Duke Center for Adolescent and Young Adult Substance Use Treatment (CAST)

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

We provide a broad range of recovery-oriented services for adolescents, young adults, and families suffering from the harmful effects of substance use. We start with a comprehensive evaluation which includes a clinical interview with the adolescent/ young adult and family including urine drug screening. Following our comprehensive evaluations, we share our clinical impressions and recommendations for care tailored to the needs of the individual. Our clinicians know the resources available for outpatient, intensive outpatient, crisis stabilization, residential and long term residential treatment. We realize that many adolescents and young adults come to evaluations with some hesitation, and our clinicians are trained in working with people who may be ambivalent about change.

We view substance use problems as having biological, psychological, social, family, and spiritual manifestations. We know that recovery is possible and that the most effective program involves treating the whole person and family. 

Clinical Services

  • Adolescents and young adults, ages 13-24
  • Comprehensive substance use disorder evaluations and recommendations
  • Individual, family, group therapy
  • Intensive outpatient therapy
  • School-mandated substance use treatment programs
  • Therapy for individuals provided opioid replacement treatment

Therapeutic modalities utilized:

Family systems, motivational enhancement, cognitive behavioral, psycho-educational, introduction to social support networks. 

Program Staff:

Paul Nagy, LPC, LCAS, CCS - Program Clinical Supervisor

Latoya Dunston, LPC-A, LCAS-A - Program Counselor

Angela M. Tunno, Ph.D., MS - Coping Skills Group Leader

Anna Van Dis, LCSW - Teen Yoga Instructor

Gary Sauls, LCAS - Program Founder and Senior Consultant

David Goldston, Ph.D. - Administrative Director

CAST Program descriptions

Outpatient Substance Use Evaluations (OPE)

Outpatient evaluations include comprehensive individual and family interviews, urine drug screening, and a feedback session to the adolescent/young adult 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 or twice a week. Urine drug testing is a part of this model. Psychiatric evaluation and medication management can be arranged as needed. Clinicians take a family systems approach in many cases, also providing psycho-education, cognitive behavioral therapy, and motivational enhancement therapy depending on the needs of the adolescent or young adult. 

Intensive Outpatient Substance Use Treatment Program (IOP)

We provide the industry standard of nine hours per week of group therapy for the IOP with an additional hour of weekly family therapy.  Patient and families may utilize our twenty-four hour on-call pager that greatly decreases family conflict, improves crisis stabilization, and works to eliminate visits to emergency facilities. Patients participate in weekly yoga and meditation, DBT-informed skills groups, and cognitive behavioral relapse prevention groups. We also help introduce our patients to members of the local recovery community so that they can see recovery as a lived reality. We use a family systems model for family work in both the parent support groups and the multi-family groups. Psychiatric and/ or psychological evaluations are available upon entrance into the program and when necessary thereafter. Outpatient, individual, family and group counseling are available as a step down from the IOP. 

12 Hour School Substance Use Treatment Program (12OP)

This program is for adolescents who have violated school system policies regarding possession and/ or use of alcohol or drugs on school property. Twelve hours of family-centered substance use education and counseling are provided as an alternative to long term suspension. This program serves local schools including the public schools in Durham and Wake counties.

For ALL referrals, contact our CAST Team at 919-681-2091.