Adolescent Substance Use in Forensic Opinions: Separating Intoxication, Disorder, and Development in New York Juvenile Matters

Stephan M. Carlson, MD, MBA, FAPA · Juvenile and Family Forensics

When a teenager's case involves substances, three things tend to get collapsed into one: voluntary intoxication at the moment of an act, a diagnosable substance use disorder, and the ordinary immaturity of an adolescent brain. They carry different legal weight, and an opinion that fuses them usually proves less than counsel hoped. Why substance use is rarely a single forensic fact In adolescent matters, "substance use" can mean a one-time intoxication, an escalating pattern of misuse, a full substance use disorder with withdrawal and tolerance, or self-medication layered over trauma and untreated mood or attention problems. Each maps onto a different legal question. Acute intoxication speaks

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