When parents determine that their child has a substance abuse problem, they’ve just taken the first step on what could be a long and difficult road.

Some families discover that it’s not easy to find affordable, effective treatment close to home.

"There’s not a lot of options locally," said Betty Guilfoile, area services director of Avita Community Partners in Gainesville.

Her agency, formerly known as Georgia Mountains Community Services, provides mental health treatment with some funding from the Georgia Department of Human Resources.

Though there are private treatment programs in metro Atlanta, for many families in Northeast Georgia, Avita is the most feasible choice.

Guilfoile said Avita’s child and adolescent services office, located on Interstate Ridge Road, provides individual, family and group therapy, along with an intensive outpatient substance abuse program.

"It’s based on a program called Seven Challenges, and it gets kids to take a look at their lives," she said.

Teens attend sessions from 4 to 6 p.m. three days a week and stay in the program for an average of 12 weeks.

"It’s all about changing behavior," Guilfoile said. "We work on their life skills, assertiveness, making good decisions, setting goals."

Thanks to state subsidies, payment is on a sliding fee scale based on income. The program also accepts Medicaid and PeachCare.

"We never turn anyone away for inability to pay," Guilfoile said.

Avita also operates a group home in Gainesville for adolescent boys with substance abuse problems.

"It’s for kids who are in an unhealthy home environment," she said. "The average stay is about six months."

In order to get sober, many teens need to be removed from the circumstances that led them to abuse drugs in the first place.

"It can be hard for kids to go back to school, where they’re known as a drug user," Guilfoile said. "They have to find a new peer group, but the nondrug kids may not accept them. Sometimes it helps to hook them up with a church. A lot of churches are offering recovery programs now."

Some teens need more than just "talk therapy," she said.

"A lot of kids who use drugs also have underlying mental health problems that need to be addressed," Guilfoile said. "We have a psychiatrist on staff full time (who can prescribe medication). But we don’t prescribe drugs that people tend to get addicted to."

Avita does not provide inpatient treatment. For that, the only local option is Laurelwood, the mental health unit of Northeast Georgia Medical Center. The program accepts children ages 12 and older. But most people need inpatient treatment only if they are psychotic, suicidal or experiencing severe withdrawal symptoms.

Dr. Jeff Black, a psychiatrist at Laurelwood, said kids who stop taking drugs usually don’t go through the agonizing withdrawal that adults do, possibly because they haven’t been using for very long.

When hospitalization is required, the stay is typically brief. Laurelwood is not state-funded, and families usually either have insurance or pay the bill out of their own pocket.

After being discharged, teens are referred for outpatient therapy. Black strongly recommends that they enroll in a 12-step program such as Alcoholics Anonymous or Narcotics Anonymous.

"Twelve-step programs are the most effective, in my opinion," he said. "It’s a very powerful therapeutic tool. And there’s accountability. It requires people to make a commitment. Continuing to go to meetings prevents them from returning to old patterns of behavior."

Black said patients are most likely to relapse when they revisit the friends and locations where their drug abuse occurred.

But he said parents should not despair if their child has a relapse.

"The average person (recovering from addiction) has about four relapses over a lifetime," he said.

If the family is paying for treatment, relapses can be frustrating, because it may seem as if money is just being thrown down the drain. But Guilfoile said each round of therapy is a step toward success.

"Most people in recovery will relapse a number of times," she said. "But each time they go through a program, they learn something new."

Black said the key is to permanently change the person’s focus in life. He believes "Just Say No" programs, which merely tell teens what not to do, are worthless.

"It’s better to help kids increase their sense of self-worth, find out what their passions are, get them involved in doing things for others," he said. "The kids who make it are those that had an adult who took an interest in them, even if it wasn’t a parent."