Substance Use Problems in Adolescents and Young Adults

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At the Duke Center for Adolescent and Young Adult Substance Use Treatment, our metal health providers work closely with you and your child to manage substance use problems and related issues. Because substance use can be a symptom of other concerns such as trauma and can lead to conditions including anxiety and depression, it is important to address it promptly. We take an individualized approach to treatment and work as a team with your child and your family to truly understand the causes and repercussions of their substance use and to create a customized plan that focuses on their specific needs. 

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Signs of Alcohol and Other Drug Problems

If you notice something different about your child, having an open conversation about the possibility of substance use can help you learn more. There aren’t always warning signs, but you should be on the lookout for:

  • Physical signs such as blurry eyes or the odor of drugs and alcohol
  • Worsening mood, depression, or anxiety 
  • Acting out, being more argumentative or secretive, lying, or sneaking out  
  • Falling grades and school truancy
  • Changes in sleep patterns 
  • New or changing friendships 
  • A worsening parent-child relationship

Seek Professional Help
It takes courage to ask for help. We are here to support you, your child, and your family. Early intervention can have a significant impact on your loved one’s future. 

We Work with 13- to 24-Year-Olds and Their Families 
Our providers work with teens, young adults, and families to collaboratively address substance use and related problems. 

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Evaluation and Treatment



We begin with an evaluation to better understand your child’s interests, strengths, and aspirations as well as the challenges they face at school or work, in social settings, and at home. We explore reasons behind their substance use, other mental health concerns, their current substance use patterns, and the effects of their drug or alcohol use. 

Drug Testing


In some cases, drug testing allows us to better understand and measure substance use. These tests can help reinforce behavior change and guide treatment. 

Intensive Outpatient Treatment


The type and frequency of outpatient treatments differ based on your child’s needs. For example, they may participate in frequent group therapy sessions after residential treatment or hospitalization. Others may take part in one-on-one and family counseling. The goals of out-patient treatment include:

  • Educating young adults and their families about the effects of substance use
  • Helping teens and young adults deal with distress and strong emotions, navigate relationships, and plan for situations that include alcohol or substance use
  • Improving individual and family function and wellbeing
  • Preparing youth for a fulfilling life free of risk and harm
  • Teaching parents and caregivers to help family members dealing with substance use problems and addiction

Effective, Evidence-Based Treatments


We use evidence-based approaches -- treatments that have been studied and are found to be effective -- including motivational enhancement therapy, cognitive-behavioral relapse prevention, mindfulness-based approaches, dialectical-behavior therapy, and trauma-focused cognitive behavioral therapy

Addressing Other Mental Health Concerns


As a patient at Duke, your child has access to other Duke mental health providers who specialize in anxiety, depression, suicidal thoughts and behaviors, and more. 

Referral to Mental Health Services


If your child needs care beyond our program or as a continuation of our services, we can connect you with a network of trusted contacts to help them get the best possible care for long-term success.

Call for an Appointment

Why Choose Duke

Decades of Experience
The Duke Center for Adolescent and Young Adult Substance Use Treatment has successfully treated people with substance use and related problems for more than 35 years. 

Active Research to Improve Treatment Options
Duke researchers are exploring adolescent and young adult alcohol and substance use issues and the best treatment options. We are actively investigating ways to treat adolescents with depression and alcohol or substance use; treatments for youth with alcohol and substance use problems, depression, and suicide risk; and the consequences of alcohol and drugs on the developing brain. 

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

This page was medically reviewed on 08/11/2022 by