Substance Use Problems in Adolescents and Young Adults

For More Information 919-681-2091

Specialists in the Duke Center for Adolescent and Young Adult Substance Use Treatment work with youth and families in a collaborative manner to address substance use and related problems. We know that substance use can be a symptom of underlying causes, such as trauma and anxiety. They can also lead to worsening problems in other areas, which can be scary for youth and families. We work with your family and youth (aged 13 to 24) to understand what is happening and develop a customized plan to address your family’s needs and circumstances.

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Signs of Alcohol and Other Drug Problems

If you notice something with your youth, an open and supportive conversation about the possibility of substance use is the first step. Although warning signs can differ, common signs include: 

  • Blurry eyes, odors of drugs and alcohol
  • Worsening mood, including depression and anxiety 
  • Disruptive behaviors, including being more argumentative or secretive, lying, or sneaking out  
  • Poorer grades or increases in school avoidance, skipping school 
  • Changes in sleep patterns 
  • Changes in peer group
  • Negative changes in the parent-child relationship
Seek Professional Help

We are here to support you and your family. Early intervention can have an enormous impact on you or your loved one’s future. We are happy to be part of your team. 

Evaluation and Treatment


We start with an evaluation to better understand what is happening with each youth or young adult. We try to understand the whole person by exploring their interests, strengths, goals, and aspirations. We also ask how things are going in school or work, in social settings, and at home. We discuss the reasons behind substance use and related challenges, such as anxiety, depression and traumatic stress symptoms. This helps us understand the current substance use, reasons behind it, and the impact it has on you, or your teen or young adult, and your family. Based on this information, we provide recommendations for the most appropriate support and treatment.  

Outpatient Treatment

We offer individual, family, and group therapy to meet you and your family’s needs. Each person is different and has different circumstances, so the frequency of treatment sessions may differ. Our program can be a first step in exploring the need for integrated substance use treatment or can serve as a step-down from more intensive treatment following hospitalization or residential treatment. In addition to our expertise in substance use treatment, we have experts in trauma, anxiety, depression, suicidal thoughts and behaviors who work as a team with each other, and with families and young people to develop effective treatment plans to address individual needs and circumstances. We may recommend drug testing as part of the process to better understand and measure current and ongoing substance use.

Our Locations

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

Why Choose Duke

Long History of Providing Care for Substance Use and Related Challenges
Our team has been providing enhanced treatment for substance use and co-occurring problems for more than 35 years through our comprehensive, integrated, family, community, and peer-based model.  

Proven, Effective Treatment Approaches
Our work is based in treatment approaches that have been studied and proven to be effective. This includes Motivational Enhancement Therapy, Cognitive-Behavioral Relapse Prevention, Mindfulness-Based Approaches, Dialectical-Behavior Therapy, and Trauma-Focused Cognitive Behavioral Therapy.   We work with Young People and Families Our goals are to: 

  • Promote awareness and understanding of the function and effects of substances
  • Help teens and young adults learn, practice, and develop life and recovery management skills. This includes skills for dealing with distress and strong emotions, navigating relationships and stresses, and planning for situations that are associated with risk for alcohol or substance use. 
  • Improve individual and family health, function and well-being 
  • Prepare youth and young adults for living a self-directed, fulfilling life free of risk and harm. Our team aims to understand what natural strengths and interests that youth/young adults have and enhance those natural strengths while also focusing on addressing current substance use and mental health concerns (e.g., trauma, anxiety, depression).

Our team aims to understand what natural strengths and interests that youth/young adults have and enhance those natural strengths while also focusing on addressing current substance use and mental health concerns (e.g., trauma, anxiety, depression).

We Value a Recovery Community as Part of Treatment
We will also encourage a connection to community and with others who are also aiming to live healthier lives as a part of the recovery process.  

Active Research Program Improves Treatment Options
Duke research is helping to provide a better understanding of the course of adolescent and young adult alcohol and substance use issues, and the best treatment options. Through our research, we are investigating the best treatment approaches for adolescents with co-occurring depression and alcohol or substance use; developing an integrated treatment approach for youth with alcohol/substance use problems, depression, and suicide risk; and conducting a multi-site study of the consequences of alcohol and drug use during adolescence and adulthood on the developing brain.  

A Network of Area Contacts
If you, or your adolescent or young adult needs care beyond the scope of our programs or as a continuation of our services, our network of contacts can help you and your child obtain quality care for long-term success.  

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 05/03/2024 by