A teen is using substances.

How do you decide what kind of treatment makes sense?

Outpatient therapy?

A more structured program?

We're breaking it down.

Welcome to the Carlisat Psychiatry Podcast.

I'm your host, Dr. Josh Bader, the editor-in-chief of the Carlat Child's

Psychiatry Report and co-author of the Child Medication Fact Book for Psychiatric Practice,

Second Edition, 2023.

And I'm Mara Government, a licensed clinical social worker in Southern California with a private

practice and an avid reader of the Carlatte Psychiatry reports.

Today, we're discussing how to determine the appropriate level of care for teens with substance use disorders.

Deciding on the right level of care involves looking at substance abuse severity, co-occurring conditions,

family support, and the teen's engagement in treatment. So, Dr. Fader, when working with teens,

how do you start thinking about treatment options? One option is to start with outpatient care

if the substance use is mild and the teen has strong family support.

That typically involves weekly therapy, often family base, and sometimes medications that treat co-occurring conditions like depression, anxiety, or ADHD, or medicines that can reduce craving of substances.

But when kids need more time in structured care, intensive outpatient programs or IOPs are a good

option to think about.

These involve three to five sessions per week while allowing the teen to stay in school and

at home.

So I've had lots of kids in IOPs, and I'm so grateful for them because the

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