A lot can change in just ten years. This conversation with Emory University’s Justine W. Welsh, MD, discusses recommendations for updating adolescent use treatment and policies that have been in place for over a decade.

Dr. Welsh is an Associate Professor in the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine, where she is Vice Chair of Child, Adolescent, and Young Adult Services, and Director, Addiction Services, for Emory Healthcare. She is also the Medical Director of the Addiction Alliance of Georgia.

Dr. Welsh was lead author and editor of a new paper titled "Recommendations for Adolescent Substance Use Treatment and Policy ” (co-writers/editors include Chestnut’s Lora Passetti and Mark Godley*). The paper updates the 13 original principles espoused in the 2014 paper, “Principles of Adolescent Substance Use Disorder Treatment” published by the U.S. National Institute on Drug Abuse. We discussed:

• What prompted Justine and the team to update the paper.
• How integrating care for co-occurring mental health disorders and substance use disorders improves treatment outcomes.
• The most effective ways to integrate substance use treatment within the educational system.
• The biggest barriers to maintaining adolescent engagement in substance use treatment, and how can providers overcome them.
• How SBIRT, an important screening and intervention tool, has been effectively used in adolescent populations.
• Harm reduction services remain controversial in some areas - Justine discusses the evidence that supports increasing funding for harm reduction in adolescent substance use treatment.
• The most effective ways of engaging families in adolescent substance use treatment.
• The one policy change she’d make that has the potential to have the greatest impact on adolescent substance use treatment.

*Welsh JW, Dopp AR, Durham RM, Sitar SI, Passetti LL, Hunter SB, Godley MD, Winters KC. Narrative Review: Revised Principles and Practice Recommendations for Adolescent Substance Use Treatment and Policy. J Am Acad Child Adolesc Psychiatry. 2025 Feb;64(2):123-142. doi: 10.1016/j.jaac.2024.03.010. Epub 2024 Mar 25. PMID: 38537736; PMCID: PMC11422521.