I completed my Pediatric internship, residency training and a Chief Residency at New York University Medical Center/Bellevue Hospital in New York City’s lower east side. At the time, in the early to middle 1990’s Bellevue Hospital cared for most of the homeless and indigent patients in New York City. As a trainee, I saw children and families plagued by poverty and all of its associated medical problems, including substance abuse. Medical staff members at Bellevue were trained to care for the conditions that resulted from substance use, but little training was devoted specifically to the treatment of substance-related disorders.

During this time period, I became interested in child and family advocacy, and after completing a year as a Chief Resident in Pediatrics, I accepted a Dyson Advocacy Training Fellowship in the Division of General Pediatrics at Children's Hospital Boston. After completing my training in 2000 I became the Director of Pediatrics for a new Adolescent Substance Abuse Program (ASAP). Shortly thereafter I received a career award from NIH to develop scientific skills in adolescent substance use disorders. In the ensuing years both clinical and research arms of ASAP have continued to grow and flourish.

ASAP is committed to delivering science based, family oriented, developmentally appropriate care for adolescents and young adults with substance use disorders. We are a "full spectrum" program, offering evaluation and treatment services for adolescents with a range of substance use experience, from new onset problems to addiction.

Just like other medical problems, optimal treatment for substance use disorders combines medical treatment with psychosocial support. For example, medications for nicotine use disorders can triple the odds of a successful quit attempt for young people who vape nicotine. Withdrawal symptoms from cannabis, including sleep difficulties, anxiety and irritability, can be mitigated with medication, but untreated, can make it challenging for a young person to sustain use reductions. Medications can also help treat symptoms of anxiety and depression that often co-occur with substance use. Ameliorating physical symptoms may alleviate a major barrier to behavior change while conveying empathy and reducing stigma. Substance use counseling can help young people identify and cope with cravings, find healthy ways of managing stress, and avoid triggers for substance use in addition to providing more general support. In ASAP, we also work with families to help them support their children through substance use treatment. The combination of medical treatment, counseling and support for families is very powerful.