California's Public Substance Use Disorder Treatment System for Youth: An Overview

Harbage Consulting

Adolescents and young adults often find it difficult to access substance use disorder treatment in California. This paper provides considerations for expanding public programs for youth.

September 2017
A aerial view of a city. The curvature of the Earth is visible in the background.

The earlier substance use begins, the more likely it is to continue into adulthood. Fully 90% of Americans who suffer with a substance use disorder (SUD) began using before age 18, so intervening with adolescents and young adults is critical to changing the trajectory of addiction. In California an estimated 8% of youth under age 18 need treatment for their substance use – about the same percentage as in the adult population.

California is in the process of redesigning its SUD treatment system under Medi-Cal, but access to effective, age-appropriate services for youth continues to be a challenge. This report describes the rules for Medi-Cal coverage of SUD treatment for youth under age 21, discusses adolescents' rights to consent for care independently, and explains the public financing streams for youth services. It summarizes effective treatment approaches specific to this population and offers considerations for the development of a comprehensive system of care for youth.

Key points include:

  • Brain development during adolescence means that younger people are particularly vulnerable to SUDs.
  • Medi-Cal covers a full range of SUD prevention, early intervention and treatment services, but responsibility for providing this care is divided among various entities.
  • Age-appropriate care during adolescence can be effective in treating SUDs.
  • Drug Medi-Cal Organized Delivery System (DMC-ODS) pilot programs are among those exploring new approaches to providing care to youth with SUDs.