The population of adolescents who need treatment is large. Findings from the 2002 National Household Survey (Substance Abuse and Mental Health Services Administration, 2003) indicate that 11 percent of 12- to 17-year-olds (about 2.6 million) are binge drinkers (five or more drinks on the same occasion at least once in the past 30 days) and 6 percent (1.4 million) are involved in the regular use of illicit drugs excluding marijuana. Many, but not all, need treatment.

Research clearly shows that early treatment is highly cost effective. From cost/benefit research conducted during the past decade, the range of savings realized has been calculated at between $2.50 and $9.60 for every dollar spent on treatment (ONDCP, 2001). Unfortunately, only one person in seven who would qualify for treatment was admitted to treatment in 1999 (National Institute on Drug Abuse [NIDA] Community Epidemiology Work Group, 1999). The potential benefit from increased early treatment is profound.

A large body of literature exists on adolescents and substance use disorders. Epidemiological studies measuring the use of any given drug over the past decade, year, or month are easily found (e.g., Johnston, O’Malley, and Bachman, 2003). Also readily available are studies of best practices in alcohol and drug prevention, and outcome studies of various adolescent treatment programs (e.g., Center for Substance Abuse Treatment [CSAT], 2000a, 2000c; NIDA, 1995). This research informs readers about the prevalence of alcohol and drug use in any given age group, the effects of alcohol and drug use on development, possible methods of treatment, and the results of selected treatment programs. Research continues on why some methods of treatment work better than others and which group responds best to which treatments. Thus, the literature on teen treatment is developing, but does not yet fully define the potential for treatment options with this population.

Three reviews of the literature stand as seminal disseminations of what is known about teen treatment: Treatment of Adolescents with Substance Use Disorders (CSAT, 2000b), Screening and Assessing Adolescents with Substance Abuse Disorders (CSAT, 2000b), and Adolescent Drug Abuse: Clinical Assessment and Therapeutic Interventions (NIDA, 1995).

These reviews point to a number of factors that must be considered in selecting appropriate treatment programs for youth. We have also conducted interviews with experts (Drug Strategies, 2003) to help define the key elements of effective teen treatment. From these, the following key