Inpatient SUD Treatment for Teens

"I understand your pain" is often my initial response to Indiana parents seeking inpatient substance use treatment for their child. As I drive the 465 loop, I notice an increasing number of billboards advertising addiction treatment centers each day. This marks significant progress over the past decade in reducing the stigma of substance use disorder and expanding treatment options in Indiana. However, there remains a critical gap for teenagers. Inpatient substance use treatment facilities for teens are nearly nonexistent in Indiana.

The most desperate families bring their children to Indianapolis hospitals, hoping they will be admitted and safe for at least a few weeks. However, many are unaware that their child may not meet the psychiatric criteria for admission, which typically requires suicidal or homicidal ideation.

With four years at a recovery high school and six years in the addiction field, I've witnessed firsthand that Indiana lacks inpatient treatment options for those under 18. Families often have no choice but to send their teens out of state, costing thousands of dollars for programs lasting 30 to 90 days—financially unrealistic for most.

Moreover, the idea of trusting and sending a struggling teenager far from home is daunting. What's the alternative? Indianapolis does offer various outpatient and private practice services for Substance Use Disorder (SUD), but residential facilities often provide the necessary intensive care. From my experience, achieving sobriety requires some amount of desire to change—one that's challenging to foster while still under the influence of drugs or alcohol. Inpatient treatment provides crucial time, minimizing the opportunity for relapse and allowing clarity of mind to consider sobriety seriously.

While outpatient programs in Indianapolis have helped many teens recover, some require a higher level of care. It's worth noting that certain outpatient groups have inadvertently facilitated drug exchanges among teens. Establishing a higher level of care prior to outpatient transition could mitigate this issue significantly.

When conducting research for this op-ed, I came across several articles that suggest outpatient treatment yields similar outcomes to inpatient. I found this data puzzling because it contrasts with my firsthand experience comparing teens' recovery rates from inpatient treatment versus our local outpatient programs. This contrast may indicate a need to enhance our outpatient programs to achieve the success seen in other facilities.

However, it's crucial to note that most research studies focus on adults, whereas teenagers have brains that are still developing. Therefore, they face additional challenges related to impulsivity and peer pressure compared to adults.

Recent state and federal funding for addiction treatment is a blessing, yet Indiana must invest wisely and equitably. Inpatient treatment for teen substance use is a critical missing piece in our state. Our teens deserve better—they deserve facilities closer to home, where families can confidently ensure their child's safety and chance at sobriety.

My hope is for our state leaders, professionals, and community to unite in making this a reality. Imagine the reassurance of telling a parent struggling with a teen with SUD, "I know a place" and "I know someone nearby who can help.”

Fløvig, J. Chr., Vaaler, A. E., & Morken, G. (2009). Substance use at admission to an acute psychiatric department. Nordic Journal of Psychiatry, 63(2), 113–119. https://doi.org/10.1080/08039480802294787

Earley, P. (2006). Crazy: a father's search through America's mental health madness.

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2017.0584

 Reif, S., George, P., Braude, L., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Residential Treatment for Individuals With Substance Use Disorders: Assessing the Evidence. Psychiatric Services, 65(3), 301–312. https://doi.org/10.1176/appi.ps.201300242

 McCarty, D., Braude, L., Lyman, D. R., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Substance Abuse Intensive Outpatient Programs: Assessing the Evidence. Psychiatric Services, 65(6), 718–726. https://doi.org/10.1176/appi.ps.201300249