Key Researchers


Overview of Barriers to Treating Alcohol and Drug Problems Among Adolescents


Hannah K. Knudsen, Ph.D., Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky

Review Panel: Susan Harrington Godley, Rh.D., Chestnut Health Systems, Bloomington, Illinois, Sharon Levy, M.D., M.P.H., Harvard Medical School, Laura Burney Nissen, Ph.D., M.S.W., School of Social Work, Portland State University
Introduction: Nearly ten percent of American adolescents have alcohol or drug abuse problems (SAMHSA, 2008). Studies have shown that treatment for these problems is effective in improving health outcomes for adolescents (Brown et al., 2001; Hser et al., 2001; Muck et al., 2001; Winters et al., 2000).

Despite the effectiveness of treatment, less than 10% of adolescents with alcohol or drug problems, also known as substance use disorders (SUD), actually receive treatment services (SAMHSA, 2007b), suggesting that adolescents face substantial barriers to treatment. A considerable barrier is a lack of problem recognition. Most adolescents with SUDs are unlikely to recognize their need for treatment (SAMHSA, 2006). That is why healthcare professionals and healthcare organizations that have routine contact with adolescents need to implement procedures to identify SUDs and refer adolescents to care (McLellan & Myers, 2004). A model of screening, brief intervention, and referral to treatment (SBIRT) is widely advocated for adults with SUDs (Babor et al., 2007; Madras et al., 2009). This model can be used for adolescents, but it is not used as often as it should be. This results in unnecessary barriers to treatment and missed opportunities for early intervention (Halpern-Felsher et al., 2000; Marcell et al., 2002; Young et al., 2007).

In many communities, adolescents with SUDs also face barriers to treatment related to availability and accessibility. Studies have shown that high-quality counseling services and adolescent-only SUD treatment programs are not widely available (Knudsen, 2009; Mark et al., 2006; Terry-McElrath et al., 2005; Young et al., 2007). Even in communities where adolescent-only treatment programs are available, lack of coverage for SUD treatment within health insurance policies may reduce access to these services (Fox et al., 2003). Failure to invest in adolescent SUD treatment services has ripple effects throughout a person’s life, since adolescence is a sensitive time period for the development of SUDs (Hingson et al., 2006; Lynskey et al, 2003; Volkow & Li, 2005; Winters & Lee, 2008).

Date Updated :
Original Date: Dec. 2009

Knudsen, H.K.; Barriers to Treating Alcohol and Drug Problems Among Adolescents Knowledge Asset, Web site created by the Robert Wood Johnson Foundation's Substance Abuse Policy Research Program; December 2009.,

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