My daughter developed an unhealthy relationship with drugs when she was 14 that blindsided us as parents. We tried to understand what was happening while facing a decision we never imagined having to make: did she need treatment, and if so, what kind of care was right for her?

For parents of adolescents, deciding to seek treatment raises questions that differ from those facing families of adults. We are responsible for our children’s safety, education, and care. Even when we have the authority to make a treatment decision, knowing what to do feels impossible.

In my daughter’s case, we had to work through questions that touched every part of her life:

• What would happen to school? How would she make up lost time and stay on track to graduate?

• Had we tried everything we could before making the difficult decision to send her away?

• Was what we were seeing teenage experimentation, or had it become something more serious?

• How would we pay for treatment?

Finding answers took time. So did accepting that we needed help we could not provide at home.

Before she began using drugs, my daughter was a good student, a soccer player, and a teenager with a strong group of friends. As her substance use progressed, I struggled to recognize the person she was becoming. I felt ashamed, confused, terrified, and remorseful. I tried everything I could think of to avoid sending her away. I also dreaded having to explain why to friends and family.

Parents who are actively searching for treatment still hold out hope that it will not be necessary. Programs need to understand that tension. Parents need guidance and time to work through their fears before they are ready to decide.

Finding care is another hurdle

Once parents decide their adolescent needs treatment, they have to find an appropriate program. The choices narrow when they need residential care, insurance coverage, or treatment close to home.

A 2024 study published in Health Affairs identified 160 U.S. residential addiction treatment programs serving adolescents with opioid use disorder. Among the programs with a waitlist, the average wait for a bed was 28.4 days. Although the study focused on residential care for adolescents with opioid use disorder, it shows the difficulty of finding care after a parent has decided their child needs help.

The parent’s role changes during treatment

When my daughter entered treatment, I expected to remain an active part of helping her. Instead, I had limited insight into her progress and little guidance on what I should do. I was still her parent, but I no longer knew how to parent her through what was happening.

A parent who made the decision to seek care now has to trust others with much of their child’s day-to-day care. When their child calls home unhappy, asks to leave, or promises things will be different, that parent has to decide how to respond while carrying all the fear that led to admission in the first place.

Programs experience that fear through repeated calls for updates, questions about treatment decisions, and disagreements about what should happen next. Those situations put pressure on staff and affect a child’s care. They also point to the need for more consistent communication, education, and support for parents. Parents need more than an occasional family session. They need help understanding what to expect, talking with their child, working with the care team, and preparing for the return home. That matches what families themselves say they need from treatment.

Supporting parents is critical to supporting adolescents

Our experience led me to create an adolescent treatment program where family support was central to the approach. I had learned firsthand that parents needed help long before admission and that their need for guidance continued throughout treatment.

That belief shapes what we are building at Pathroot Health as we expand our provider-branded family engagement service for adolescent programs: guidance while parents are considering care, support and connection while their child is in treatment, and help preparing for what comes next.

For a parent, treatment is not a single decision followed by a period of waiting. It is a series of difficult decisions made under stress, with consequences for their child and their family. When programs give parents a way to understand those decisions and participate constructively, they support the people their adolescent will continue to rely on long after treatment ends.

Frequently asked questions

How do parents know if a teenager needs addiction treatment?

Parents often struggle to tell teenage experimentation from something more serious, and most work through that question over time while trying other solutions first. Warning signs that led one family to act included changes in identity, friendships, and functioning in a teen who had been a strong student and athlete. Parents deciding whether to seek treatment benefit from guidance and time to work through their fears, and from programs that understand they may still hope treatment will not be necessary.

What questions do parents face when considering treatment for an adolescent?

Common questions include what will happen to school and staying on track to graduate, whether the family has tried everything short of residential care, whether the behavior is experimentation or something more serious, and how to pay for treatment. These questions differ from those facing families of adults because parents remain responsible for their child’s safety, education, and care.

How hard is it to find adolescent residential addiction treatment?

A 2024 study published in Health Affairs identified 160 U.S. residential addiction treatment programs serving adolescents with opioid use disorder, and among programs with a waitlist the average wait for a bed was 28.4 days. Options narrow further when families need insurance coverage or care close to home.

What role do parents play while their adolescent is in treatment?

Parents remain their child’s parent but must trust the program with much of their child’s day-to-day care, often with limited insight into progress. They face difficult moments, such as when their child calls home unhappy or asks to leave, and need consistent communication, education, and support to respond well and to work constructively with the care team.

How can treatment programs better support parents of adolescents?

Parents need more than an occasional family session: help understanding what to expect, guidance for talking with their child, a constructive way to work with the care team, and preparation for the return home. Support ideally begins before admission, while parents are still considering care, and continues through treatment and the transition home.

Sources

• Health Affairs (2024). Study of U.S. residential addiction treatment programs serving adolescents with opioid use disorder (160 programs; average waitlist of 28.4 days)

• SAMHSA, Treatment Improvement Protocol (TIP) 39: Substance Use Disorder Treatment and Family Therapy (updated 2020)

• Children and Youth Services Review (2024). Identifying family engagement priorities in youth residential treatment settings: A group concept mapping study

• Hogue, A., et al. (2021). Family involvement in treatment and recovery for substance use disorders among transition-age youth. Journal of Marital and Family Therapy