New clinical standards aimed at improving the treatment of adolescents (younger than 18 years) and transition-aged youth (16-25 years) with substance use disorder (SUD) have been established by the American Society of Addiction Medicine (ASAM).

The Adolescent and Transition-Aged Youth volume of The ASAM Criteria establishes a dedicated framework for youth-specific SUD care, including the types and intensities of treatment that should be available.

Until now, standards for adolescent SUD care were interwoven with those for adults in The ASAM Criteria.

“Adolescents and transition-aged youth have unique developmental needs that the addiction treatment system should be organized to meet,” Corey Waller, MD, editor-in-chief of the Adolescents and Transition-Aged Youth volume, said in a press release.

“Ongoing brain development during these formative years puts youth at a greater risk of developing the disease of addiction, which can lead to poor health outcomes and delayed life skill development,” Waller noted.

The new standards outline “the full range of treatment services that should be available to all adolescent patients in order to effectively prevent and treat substance use disorder and set them up for long-term health and success into adulthood,” Waller said.

SUD Starts Early

SUD is increasingly recognized as a pediatric-onset condition. Research has shown that about 80% of adults with SUD initiated substance use before the age of 18 years. Those who start before the age of 15 years are 6.5 times more likely to develop SUD than those who delay use until the age of 21 years or older.

Given the vulnerability of the adolescent brain, the ASAM recommends early intervention to prevent adolescent substance use from transitioning to SUD. This includes specialty treatment for young people who are using substances and are at a high risk for rapid escalation to SUD.

The new standards encourage a holistic, family-centered approach that fully integrates mental health services, coordinates with schools and community systems, and emphasizes prevention alongside treatment.

A central feature of the updated framework is the expansion of the continuum of care, including new service levels such as ongoing remission monitoring and integrated withdrawal management within youth-specific programs.

The guidance also highlights the increasing clinical complexity of adolescent SUD, including rising exposure to high-potency substances such as fentanyl and the high prevalence of co-occurring psychiatric conditions.

“While there will be challenges to overcome to make this vision a reality, we must commit to building systems and payment models capable of delivering effective interventions and treatments for all young people who need them,” Waller said in the release.

The Adolescent and Transition-Aged Youth volume of The ASAM Criteria were presented on March 25 at the Joint Meeting on Youth Prevention, Treatment, and Recovery, hosted by the National Center on Youth Prevention, Treatment, and Recovery.

The complete volume, published by the Hazelden Betty Ford Foundation, will be available online on March 31 and in print in June.

“The ASAM Criteria’s new adolescent treatment standards represent a tremendous opportunity to further elevate and individualize SUD care for our nation’s children and young adults,” Joseph Lee, MD, president and CEO of the Hazelden Betty Ford Foundation, said in the release.

“To help clinicians adopt The ASAM Criteria and put these standards into practice, Hazelden Betty Ford Foundation was intentional about creating a user-friendly, digital interface that can serve all members of the SUD care team, and by extension, families and children impacted by this disease,” Lee said.