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Teen Alcohol Rehab: Addressing the Unique Needs of Adolescents

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Alcohol is the most widely misused substance among American teenagers. Research shows that even though teens tend to drink less than adults overall, teens are more likely to binge drink.1 Underage drinking is dangerous for numerous reasons. Treatment for alcohol misuse usually takes place in a teen alcohol rehab.

Signs of Adolescent Alcohol Misuse in Adolescents

The teenage years are a time of development where people learn to become more independent, try new challenges, and participate in risky behaviors.2 This can lead many teens to experiment with substances, including alcohol.

According to the Centers for Disease Control and Prevention (CDC), any underage drinking is alcohol misuse even if the same frequency of drinking or amount of alcohol would not qualify as misuse for an adult.

Signs that your teen may be misusing alcohol include:1

  • Changes in mood, such as anger or irritability
  • Academic or behavioral problems at school
  • Changes in the friend group
  • Low energy level
  • Less interest in activities they used to enjoy
  • Finding alcohol in their things, such as in their room or car

Signs that your teen may be intoxicated with alcohol include:

  • Smelling alcohol on their breath
  • Difficulty concentrating or remembering things
  • Slurred speech
  • Coordination problems

A teen may struggle with alcohol misuse and may not be physically dependent on alcohol or meet the full criteria for alcohol use disorder. However, alcohol use disorder, or alcohol addiction, can happen during adolescence.

According to the American Psychiatric Association, the first signs of AUD are likely to appear during the late teen years or early 20s. Signs of AUD in teens are:3

  1. Alcohol is taken in larger amounts or used for a longer period than initially intended
  2. Ongoing desire or unsuccessful attempts to stop drinking or control their alcohol use
  3. A lot of time spent doing things to get alcohol or to drink
  4. Cravings or strong desire to drink alcohol
  5. Ongoing alcohol use causes problems with relationships, hobbies, or school
  6. Continued drinking despite negative consequences
  7. Giving up on important friendships, school responsibilities, a job, or hobbies as a result of alcohol use
  8. Continuing to drink even when it’s not safe to do so, such as while driving
  9. Continuing to drink even if alcohol use is causing or worsening a known medical or mental health issue
  10. Developing tolerance, which is characterized by 1) if your teen needs to drink more alcohol over time to get the same effect and 2) if they aren’t really impacted by the same amount of alcohol after repeated use
  11. Withdrawal symptoms after not drinking

If your teen shows any of these signs or symptoms, there is hope. You may be wondering how to help a teenage alcoholic. There are ways to support your teen so they can get the support they need to recover from alcohol misuse.

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Risk Factors for Teen Alcohol Misuse

Several risk factors can contribute to teenage alcohol misuse or alcohol use disorder. Research indicates that the following factors increase the likelihood that a teenager may misuse alcohol and that, if they do misuse alcohol, they may develop addiction.

Family History and Genetics

Teenagers with parents who have a history of substance misuse or addiction, or who grew up in a home with any adults who misused substances may be more at risk. Current research has identified three reasons why:4

  1. Homes of origin affected by substance misuse may create an environment where other risk factors, such as neglect or instability, occur
  2. Behavior modeling and learned behavior can increase the likelihood of later-life substance use
  3. While there is no “alcoholism gene,” some genetic traits that can be inherited are linked to an increased risk of substance misuse

Mental Health

Certain mental health conditions are associated with a higher occurrence of teen alcohol use disorder, including:5

  • Depression, especially depression that presents with suicidality
  • Anxiety
  • Attention-deficit hyperactivity disorder (ADHD)
  • Conduct disorders

Childhood Behavior

Certain childhood behavior is linked to teenage alcohol use. This behavior is also seen in much higher rates among adolescents whose first exposure to any substances happens before age 15.5

This behavior includes impulsivity, aggression, and acts that are considered antisocial.

Peer drinking and peer pressure also reportedly increase the likelihood of teenage alcohol misuse.


Adolescents in teenage alcohol rehab report high instances of trauma, such as physical abuse and sexual assault, compared to teens with no substance use issues.6

Rejection and Marginalization

Rejection and marginalization have a dramatic impact on the risk of alcohol misuse among teenagers. This includes:6

  • Rejection in the home: Teenagers report a strong effect from discipline by parents that made them feel unworthy as a person and rejected by that caregiver
  • Racial and ethnic marginalization: Teens who were racially or ethnically marginalized at school (usually meaning there were less than 15% of same-identity peers) are more likely to misuse alcohol
  • Gender and sexual marginalization: Research shows that teens who identify as gay, lesbian, or bisexual were more likely to misuse alcohol when compared to teens who identify as straight. Transgender people are 4 times more likely than the general population to have alcohol addiction.

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Treating Alcohol Misuse in Teens

There are ways to support and treat teens dealing with alcohol misuse or alcohol use disorder.7Research shows there are effective treatment approaches for teens. These include:7

  • Behavioral therapies, such as cognitive-behavioral therapy (CBT)
  • 12-step meetings, such as Alateen
  • Family-based therapies
  • Medication

However, there are special considerations to examine for treatment to be effective for teens. Some important things to consider and integrate into the treatment process are:7,8

  • Confidentiality: It’s also important to allow teens confidentiality with their healthcare provider while complying with mandated reporting procedures. Research demonstrates that confidentiality between a teen and their provider has a positive impact on the treatment process.
  • Family involvement in the treatment process: Family dynamics have a well-documented impact on alcohol addiction recovery at every age.
  • Developmentally appropriate treatment: For example, the adolescent years are a time when individuals are exploring their sense of independence. Mental health providers and addiction professionals need to hold this in mind and allow teens to have an active voice in the treatment process Research shows this often isn’t the case, creating tension between the teen and provider.
  • Strategies to keep teens engaged in treatment: Similar to accounting for their developmental needs, treatment providers need to establish creative ways to keep teens engaged in treatment. Teen treatment can’t mimic adult treatment if it’s going to be effective. Another way to keep teens interested and involved in treatment is to provide positive incentives for behavioral change. For example, focusing on tangible things related to relationships or school can keep teens engaged and motivated for recovery.
  • Gender and cultural competence: All addiction treatment providers must be culturally competent in the demographic they serve, including when they serve teenagers. It’s important for treatment providers to be culturally competent and to understand the various societal factors that can influence a teen’s substance use. For example, there are societal factors that are unique to girls that contribute to substance misuse. Research shows that girls are more likely to use alcohol as a way to cope with sexual trauma, while boys are more likely to misuse alcohol as a way to enhance pleasure or have more fun.

If you or your teen could benefit from alcohol misuse treatment, call 800-948-8417 Question iconCalls are forwarded to these paid advertisers to speak with a treatment specialist.


  1. National Institute on Alcohol Abuse and Alcoholism. (2021). Underage Drinking.
  2. Centers for Disease Control and Prevention. (2021, October 6). Underage Drinking.
  3. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Association Publishing.
  4. National Institute on Alcohol Abuse and Alcoholism. (1997) Youth Drinking: Risk Factors and Consequences. Alcohol Alert.
  5. Benner, A.D., & Wang, Y. (2015) Adolescent substance use: The role of demographic marginalization and socioemotional distress. Developmental Psychology, 51(8), 1086-1097.
  6. Dunn, M.S., & Yannessa, J.F. (2020) Sexual identity and risk of alcohol, tobacco, and other drug use behaviors among a representative sample of youthJournal of Alcohol and Drug Education, 64(2), 41-51.
  7. Maurer, M.A., & Fields, S.A. (2022) How to screen for and treat teen alcohol useThe Journal of Family Practice, 71, 31-34.
  8. National Research Council and Institute of Medicine Committee on Developing a Strategy to Reduce and Prevent Underage Drinking. (2004) Reducing underage drinking: A collective responsibility. National Center for Biotechnology Information.
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