Assertive outreach strategies for narrowing the adolescent substance abuse treatment gap: implications for research, practice, and policy.
Ozechowski T.J., Waldron H.B. et al. Journal of Behavioral Health Services and Research: 2010, 37(1), p. 40–63.
This comprehensive US-focused review addresses the need to enrol more young problem substance users in treatment even if they at first refuse, validated methods for identifying such young people and engaging them in treatment with the help of family and others, and ethical and financial considerations involved in implementing these methods.

Summary
The Gateway Provider Model of youth service access hinges on equipping providers within so-called gateway service systems for youth with the knowledge and tools to recognise substance use problems, and to work in a coordinated manner across agencies to link youth exhibiting such problems with appropriate treatment services. Primary gateway service systems for adolescent substance abusers include juvenile justice, child and adolescent mental health, school-based counselling and other special programmes, emergency rooms, hospitals, and primary medical care settings, child welfare and related social services, as well as shelters and other facilities serving runaway and homeless youth.

However, specialised strategies may be warranted for the subpopulation of adolescents whose substance use disorders are unaccompanied by other emotional or behavioural disorders. In the USA, about one third to one half of the population of adolescents with substance use disorders may be relatively free of diagnosable comorbid conditions, which, some evidence suggests, may be associated with the likelihood of receiving substance abuse treatment. Specialised assertive outreach strategies may benefit this subpopulation given that such adolescents are unlikely to make contact with existing services and systems that could provide an entryway into substance abuse treatment, are relatively unlikely to have their substance use problems detected even if such contact is made, and may have parents who are not fully aware of the severity of their substance use problems and who may be unmotivated or unable to persuade or compel them to enter substance abuse treatment. The remainder of this review discussed some promising directions for developing assertive outreach strategies for this subpopulation which may also be useful for young people who do have other diagnosable comorbid conditions.