Teen Vaping, Cannabis and Alcohol: Outpatient Options

If you have found a vape, cannabis or alcohol, or your teen’s grades, mood or friends have changed, an outpatient assessment is a sensible first step, and most high school students can be helped without leaving school or going to a program away from home. Blackburn Clinical Services offers one-on-one outpatient therapy in our West Los Angeles office or by secure video (for clients located in California) for teens 13 to 17, with family sessions for parents. Our Concierge Outpatient Program is an individualized alternative to a traditional intensive outpatient program, with no groups.

How common is this in high school?

Very common, and not limited to any kind of school. In the 2023 Youth Risk Behavior Survey, the Centers for Disease Control and Prevention found that 22 percent of U.S. high school students currently drank alcohol and 17 percent currently used marijuana. The CDC also reported that about 1.21 million high school students used e-cigarettes in 2024. Vapes can hold nicotine or cannabis, and both are easy to hide.

Spending money, unsupervised time on long commutes and pressure to keep up can all make substances easier to get and easier to hide. Some teens use to cope with anxiety, sleep or stress, which is why we look at mental health and substance use together.

Signs parents notice

• vape devices, pods, chargers or sweet smelling clouds; edibles, cartridges or empty bottles
• red eyes, unusual sleepiness, increased appetite or a change in sleep schedule
• sudden changes in friends, secrecy about plans or a locked phone
• missing money, or purchases they cannot explain
• slipping grades, missed assignments or trouble at school
• irritability, anxiety or low mood, especially when they cannot use

Outpatient options at Blackburn

• An assessment. We start by understanding what your teen is using, how often, why, and what else is going on, such as anxiety, depression, ADHD or trauma.
• Weekly one-on-one therapy in our office or by secure video for clients located in California. For many teens, regular therapy plus family sessions is enough. Approaches include CBT, DBT and ACT.
• The Blackburn Concierge Outpatient Program. For teens who need more, this individualized alternative to traditional IOP offers typically 3 to 5 hours a week of focused one-on-one therapy. There are no groups and no hour requirements; care flexes with clinical need and begins with a biopsychosocial assessment. Psychiatric support, medication management, coaching or case management can be included as needed.
• Family sessions. Parents learn how to set limits, monitor without constant fights and respond to a slip. If your family decides drug testing should be part of the plan, Blackburn Monitoring, a sister organization, offers it.
• Co-occurring conditions. When anxiety, depression or trauma is part of the picture, we treat them together. See dual diagnosis treatment.
• Hours: Monday to Friday, 9 AM to 5 PM, scheduled within those hours to work around the school day.

Some families are told their teen needs a group based program. For many teens, especially those worried about privacy in a small school community, one-on-one care is a better fit. If an assessment shows your teen needs a higher level of care, we will tell you.

What parents can do this week

• Wait until everyone is calm. Talk when your teen is sober and you are not angry.
• Be specific and curious. Say what you found or noticed, then ask questions and listen.
• Set clear, short-term rules. For example, no driving, curfews and phone access tied to safety.
• Remove easy access. Lock up alcohol and medications at home, including stimulants and pain medicine.
• Talk about pills. Tell your teen never to take a pill that did not come from a pharmacy with their name on it, even from a friend.
• Call for an assessment. You do not have to decide alone how serious it is.

When to get urgent help

Call 911 if your teen is unresponsive, has slow or stopped breathing, is vomiting while very drunk, or you suspect an overdose. If your teen talks about wanting to die or you are worried about their safety, call or text 988 to reach the 988 Suicide and Crisis Lifeline.

When vaping or drinking comes with anxiety, depression or trauma, see teen dual diagnosis treatment in Los Angeles.

Questions

Does my teen need to go to rehab?

Not necessarily. Many high school students can be treated outpatient while staying in school. An assessment helps decide the right level of care.

Are there groups in your outpatient program?

No. The Blackburn Concierge Outpatient Program is entirely one-on-one, typically 3 to 5 hours a week of focused therapy, with no groups.

Is vaping really a big deal?

Teens who vape often use many times a day, and it can become hard to stop. If your teen cannot stop, or uses to manage stress or sleep, it is worth getting help.

Will the school be told?

Not by us without your written permission. Many families prefer to handle this privately.

Can parents be part of treatment?

Yes. Family sessions are a core part of care for teens, and parents can get guidance of their own.

Can you help with anxiety or depression too?

Yes. Substance use and mental health often go together in teens, and we treat both.

More for families: therapy for private school students and alcohol use treatment.

Get started

You can also email info@blackburnclinical.com or contact us. Parents usually make the first call; your teen does not need to be on the line.

Sources

• Centers for Disease Control and Prevention: YRBS Data Summary and Trends Report, 2013 to 2023
• Centers for Disease Control and Prevention: Youth E-Cigarette Use Drops to Lowest Level in a Decade (2024)
• 988 Suicide and Crisis Lifeline