ABSTRACT
This chapter discusses non-judgemental and validating approaches in assessing and managing youth who have substance use disorders. The only medication that has been shown to be effective in youth with substance use disorders in replicated randomised controlled trials is fluoxetine to target depressive symptoms. The chapter explores biological and psychological treatment strategies in the acute phase of substance use disorders in youth. Routine biochemistry and haematology may be helpful in picking up liver enzyme abnormalities, anaemia or acute infections. Extreme body mass index for developmental stage may require medical attention; many adolescents preoccupied with body image use stimulants to reduce or increase body weight. Psychosocial treatment is the keystone of longer-term treatment, as such, elements of the evidence-based psychotherapies should be the foundation of early management. Different jurisdictions will have different laws regarding what information parents have a right to know; the adolescent should be informed of these limits prior to the assessment.
