What If My Child Isn’t Motivated to Get Treatment for Addiction?
Suggesting Treatment to a Loved One
Intervention – a Starting Point
Drug Use, Stigma, and the Proactive Contagions to Reduce Both
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Young people struggling with youth drug treatment needs have long been underserved by a system built around adults. That is now changing. The American Society of Addiction Medicine (ASAM) has published a landmark framework dedicated entirely to substance use disorder care for adolescents and young adults under 25, separating their standards from adult guidance for the first time.
The new volume, titled the Adolescent and Transition-Aged Youth edition of The ASAM Criteria, sets out the full range of services that should be available to every young patient. Previously, adolescent addiction treatment standards sat buried within adult-focused criteria, a setup that many clinicians had criticised for years.
Brain development continues well into a person’s mid-twenties. That biological reality shapes the entire framework. Young people are not simply smaller adults, and the risks they face from substance use reflect that difference.
Why Youth Drug Treatment Needs Its Own Framework
The numbers make a sobering case. Around 80% of adults living with substance use disorder started using substances before the age of 18. Those who begin before 15 are 6.5 times more likely to develop a dependency than those who wait until 21 or older. Early exposure does not just raise risk. It can reshape development, delay the acquisition of life skills, and set a difficult course for decades to come.
“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,” said Dr Corey Waller, editor-in-chief of the new volume.
The ASAM now recommends early intervention for any young person already using substances and showing signs of rapid escalation. Waiting for a formal diagnosis before acting is no longer the preferred approach.
Adolescent Addiction Treatment: A Holistic, Family-Centred Model
The updated standards place the young person firmly at the centre, but they also widen the lens considerably. The framework promotes a model that brings in mental health services, connects with schools and community networks, and treats prevention as seriously as treatment itself.
This matters because youth drug treatment challenges rarely travel alone. Most adolescents dealing with substance-related difficulties also carry co-occurring mental health conditions. The new guidance pushes clinicians to address both at the same time, not in sequence.
The continuum of care expands too. New service levels include ongoing remission monitoring and integrated withdrawal management within youth-specific programmes. These are areas that existing guidance had largely overlooked.
Rising Risks Make the Case for Change
The clinical picture for young people has grown more complex in recent years. Fentanyl and other high-potency substances now reach adolescents far more readily than before. Clinicians report encountering levels of risk in young patients that would have been uncommon a decade ago.
“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,” said Dr Waller.
Putting the New Standards Into Practice
ASAM presented the new criteria on 25 March at the Joint Meeting on Youth Prevention, Treatment, and Recovery. The Hazelden Betty Ford Foundation published the complete volume online and will release a print edition in June.
The Foundation also built a digital interface to help clinicians across the full care team put adolescent addiction treatment into practice without friction.
“The ASAM Criteria’s new adolescent treatment standards represent a tremendous opportunity to further elevate and individualise care for our nation’s children and young adults,” said Dr Joseph Lee, president and chief executive of the Hazelden Betty Ford Foundation.
The framework asks more than clinicians to act. It calls on commissioners, policymakers and system leaders to fund and build the infrastructure these standards require. With the evidence pointing clearly to adolescence as the window where intervention matters most, getting that infrastructure right carries consequences that stretch well beyond the clinic.
(Source: WRD News)
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There is a well-established and often underestimated connection between trauma and substance use disorders. For many individuals struggling with addiction, the roots of their substance use trace back not to a simple choice, but to a nervous system shaped by painful, unresolved experiences. Understanding this connection is no longer optional for those working in behavioural health. It is foundational.
On 16 April 2026, Dr Denis Antoine II, a board-certified psychiatrist and addiction medicine specialist at Johns Hopkins Bayview Medical Center, will lead a live training session exploring precisely this topic. The session, How Trauma Impacts SUD and Subsequent Treatment Efforts, is open to clinicians, counsellors, peer recovery specialists, social workers, and programme administrators, and offers up to 1.25 contact hours.
The Neurobiological Link Between Trauma and Substance Use Disorders
Trauma does not simply leave emotional scars. It physically alters the brain. When a person experiences chronic or acute trauma, particularly during childhood, the stress response systems become dysregulated. The hypothalamic-pituitary-adrenal (HPA) axis, which governs cortisol release, can become either hyperactive or blunted. The prefrontal cortex, responsible for decision-making and impulse control, loses some of its capacity to regulate the amygdala, the brain’s alarm centre.
This neurobiological disruption creates fertile ground for substance use. Research consistently shows that individuals with a history of adverse childhood experiences (ACEs) are significantly more likely to develop substance use disorders in adulthood. A landmark study published in the American Journal of Preventive Medicine found that individuals with four or more ACEs were five to twelve times more likely to use illicit substances compared to those with no adverse childhood experiences.
Substances, in this context, are not random choices. They become functional tools for managing an overwhelmed nervous system. Alcohol may dampen hypervigilance. Opioids may numb emotional pain. Stimulants may help individuals feel present and alive when dissociation takes hold. The substance use, however problematic, is often an attempt at self-regulation in the absence of healthier coping resources.
How Trauma Complicates Treatment Engagement
One of the most clinically significant consequences of trauma is its effect on how individuals engage with treatment. Trust, which is the very foundation of a therapeutic relationship, is often one of the first casualties of trauma. For someone whose traumatic experiences involved a caregiver, authority figure, or institution, entering a treatment programme can feel not like a refuge but a re-exposure to dynamics they have learned to fear.
This is why trauma and substance use disorders must be considered together, not sequentially. A clinician who addresses only the substance use without understanding its traumatic underpinnings may find a patient disengaging, missing appointments, or leaving treatment prematurely. These are not signs of poor motivation. They are often signs of an unaddressed trauma response.
Research supports this: individuals with co-occurring post-traumatic stress disorder (PTSD) and substance use disorders show significantly lower treatment retention rates compared to those without PTSD. They are also more likely to experience relapse, particularly when trauma symptoms are triggered during the recovery process.
Common Clinical Presentations to Recognise
Trauma does not always present in obvious ways within an addiction treatment setting. Clinicians who are familiar with the spectrum of trauma-related presentations are far better positioned to respond with empathy and precision.
Some of the most common presentations include persistent emotional dysregulation, difficulty tolerating distress, shame-based thinking, avoidance of therapeutic topics, dissociation during sessions, and a pattern of escalating substance use in response to environmental stressors. Individuals may appear guarded, hostile, or erratic, not because they are unwilling to engage, but because their nervous system has learned that vulnerability is dangerous.
Physical health complaints without clear medical explanation, sleep disturbances, and a history of multiple treatment episodes without sustained recovery are also common markers worth exploring with a trauma-informed lens.
Applying Trauma-Informed Principles in Addiction Care
Recognising trauma is only the first step. The real clinical challenge lies in embedding trauma-informed principles into the day-to-day fabric of addiction treatment. This means shifting from a model that asks “what is wrong with this person?” to one that asks “what happened to this person, and how has it shaped the way they are showing up today?”
Practically, this looks like creating physical and relational environments that feel predictably safe. It means being transparent about treatment expectations, offering choice wherever possible, and actively building collaborative rather than hierarchical therapeutic relationships. It also means training all staff, not only therapists, but intake workers, reception staff, and peer support specialists, to understand how trauma responses can manifest across every point of contact.
Screening for trauma early in the treatment process, and using validated tools such as the ACE questionnaire or the Trauma Screening Questionnaire, allows clinicians to tailor treatment plans that account for underlying trauma histories.
Integrated approaches that address trauma and substance use disorders simultaneously, such as Seeking Safety or Trauma-Focused Cognitive Behavioural Therapy adapted for addiction settings, have shown promising outcomes in improving both retention and recovery.
Why This Matters Now
The intersection of trauma-informed addiction treatment and public health has never been more urgent. In the United States alone, over 46 million people aged 12 or older met the criteria for a substance use disorder in 2021, according to the National Survey on Drug Use and Health. Simultaneously, population-level trauma exposure, including the lasting effects of the COVID-19 pandemic, community violence, and systemic inequality, continues to rise.
Clinicians and programme leaders who invest in deepening their understanding of trauma and substance use disorders are not simply improving individual outcomes. They are building systems that are more responsive, more humane, and ultimately more effective.
Dr Antoine’s upcoming session offers a structured opportunity to do exactly this. Whether you are a seasoned clinician seeking to refine your practice or a programme leader looking to embed trauma-informed principles across your service, this training provides a meaningful conceptual and practical foundation. (Source: WRD News)
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Based on the World Youth Report 2025 (Insights from 3,000 youth across 137 countries)
One in seven young people aged 10 to 19 experiences a mental health condition. That’s millions navigating anxiety, depression, and other challenges whilst trying to figure out life.
The World Youth Report 2025, based on consultations with nearly 3,000 youth from 137 countries, examines how to support young people in building resilience through prevention, support systems, and evidence-based interventions.
This isn’t another lecture about being ‘tough’ or ‘resilient’. It’s about the real factors shaping mental health outcomes, from substance use to economic pressures, and creating systems that genuinely support us.
“If best practice isn’t sought and in place, then a lesser system will emerge and young
people will subscribe to the dominant cultural voice in the absence of the best practice.
Identifying and deploying these best practice principles must at least be in the offering to
develop community wellbeing.”
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Research shows that spirituality and drug use prevention are closely linked. Millions of people struggle with alcohol and drug use, yet spiritual engagement remains one of the least discussed protective factors in mainstream health. A landmark meta-analysis in JAMA Psychiatry (February 2026) pooled data from 55 longitudinal studies and over 540,000 participants. The results were clear: spiritual practice consistently reduces the risk of harmful substance use.
People with higher spiritual engagement showed a 13% reduction in harmful substance use across all drug categories. Those attending religious services more than once a week saw an 18% reduction.
What Does “Spirituality” Actually Mean?
An international consensus definition describes spirituality as a dynamic aspect of humanity. People use it to seek ultimate meaning, purpose, and transcendence. It also covers connection to self, family, community, nature, and the sacred.
This is a broad and inclusive definition. It covers formal religious practice, but it also reaches far beyond it. Prayer, meditation, a sense of life purpose, and connection to community all count as spiritual practice. So does seeking meaning through nature or service to others. Notably, 28% of adults in the United States now identify as religiously unaffiliated. That makes this wider framing of spiritual practice and substance use especially relevant.
Spirituality and Drug Use Prevention Across All Age Groups
Spiritual practice protects people across the full life course. Several studies in the review focused on adolescents and young adults, a group especially vulnerable to early substance use initiation.
Early initiation matters. The younger a person is at first use, the more likely they are to face chronic problems later in life. One large prospective study tracked more than 5,000 young people aged 12 to 17. Regular religious service attendance linked to a 15% drop in cigarette smoking and a 33% reduction in illicit drug use. Studies in adults showed consistent benefits too, spanning populations across Europe, Australia, Japan, South Africa, and North America.
Spirituality and drug use prevention work hand in hand at every age. That is a finding worth taking seriously.
What the Research Found
The 2026 meta-analysis is the first to formally measure the longitudinal relationship between spirituality and alcohol and other drug (AOD) use. Researchers pooled data from studies published between 2001 and 2022. The protective effect held firm across every drug category studied.
Key statistics from the research:
The overall risk reduction across all substance types reached 13% (risk ratio 0.87, 95% CI 0.84 to 0.91). Attending religious services more than once a week produced an 18% risk reduction. An estimated 60% of effects showed at least a 10% risk reduction. Virtually all 134 individual effects across the 55 studies pointed in a protective direction.
Multiple sensitivity analyses confirmed these findings. Excluding any single study did not shift the overall result. Researchers also confirmed that any unmeasured confounding factor would need to be very large to explain away the association entirely.
Why Spiritual Practice Supports Substance Use Prevention
Researchers point to several reasons why spiritual practice and substance use prevention connect so reliably.
Being part of a spiritual community gives people social belonging and support. It introduces shared norms around abstinence or moderation. It provides access to meaning and purpose, which can reduce the appeal of substances as a coping tool. People also build practical coping strategies through prayer, meditation, self-reflection, and community engagement.
Neuroscience adds another layer. Regular spiritual practices appear to influence brain regions that handle stress regulation, reward processing, and social connection. These are exactly the systems that substance use disrupts.
Social norms play a big role too. When a person belongs to a community where heavy drinking or drug use is uncommon, and where other sources of joy and connection are available, exposure to risk naturally falls. Community belonging shifts what feels normal and what feels appealing.
Spiritual Practice and Recovery: Not Just Prevention
Spiritual practice and substance use recovery show the same positive relationship. The meta-analysis examined recovery-focused studies and found a risk ratio of 0.82 for recovery outcomes. That sits close to the prevention figure of 0.87.
This aligns with the long-standing role of spirituality in mutual support programmes like Alcoholics Anonymous and other 12-step models. These programmes build recovery around spiritual concepts: connection to something greater than oneself, self-reflection, forgiveness, and community.
The cultural dimension matters here. Over half of African American adults in recovery say spirituality or faith “made all the difference” in their journey. That rate is two to three times higher than among White respondents. Effective support needs to respect those differences and meet people where they are.
What This Means in Practice
These findings carry practical weight for clinicians, communities, and families.
Clinicians can ask simple questions: “Is religion or spirituality important to you when thinking about your health?” That opens a conversation without imposing any belief system. Acknowledging spiritual practice as part of person-centred care fits both the evidence and good clinical ethics. Addiction training programmes could also expand to include this dimension.
At a community level, spirituality and drug use prevention goals align well with public health outreach. Partnerships between health bodies and faith or spiritual communities can extend reach, strengthen social connection, and create genuine alternatives to substance use. Any such work must respect individual autonomy. Participation in faith activities should always be a free choice.
People who do not identify with a religious tradition still benefit from community life and meaning-making. The mechanisms, belonging, purpose, coping, and connection, apply beyond any single tradition or worldview.
Looking Ahead
This field is still developing. Future research should explore how spiritual practice and substance use prevention interact across different substances, demographic groups, and cultural contexts. The current evidence base leans heavily on Western, predominantly Christian settings. A more globally representative body of research is needed.
Standardising spirituality measures across studies will also strengthen future findings. Randomised trials, where ethical and feasible, will help determine whether these associations are genuinely causal.
What is already clear: the relationship between spiritual practice and substance use is consistent, meaningful, and well evidenced. Treating spirituality as part of a whole-person approach to wellbeing, always with respect for individual belief and culture, is a direction that deserves serious attention.
The research referenced in this article: Koh et al., “Spirituality and Harmful or Hazardous Alcohol and Other Drug Use: A Meta-Analysis of Longitudinal Studies.” JAMA Psychiatry, February 2026.
Source: jamanetwork
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A groundbreaking study from The University of Texas at Arlington has revealed a disturbing reality: one in four American adolescents is exposed to violence in their neighbourhood. Moreover, these young people are more than twice as likely to turn to cigarettes, alcohol, or drugs as a coping mechanism. This pattern of teen substance use represents a critical public health challenge that demands immediate attention.
The research, published in the Journal of Affective Disorders, analysed responses from 20,005 adolescents aged 12 to 18 using data from the 2023 Youth Risk Behaviour Survey. Furthermore, the findings shed light on alarming patterns connecting environmental trauma to risky behaviours.
How Neighbourhood Violence Fuels Teen Substance Use
Professor Philip Baiden led the study at UT Arlington’s School of Social Work. He emphasised that violence is far from rare in young people’s lives. “Youth exposed to neighbourhood violence often carry the psychological weight of chronic stress, fear, and trauma,” Dr Baiden explained. Consequently, many turn to alcohol, marijuana, vaping, or other substances to self-medicate or numb the emotional impact.
The study examined five categories: cigarette smoking, alcohol consumption, electronic vaping products, marijuana use, and prescription opioid misuse. Notably, exposure to neighbourhood violence was associated with higher odds of using all five substances. Additionally, researchers controlled for demographics, mental health symptoms, physical activity, and bullying involvement.
Youth Drug Abuse Reaches Crisis Levels
According to the 2024 National Institute on Drug Abuse annual report, 58.3% of individuals aged 12 or older reported using tobacco, vaping nicotine, alcohol, or an illicit drug in the prior month. This widespread youth drug abuse contributes to preventable illness and death across the nation.
Dr Catherine LaBrenz is the study co-author and associate professor at UTA’s School of Social Work. She noted that previous research has shown neighbourhood violence can fundamentally alter how the brain processes emotions. “When teens experience chronic fear or trauma, it can increase vulnerability to substance use,” she said.
Cyberbullying Drives Adolescent Drug Abuse
The research uncovered several surprising patterns beyond neighbourhood violence. Indeed, cyberbullying emerged as more strongly linked to adolescent substance use than traditional school bullying. This finding carries profound implications for prevention strategies.
“Cyberbullying is distinct in that it follows adolescents everywhere,” Baiden explained. “There is no escape. When it is cyberbullying, it spreads widely and persists indefinitely. You don’t know who has access to it, which makes its emotional impact even more traumatic. You can’t just delete it.”
The Sports Paradox
In a nuanced finding, the study identified that students participating in team sports tend to report higher rates of alcohol use. Team sports offer structure, belonging, and social support. However, they also expose adolescents to peer cultures where drinking may be normalised.
“That helps explain why we see increased odds of drinking amongst youth who participate,” Baiden noted.
Pathways to Prevention
The researchers emphasise that documenting these adverse effects is only the beginning. Therefore, the team plans to focus future research on identifying specific interventions. Counsellors, mental health professionals, and social workers can implement these when working with youth who experience neighbourhood violence.
Understanding the connection between environmental trauma and teen substance use represents a crucial step towards developing targeted prevention programmes. By addressing the root causes rather than simply treating the symptoms, communities can better support vulnerable adolescents.
The study’s findings highlight the urgent need for comprehensive approaches. These must consider young people’s lived experiences, including exposure to violence, online harassment, and peer influence. Consequently, only through such holistic understanding can effective strategies emerge to protect adolescents from the devastating cycle of trauma and substance misuse.
Statistics tell a sobering story. With one in four teens exposed to violence and 58.3% of young people aged 12 or older using substances, the scale of this crisis cannot be ignored. Nevertheless, armed with this research, communities now have a clearer roadmap for intervention.
UTA Social Work professors Angela J. Hall and Joshua Awua were contributing authors to the study.