Adolescent Substance Use Disorders

Adolescent substance use and experimentation are common; however, problematic use can quickly develop and require treatment. Currently, treatments for adolescent substance use disorders (SUDs) are primarily psychosocial, such as family-based therapy, cognitive behavioral therapy, and motivational interviewing. Given the relative success of pharmacotherapy in treating adult SUDs, pharmacotherapy has emerged as a potential adjunctive treatment modality for adolescent SUDs as well. This chapter examines the literature on the available pharmacotherapies for treating the most common SUDs among adolescents, as well as provides commentary on the evidence for each. To date, there are no FDA-approved medications for adolescent SUDs, other than buprenorphine, which has been approved in youth 16 years of age and older for opioid use disorder. Although there is some promising evidence in opioid and tobacco use disorders, as well as emerging evidence in alcohol and cannabis use disorders, the treatment of adolescent SUDs remains mainly psychosocial. The role of pharmacotherapy in adolescent SUD treatment is primarily as an adjunctive treatment with the goal of increasing the efficacy of well-established psychosocial interventions.