Duke Center for Adolescent Substance Use Treatment (CAST)

Welcome to Duke’s Center for Adolescent Substance Use Treatment (CAST) program for adolescents and their families. CAST has over 20-years established history of providing evidence based addiction services for adolescents aged 13-24 and their families.

We provide a broad range of services for adolescents and their families suffering from the effects of substance use and addiction. We start with a comprehensive evaluation, clinical interview with the adolescent and family including urine drug screening. We do an interpretive to recommend specific levels of care. Our clinicians know the resources available for outpatient, intensive outpatient, crisis stabilization, residential and long term residential treatment. We know that most adolescents come to evaluations resistant and our clinicians are trained about rolling with that resistance.

Teenagers are in their prime developmental years. Substance use interrupts and delays this important process. Helping a teen return to normal developmental functioning is the primary goal of the treatment process.

We are not a crisis stabilization clinic. Some teens use substances as a result of suffering from other psychiatric problems and need additional care and sometimes stabilization before outpatient treatment can be helpful. We make appropriate referrals for assessments and treatment of other psychiatric problems that may be possible contributions to or results of substance use.

Addiction is treated as a medical issue with biological, emotional, social, family, and spiritual aspects/vulnerabilities. We know it is treatable and the most effective program involves treating the whole person and family. The CAST Program is family centered. We know it is difficult to maintain recovery without the active support of those around you, including family, extended family, and social/peer supports.

Clinical Services

  • Triage, comprehensive evaluation, interpretive, treatment and referral
  • Individual, family, group and intensive outpatient therapy
  • Therapy for individuals provided opiate replacement treatment
  • On-going residency, fellow and medical student training for psychiatry and pediatrics at Duke Medical as well as developmental pediatrician rotations from UNC Hospital

Therapeutic modalities utilized:

Family systems, motivational enhancement, cognitive behavioral, psycho-educational, introduction to social support networks. Manualized Intensive Outpatient Treatment (IOP), approximate 8 week cycle, and Drug Education and Counseling (DEAC), 8 1.5 hour cycle.

Program Staff:

John Looney, MD - Consultant Adolescent and Child Psychiatrist, Addictionologist

Gary Sauls, LCAS - Licensed Clinical Addictions Specialist, Program coordinator

Latoya Dunston, LCAS - Licensed Clinical Social worker with a specialty in addiction treatment and yoga

CAST Program descriptions

Adolescent Intensive Outpatient Substance Use Treatment Program (AIOP)

This program provides the industry standard of nine hours per week of group therapy for patients and an additional hour of weekly family therapy. Patients and families may access our 24 hour on-call system for crisis stabilization and family conflict, which often eliminates an urgent visit to a hospital Emergency Department. Adolescent group counseling is performed using a cognitive behavioral psychotherapeutic approach to help connect thoughts, feelings, and behaviors, as well as skill building. Family therapy during individual or multiple family group sessions takes a family systems approach. Patients participate in daily recreational activities that include outdoor sports. Outpatient psychiatric evaluations can be arranged when indicated. Abstinence is a program expectation. Various outpatient individual, family, or group counseling programs are available as a step down from the AIOP.

Outpatient Substance Use Evaluations (OPE)

Outpatient evaluations include comprehensive adolescent and family interviews, urine drug screening, and an interpretive with the adolescent and family members to discuss recommendations for treatment or referral. The evaluation covers all areas of functioning. Clinicians have expert knowledge of local or national services for referral or placement. Outpatient psychiatric evaluations can be arranged when indicated.

Outpatient Individual and Family Substance Use Treatment Program (OPT)

Outpatient treatment typically occurs once a week. Urine drug testing is a part of this model. Psychiatric evaluation and medication management when required are available through the substance use team. Clinicians take a family systems approach in most cases. Psycho-education, CBT and supportive counseling are also utilized. A level of care system is utilized to motivate change in both the patient and in his or her family. Abstinence is a goal in this level of care.

12 Hour School Substance Use Treatment Program (12OP)

This program is for adolescents who have violated school system policies regarding possession of alcohol or drugs or who have been caught using or have become intoxicated at school. Twelve (12) hours of family centered substance use education and counseling are provided. This is an alternative to long term suspension. Abstinence is required prior to completion of the 12 hour program. This program serves students in both the Durham and Wake county public school systems.

For ALL referrals, contact Gary Sauls, LCAS at 919-668-4497