Adolescent substance misuse

Substance misuse is common in adolescence. Young people with substance misuse have comorbid mental health problems and multiple psychosocial difficulties, including family conflict, interpersonal difficulties, academic failure, and offending behaviour. Adult definitions of substance misuse are often inadequate and restrictive. Developmental and systemic perspectives are essential in the assessment and treatment of young people with drug- and alcohol-related problems. There is a robust body of evidence, mainly from the USA, to indicate that integrated multimodal treatment programmes produce significant improvement across a number of domains. Clinical experience suggests that practitioners from a wide variety of backgrounds could offer safe and effective treatment. Clinicians working in child and adolescent mental health services and paediatrics have a key role to play in the assessment and treatment of young people with substance misuse and comorbid mental health problems. Early identification and treatment could alter the developmental trajectory of young people at high risk of developing substance misuse and prevent potentially serious complications.