The American Academy of Child and Adolescent Psychiatry (AACAP) just released a new clinical practice guideline, Assessment and Treatment of Adolescents and Young Adults with Substance Use Disorders and Problematic Substance Use (Excluding Tobacco). AACAP’s goal for the guideline was to summarize empirically-based guidance about therapeutic interventions for substance/problematic substance use disorders and summarize expert-based guidance on the assessment of those disorders.

The AACAP notes an overall decline in the last decade in substance use among adolescents, though new health risks have emerged including vaping and consuming cannabis concentrates. Ongoing evaluation and treatment can help adolescents with substance use disorder achieve better health outcomes. The AACAP’s guidelines are meant to enhance clinical outcomes specifically for adolescents with substance use disorders and problematic substance use. 

Let’s take a look at the key points included in the new 2025 AACAP guideline.

Key Treatment Statements of the 2025 Update:
  1. Motivational interviewing could be offered to adolescents and young adults with problematic alcohol use or an alcohol use disorder.
  2. Non-brief family therapy, motivational interviewing, or cognitive behavioral therapy (CBT) could be offered to adolescents and young adults with problematic alcohol use or an alcohol use disorder with/without drug use. CBT and non-brief motivational interviewing could be offered to adolescents and young adults with illicit drug-related disorders.
  3. Behavioral interventions that include motivational interviewing or motivational enhancement therapy could be offered to college students with problematic alcohol use or those who have an alcohol use disorder.
  4. Buprenorphine treatment could be offered to adolescents and young adults with opioid use disorder.

For a more comprehensive look at the reasoning behind those four key treatment statements, view the full-text version of the guidelines.

Overall, the AACAP guideline makes note of the fact that motivational interviewing, family therapy, and CBT combined with family therapy as having the strongest effect for problematic alcohol use with or without other substance use. For illicit drug use, motivational interviewing in combination with CBT was noted most effective. For college students it was behavioral intervention that was most effective. For adolescents and young adults with opioid use disorder, longer use buprenorphine treatment with a slow buprenorphine taper was noted as ideal. 

Sign up for alerts and stay informed on the latest published guidelines and articles.

Copyright © 2025 Guideline Central, all rights reserved.