Key points:

  • CBT and family therapy approaches appear to be most promising with young people, but there is little difference between different treatment modalities. A wide range of comprehensive interventions that target a range of factors needs to be offered.
    Strength of evidence: 2 stars

  • Pharmacotherapies appear to be of little value except for specific psychopathology.
    Strength of evidence: 2 stars

  • Treatment needs to be readily available, accessible and attractive to young people.
    Strength of evidence: 1 star

  • A comprehensive assessment is the critical first step in the treatment of young people due to the plethora of risk and protective factors, which may be targets for intervention.
    Strength of evidence: 1 star

  • The intensity of treatment intervention offered to young people should ideally be matched to the severity of substance misuse and the level of impairment in functioning. The least intrusive options should be tried first.
    Strength of evidence: 1 star

  • Coexisting mental disorders should be assessed and addressed.
    Strength of evidence:

  • Detoxification is only a stage of treatment and by itself does little to change long-term use.
    Strength of evidence: