Four Themes in Youth Recovery

Young girl behind a gate, holding the gate railings with her hand.

September marks the Substance Abuse and Mental Health Services Administration’s (SAMSHA) 30th Recovery Month! In these past 30 years we have witnessed the expansion of evidence-based clinical drug treatment and a shift towards addressing substance use as a public health issue rather than an individual moral failing. With new evidence and approaches, policy makers, medical professionals, and social workers are combating a decades-rise of drug related deaths: due to the often cited opioid-crisis. But one group is often left out of the conversation: young people.

It is well established that teenagers are not mini-adults. Young people have very different social priorities, cognitive reasoning abilities, and emotion regulation skills that are distinct from those of people aged over 25. As part of the Justice Programs Office Juvenile Drug Treatment Court Training and Technical Assistance Initiative, our team translated the research on youth development and clinical treatment into practical advice and solutions for juvenile justice professionals. From this combination of research and field observation, we identified some common themes and challenges in drug treatment with teens. Here are four things to address when grappling with youth recovery:

1. Forgetfulness is a reality

Drug treatment, and especially participation in treatment courts, requires participants to keep track of many appointments and tasks. This is in direct conflict with a teen’s brain development. The part of the brain that directs working memory, attention, and planning, called the prefrontal cortex, is not fully developed until the mid-twenties. Teenagers, thus, need coaching and encouragement to write appointments in a calendar and keep an organized list of requirements. Also, don’t be afraid to repeat instructions.

2. Peer relationships are key

In the young adult years, peers become the primary relationships of value and the influence of family members are reduced. This is because teens are forming their identity and testing the waters of life outside the family structure, preparing themselves for adulthood. Unfortunately, we cannot simply tell youth in recovery to stop hanging out with other young people who are using substances. Those peer relationships are central to their lives. Instead, treatment programs should focus efforts on teaching about healthy relationships and giving young people opportunities to form more positive peer relationships, such as joining a sports team.

3. Family matters

Even though a family’s influence and control over their teen is reduced, young people are still very much embedded in a family structure with limited authority of their day to day life. Teens rely on others for food, shelter, money, and a sense of safety. If their basic needs are not being met by their family or the family is heavily dysfunctional, effective drug treatment will be severely impeded. Treatment programs should address the needs of the family as well as the needs of the individual teen.

4. Growth will happen

Trust that a young person will grow and improve with the aid of life experience and brain development. Research has shown that criminal behavior is most likely to occur in the teen and young adult years, and with age criminality drops significantly. Behavior change is a journey and the skills and coping mechanisms young people learn in treatment programs will continue to impact them as they grow into adults.

For more information on the Juvenile Drug Treatment Court Initiative, please visit