‘You’re not going to tell my parents about this are you?’

In most cases, adolescents should be informed of a decision to disclose substance use to their parents. Inviting adolescents to discuss how this will be done, including if the adolescent will be present, and whether you or the adolescent will disclose the use can be an opportunity to discuss their concerns. You should seek to understand if an adolescent has specific fears related to such a disclosure including careful consideration of any history of domestic violence or abuse.

Although adolescents increasingly identify with the opinions and values of their peers, it is a mistake to assume that they therefore do not value the opinions of their parents and the concerned adults in their lives. Parents play an integral role in preventing and treating adolescent substance use disorders. Except in rare instances of severe parent-child relationship problems or abuse, parents can and should be engaged as invaluable participants

Parents should be reminded that their actions speak louder than words and should not assume their teen knows their opinions about substance use until they have been clearly verbalized.⁶ Screening is more accurate when collateral information from a parent is included. Of the therapeutic interventions most effective for treatment of adolescent substance use, five out of six are family-based treatments.⁷ Promising parent-focused interventions such as the Community Reinforcement and Family Training (CRAFT) approach can decrease the duration and severity of that adolescent’s substance use disorder even if the adolescent refuses to participate.⁸ Parents also should be encouraged that positive parenting can lessen the influence of substance use not only in the life of their own child but also in the lives of their children’s peers.⁹

Being aware of the legal and ethical obligations in treatment of adolescents presenting with any level of substance use, you can improve outcomes by thoughtfully inviting the participation of parents and other concerned adults into the prevention, screening, and treatment of adolescent substance use disorders.