My teen is using drugs or alcohol: what help is out there?

This page is general information, not medical or legal advice. Do Not Lose Hope does not provide treatment or crisis help. This page is about teens. For adults, see How to find drug and alcohol treatment for an adult in California.

What should I do first?

1. Check for danger. If your teen cannot be woken up or has trouble breathing, call 911. Give naloxone (Narcan) if you have it. If you are not sure what they took, call Poison Control at 1-800-222-1222.
2. If your teen talks about wanting to die or hurting themselves, call or text 988 now. In a life threatening situation, call 911.
3. Wait until everyone is calm before the big talk. Not while your teen is high or drunk, and not while you are angry.
4. Talk with care. "I'm worried about you. I want to understand what is going on." Ask what the alcohol or drug does for them. Sleep? Stress? Friends? Sadness? See How to talk with your teen about alcohol and drugs.
5. Make one call this week. Your teen's doctor, the school counselor, or a county line listed above. You do not need to be sure how bad it is before you call.

Does getting help mean rehab?

Usually not. Help comes in levels, and many teens start with the lightest one, close to home. Santa Clara County lists these kinds of youth services:

• Early help. A short check of what your teen is using and why, plus education and counseling. Medi-Cal rules say a teen under 21 who is found at risk can get early intervention services without a diagnosis.
• Outpatient care. Your teen keeps living at home and going to school. They meet with a counselor alone, in a group or with the family. In Santa Clara County, this happens at county clinics and at some school sites.
• Intensive outpatient care. More hours each week for teens who need more support. Santa Clara County lists at least 6 hours a week.
• Residential care. Living for a time at a licensed treatment program. This is for teens with the highest needs. In Santa Clara County it is for ages 13 to 17 and needs special approval.
• Recovery support. Ongoing check ins and support groups after treatment, so progress lasts.

A trained counselor works with you and your teen to choose the level that fits. If your teen also seems sad, anxious or has been through something hard, say so. Santa Clara County says its youth therapists specialize in both mental health and substance use needs.

Who can help near home?

Outside San Mateo and Santa Clara counties, every California county has a drug and alcohol access line. Find yours on the DHCS county list. Outside California, call the SAMHSA National Helpline at 1-800-662-4357.

Your teen's doctor or clinic. A good first stop. Medi-Cal health plans must offer alcohol and drug screening, brief counseling and referral to members ages 11 and older who may have a problem.

San Mateo County, including East Palo Alto. Call the BHRS ACCESS Call Center at (800) 686-0101, any time. Staff speak English, Spanish and Chinese, and offer free interpreters for other languages. They give information, an assessment and a referral. You can call about your teen, not only for yourself. County treatment options include outpatient, residential, detox and medication treatment.

Santa Clara County. Call (800) 704-0900. The county's youth substance use services are for ages 12 to 21 and include outpatient, intensive outpatient, residential and recovery support. Many staff are bilingual. Services are free or low cost.

allcove (ages 12 to 25). Centers for young people, with substance use help, counseling and more. Free or low cost, and most services do not need a parent's consent. San Mateo (650) 226-7030, English, Spanish and Cantonese. Palo Alto (650) 798-6330, English, Spanish and Vietnamese.

StarVista Insights, Redwood City. San Mateo County's SMC Connect directory lists this teen drug and alcohol program for ages 13 to 18 and their families, with individual, family and group counseling and a parent and teen group, at 609 Price Avenue, Suite 101. It lists a sliding fee, Medi-Cal and Spanish. StarVista's own site did not list the program when we checked on October 21, 2026. Call ACCESS first and ask whether Insights is still open and how to reach it.

Your teen's school. Ask the school counselor what support the school offers. In Santa Clara County, some youth treatment happens at school sites.

How do we pay for it?

If your teen has full Medi-Cal and is under 21, Medi-Cal must cover the substance use services your teen needs under the federal children's health rule called EPSDT. Counties must provide screening and early intervention, plus treatment, including residential care when it is needed.

If your teen does not have Medi-Cal yet, apply. Children and teens 0 to 18 can get full Medi-Cal whatever their immigration status, if they meet the other rules, such as income. Children do not pay the Medi-Cal premium DHCS plans for some adults starting July 2027 (DHCS). Apply online, by phone, by mail or at a county office. Questions: Medi-Cal helpline 1-800-541-5555.

A change on January 1, 2027. DHCS will move Medi-Cal members with unsatisfactory immigration status (undocumented, PRUCOL including DACA, green card holders in the five year wait), children included, from health plans to Fee for Service Medi-Cal. Your teen keeps Medi-Cal, and county drug and alcohol treatment continues. What changes is how you reach a doctor, since there is no health plan to call (DHCS FFS transition page, updated October 14, 2026). For help finding a provider, call 1-800-541-5555.

If you have private insurance, call the number on the card and ask for "behavioral health" or "substance use" services for a teen.

If you have no insurance, San Mateo County BHRS says it uses a sliding fee and turns no one away for lack of funds. Santa Clara County says its youth services are free or low cost and offers a financial help application.

Can my teen get help without me?

Yes, in many cases. In California, a teen 12 or older can agree on their own to medical care and counseling for a drug or alcohol problem. This law also says:

• The provider should involve a parent if appropriate. The provider decides, and must write down whether and when they tried to contact you.
• You usually do not have to pay for care your teen gets this way. If you join the counseling yourself, you can be charged for it.
• Some medicines need a parent's consent. Replacement narcotic treatment, such as methadone, at a licensed program needs a parent or guardian's consent. For other opioid medicines, ask the provider.

Santa Clara County says its youth outpatient treatment does not require a parent to be involved, but parents are encouraged to take part, and treatment information is shared only with the teen's consent.

This can feel hard as a parent. Remember why the law works this way: some teens will only get help if they can go on their own. If your teen is getting help, that is good news, even if you are not in the room.

What if my teen will not go?

California law respects a parent's right to seek care for a teen's drug or alcohol problem even when the teen does not agree. When a parent seeks that care, the doctor must share the teen's medical information with the parent who asks.

In real life, help works best when your teen is willing. Some ways to get there:

• Offer a choice, not an order. "Would you rather talk to Dr. Lee or the counselor at allcove?"
• Start with one visit. "Just go once and see."
• Get help for yourself first. Call a county line and ask how to support a teen who refuses. Your calm, steady presence matters.
• Keep your house rules, and keep showing love. Both together.

If your teen's use puts them in danger, such as driving after using or mixing pills, say so plainly and call a county line the same day.

How do I support my teen during treatment?

• Show up for family sessions if you are invited.
• Praise effort, not only results. Slips happen. A slip is a reason to keep going, not to quit.
• Lock up alcohol and medicines at home. Get rid of old pills at a pharmacy take back site.
• Keep naloxone at home if opioids or pills are part of the picture, and know where it is.
• Watch for sadness, anxiety or hopelessness. Tell the counselor. See When your teen is struggling.
• Take care of yourself. Talk with someone you trust. Support for you is support for your teen.

What should I avoid?

• Waiting for rock bottom. Help can start early. Medi-Cal even covers early help for teens at risk, before any diagnosis.
• Searching for a far away program first. Start with the county line or your teen's doctor.
• Paying for a program you found online without checking it. Ask if it is licensed and if it treats teens. Ask the county line for a referral.
• Shaming or threatening to throw your teen out. It pushes use out of sight, where you cannot help.

Questions parents ask

My teen only vapes or uses cannabis. Is that serious enough to get help? You can ask for help at any level. Early help is designed for teens at risk, before things get worse. The CDC says nicotine is highly addictive, so ask your teen's doctor about help quitting.

Will my teen get in trouble with the police if we ask for help? Federal law limits how drug and alcohol treatment records can be used to investigate or prosecute a patient. Generally that takes the patient's written consent or a court order. If your teen already has a legal case, ask a lawyer how treatment fits in.

Can the school find out? Ask the provider what they share and with whom. School counselors in California must keep what a student 12 or older tells them private, with some safety exceptions.

How long does treatment take? It depends on the teen and the level of care. Ask the program at the first visit, and ask how they will measure progress.

My teen is 19. Is this still the right page? County youth services in Santa Clara go up to 21, and allcove serves ages 12 to 25. For adult programs, see How to find drug and alcohol treatment for an adult in California.

Who can help

Contact them to confirm hours, languages and openings. Being listed here is not a referral or a promise of service.

• San Mateo County BHRS ACCESS Call Center: (800) 686-0101, 24/7, TTY 711. Alcohol and other drug services (smchealth.org)
• Santa Clara County Behavioral Health Services Call Center: (800) 704-0900. Youth substance use treatment (bhsd.santaclaracounty.gov)
• allcove: San Mateo (650) 226-7030; Palo Alto (650) 798-6330. allcove FAQ
• SAMHSA National Helpline: 1-800-662-4357, free referrals, 24/7, English and Spanish.
• Poison Control: 1-800-222-1222, 24/7.
• Medi-Cal helpline: 1-800-541-5555.
• 988 Suicide & Crisis Lifeline: call or text 988, or chat at 988lifeline.org. Also for alcohol or drug use concerns.

Is there something I can print?

Your teen is more than this moment. With the right help, many teens get through it and grow stronger. Keep going, one call at a time.