Adolescents In Treatment — Fact Sheet 5 (2008) (PDF)
Offers tips for providers on identifying youth who need help and encouraging them to commit to treatment.

Trauma and Co-Occurring Disorders: Understanding and Working with Youth and Their Caregivers (2008) (Video)

Part 1
Part 2
Part 3
Part 4

This four-hour multimedia presentation is conducted by NCTSN member Liza Suarez, PhD, of the Institute for Juvenile Research, University of Illinois at Chicago, and Dina Daleo, PsyD, Prototypes Centers for Innovation in Health, Mental Health and Social Services. It is a train-the-trainer presentation created in conjunction with a series of sessions developed for the Los Angeles County Department of Mental Health.

Goals of the presentation include: fostering an understanding of the relationship between child traumatic stress and co-occurring disorders, especially substance abuse; outlining assessment strategies for traumatized youth with substance abuse disorders; describing the key components of trauma-informed substance abuse interventions; and offering strategies for providers to manage their personal and professional stress.

The training relies heavily on four case examples, listed below:

Case Examples
Each case example describes the client's presenting problems and offers background information on the adolescent's personal history, family, peer group, and cultural context. Discussion questions guide users to consider possible diagnoses, engagement strategies, and interventions.

Case Example: Jenny
Case Example: Karen
Case Example: Lamont
Case Example: Michael

Youth with Trauma Histories, PTSD, and Co-Occuring Substance Abuse (2008) (Video)

This one hour video presentation is given by Robert Pynoos, MD, MPH, Co-Director of the National Child Traumatic Stress Network, Director of the UCLA Trauma Psychiatry Program, and Professor in the Department of Psychiatry and Behavioral Sciences at UCLA. The presentation was part of the series, Co-Occuring Psychiatric and Substance Abuse Disorders in Children and Adolescents sponsored by Integrated Substance Abuse Programs at UCLA and the Los Angeles County Department of Mental Health (DMH) for DMH child psychiatrists and administrators.

Goals of the presentation include: understand the impact of child and adolescent traumatic stress in the development and behavior of youth; understand the relationship between child and adolescent traumatic stress and co-occuring disorders, primarily substance abuse; and learn about assessment and treatment strategies for youth affected by trauma and substance abuse. 

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For Parents and Caregivers

Helping Your Teen Cope with Traumatic Stress and Substance Abuse (2008) (PDF)
Provides help for parents and caregivers whose teen might be or is experiencing substance abuse and/or stress from a traumatic event.
    >En Español [Ayudando a Su Adolescente a Enfrentarse al Estrés Traumático y Abuso de Sustancias]
Recognizing Drug Use in Adolescents: A Quick Guide for Caregivers and Adults (2007) (PDF)
Summarizes signs of intoxication, use, and abuse commonly reported by substance users, and provides descriptions of numerous substances and their use.

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For Youth

Using Drugs to Deal with Stress and Trauma: A Reality Check for Teens (2008) (PDF)  
Provides information to help teens understand traumatic experiences and some of the reasons behind drug use.
    >En Español [El Uso de Drogas Para Manejar el Estrés y el Trauma: Una Dosis de Realidad para los Jóvenes]

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