Substance abuse among adolescents (13 to 18 years old) is a serious and growing problem. It is important to identify effective treatments for those who are opioid dependent. For adults, pharmacotherapy is a necessary and acceptable part of effective treatment. Detoxification agents are used to reduce withdrawal symptoms during managed withdrawal but the rate of completion of detoxification tends to be low, and rates of relapse are high. Withdrawal symptoms, particularly drug craving, may continue for weeks and even months after detoxification. The period of recovery from dependence is typically influenced by a range of psychological, social and treatment related factors. Detoxification treatments include methadone, buprenorphine, and alpha2-adrenergic agonists. Medications have been used less frequently in treating substance abuse disorders among adolescents.The review authors searched the literature for controlled clinical trials investigating pharmacological interventions with or without psychosocial intervention aimed at detoxification in adolescents.They found only two US trial, one compared 28-day treatment with buprenorphine, using tablets placed under the tongue, to wearing a clonidine patch in 36 opiate dependent adolescents who were treated as outpatients. The trial reported a trend in favour of buprenorphine in reducing the dropout rate but no difference between treatments in the duration and severity of withdrawal symptoms. More participants in the buprenorphine group went on to long-term naltrexone treatment. Side effects were not reported. The other trial compared maintenance treatment vs detoxification treatment: buprenorphine-naloxone maintenance vs buprenorphine detoxification. For drop out the results were in favour of maintenance treatment, as well as for results at follow up; no differences for use of opiate.Methadone is the most frequently used drug for the treatment of opioid withdrawal yet the review authors did not find any controlled trial using methadone. Conducting trials with young people may be difficult for both practical and ethical reasons.