The 18th birthday problem: what changes when your child becomes a legal adult
In Georgia, the age of majority is 18. When your child turns 18, they gain full legal autonomy over their healthcare decisions. This includes the right to consent to or refuse addiction treatment and mental health care.
For parents who have been managing their child’s health decisions for 18 years, this shift can feel sudden and disorienting, especially when substance use is involved. The person you raised, fed, drove to school, and took to the pediatrician can now legally refuse to see a doctor, leave a treatment facility, or decline help entirely.
Understanding what you can and cannot do is the first step toward being effective.
- You can set boundaries in your own home (including requiring sobriety as a condition of living with you)
- You can stop funding behavior that supports substance use
- You can offer to help them find treatment and offer to pay for it
- You can educate yourself about addiction so you understand what they are experiencing
- You can attend family therapy or support groups (Al-Anon, Nar-Anon) whether or not your child is in treatment
- You can be ready when they are ready
- You can request a professional intervention through a licensed interventionist
- You cannot consent to addiction treatment on their behalf
- You cannot access their medical records without their written authorization
- You cannot force them into treatment (with narrow exceptions for involuntary commitment in life-threatening situations)
- You cannot contact their treatment providers for information unless they sign a release
- You cannot make them stay in a treatment program
Georgia law (O.C.G.A. § 37-3-41) allows for involuntary psychiatric evaluation (commonly called a 1013) when a person is an imminent danger to themselves or others due to mental illness. This can apply to substance use disorders in extreme situations, such as active psychosis, suicidal behavior, or overdose.
However, involuntary commitment is not a treatment plan. It is a crisis intervention that typically results in a 48-72 hour hold for evaluation. It does not compel the person to enter addiction treatment after discharge. It is a last resort, not a strategy.
Why young adults are at the highest risk
The numbers
- 39% of 18-25 year olds used an illegal drug in the past year, the highest rate of any age group
- 1 in 4 (9.8 million) young adults needed substance abuse treatment in the past year
- Only 16.6% of those who needed treatment received it
- 28.9% of Georgia young adults reported binge drinking in the past month
- 14% of Georgia young adults ages 18-25 have an alcohol use disorder
- Methamphetamine is the primary drug for 22.4% of Georgians ages 21-25
- Users who try drugs before age 15 are 6.5x more likely to develop a substance use disorder than those who wait until 21
Why this age group
Warning signs parents miss
Parents of young adults often miss early signs of substance use because they are no longer living with their child full-time, because they attribute behavioral changes to “growing up,” or because they do not know what to look for in an adult context.
- Dropping out of college or switching majors repeatedly (may indicate inability to function academically due to substance use)
- Frequent requests for money with vague explanations
- New friend group that you have never met
- Sleep schedule that seems erratic or reversed
- Weight loss or gain that they cannot explain
- Avoiding family events or holidays
- Defensiveness when asked about their life
- Car accidents, traffic tickets, or legal trouble
- Loss of job or inability to hold a job
- Borrowing money and not paying it back
- Items missing from your home after visits
- Finding drug paraphernalia (pipes, syringes, burnt foil, small baggies)
- Track marks on arms or legs
- Dramatic personality changes: someone who was gentle becomes aggressive, or someone who was social becomes withdrawn
- Paranoia, hallucinations, or delusional thinking
- Nodding off mid-conversation
- Pinpoint pupils or extremely dilated pupils
- Expressing hopelessness, worthlessness, or suicidal thoughts
- Overdose (call 911 immediately, Georgia’s 911 Medical Amnesty Law protects both of you)
Substances most commonly misused by first responders
Alcohol
Alcohol is the most commonly used substance among young adults. Nearly half of 18-25 year olds report past-month use. Binge drinking (5+ drinks in a single session) is reported by 28.9% of Georgia young adults. Because alcohol is legal, socially acceptable, and embedded in college and young professional culture, many parents do not recognize when social drinking has crossed into dependence.
Medical detox for withdrawal (which can be life-threatening with alcohol), naltrexone or Vivitrol to reduce cravings, CBT to address triggers, group therapy.
Marijuana
Marijuana is the most commonly used illegal drug among young adults. Georgia has not legalized recreational use, though low-THC oil is legal for certain medical conditions. High-potency THC products (concentrates, edibles, vape cartridges) have changed the risk profile of marijuana significantly compared to previous generations.
Daily use, inability to function without it, loss of motivation, academic or job performance decline, using before driving, anxiety or paranoia when not using, withdrawal symptoms (irritability, insomnia, loss of appetite).
Today’s marijuana products can contain 60-90% THC compared to 3-5% in the 1990s. This is not the same drug you may have tried in college. High-potency THC is associated with increased risk of psychosis, particularly in young adults with developing brains.
Fentanyl and opioids
Fentanyl is the leading cause of overdose death in Georgia and nationwide for adults under 35. It is 50-100 times more potent than morphine and is now found in counterfeit prescription pills, heroin, cocaine, and even marijuana. Many young adults do not know they are taking fentanyl.
Counterfeit pills sold as Percocet, Xanax, or Adderall that actually contain fentanyl. Purchased through social media or from peers. A single pill can contain a lethal dose.
Medication-assisted treatment (MAT) with buprenorphine, naltrexone, or Vivitrol. MAT is the most effective approach for opioid use disorder and significantly reduces overdose death risk.
Stimulants (Adderall, cocaine, methamphetamine)
Prescription stimulant misuse is common among college students who use Adderall or Ritalin (often obtained from friends with prescriptions) as study aids. Cocaine use is prevalent in social and party settings. Methamphetamine is the primary drug of abuse for 22.4% of Georgians ages 21-25, particularly in suburban and rural areas.
Benzodiazepines
Xanax is one of the most commonly misused substances among young adults. Often combined with alcohol, which dramatically increases overdose risk. Some young adults obtain prescriptions for anxiety and develop dependence; others buy pills from peers or online.
Benzodiazepine withdrawal can cause seizures and death. Never stop taking benzodiazepines abruptly. Medical detox with a supervised taper is required.
How to talk to your young adult about substance use
This is the conversation most parents dread. The instinct is to confront, lecture, threaten, or issue an ultimatum. Research consistently shows that none of these approaches work with young adults. What does work is a combination of honesty, boundaries, and patience.
What works
“I’ve noticed some changes and I’m worried about you” is more effective than “I know you’re using drugs.” The first opens a conversation. The second triggers defensiveness.
“You’ve lost weight, you’ve missed work three times this month, and you asked me for money twice” is concrete. “You seem different” is dismissable.
“I love you and I’m worried about what’s happening” is different from “You’re ruining your life.” Addiction carries enormous shame already. Adding more shame pushes people away from help, not toward it.
“You can’t live here if you’re using” is a boundary. “If you don’t stop, I’ll never speak to you again” is a threat. Boundaries protect you. Threats try to control them. Boundaries you enforce. Threats you usually don’t.
What does not work
- Lecturing or repeating yourself (they heard you the first time)
- Comparing them to siblings or peers
- Threatening to cut them off entirely (and then not following through)
- Trying to monitor or control their behavior as if they were still a minor
- Enabling by giving money, paying rent, or covering consequences
- Pretending the problem does not exist because the alternative is too painful
Treatment options for young adults in Georgia
Treatment for young adults is most effective when it addresses both the substance use and the developmental stage. An 18-year-old has different needs than a 45-year-old. Programs designed for young adults account for this.
Levels of care
What makes young adult treatment different
- Peer groups composed of other young adults (not mixed-age groups where a 22-year-old is in therapy with a 55-year-old)
- Focus on life skills: employment, financial literacy, healthy relationships, independent living
- Academic support or re-enrollment planning for those who left school
- Treatment for co-occurring mental health conditions (anxiety, depression, ADHD, trauma) which are highly prevalent in this age group
- Family therapy that addresses the parent-adult child dynamic, not the parent-minor dynamic
- Aftercare and alumni support to sustain recovery during the critical first year
Evidence-based approaches
Paying for treatment
Cost is one of the most common reasons families delay treatment. Understanding your options can remove this barrier.
Insurance
Most major insurance plans are required to cover addiction treatment under the Mental Health Parity and Addiction Equity Act. This includes detox, inpatient, outpatient, and medication-assisted treatment. If your young adult is still on your insurance (they can remain on a parent’s plan until age 26 under the ACA), your plan likely covers treatment.
Lanier Recovery Center accepts most major insurance plans and can verify coverage before you commit to anything. Call (470) 470-5697 for a free, confidential insurance verification.
If your young adult is uninsured
- Georgia Medicaid may cover treatment for qualifying individuals
- SAMHSA’s treatment locator (findtreatment.gov) includes facilities that accept uninsured patients
- Georgia DBHDD administers state-funded treatment programs
- Sliding scale payment options may be available
Georgia crisis and support resources
Crisis lines
(470) 470-5697, confidential line for families and young adults considering treatment
Overdose response
If you suspect an overdose, call 911 immediately. Georgia’s 911 Medical Amnesty Law (O.C.G.A. § 16-13-5) protects both the person overdosing and the person who calls for help from drug possession charges. Do not hesitate to call. Naloxone (Narcan) can reverse an opioid overdose and is available at most Georgia pharmacies without a prescription.
Support for parents
Local resources
What you can do right now
- Educate yourself. Read this guide. Understand what addiction is (a medical condition) and what it is not (a moral failing or a choice). The more you understand, the more effective you will be.
- Get support for yourself. Call Al-Anon or Nar-Anon. Attend a meeting. You cannot pour from an empty cup. Parents who have their own support system are more effective at supporting their child.
- Set boundaries. Decide what you will and will not accept, communicate it clearly, and follow through consistently. This is the hardest part. Boundaries without follow-through are just suggestions.
- Stop enabling. Enabling is anything you do that makes it easier for your child to continue using. Paying their rent, giving them cash, bailing them out of legal trouble, making excuses for them. Stopping is painful but necessary.
- Have the conversation. Use the guidance in this guide. Lead with love, be specific, respect their autonomy, and keep the door open.
- Know what treatment options exist. When your child is ready, you need to be ready too. Having a plan in place means you can act quickly when the window opens.
- Call us. Lanier Recovery Center’s admissions team can walk you through your options, verify insurance, and help you plan next steps. The call is free and confidential. You do not need to have all the answers before you pick up the phone.
Frequently Asked Questions
Can I force my 18-year-old into treatment in Georgia?
Generally, no. At 18, your child is a legal adult and can consent to or refuse treatment. Involuntary commitment (1013) is available in Georgia for situations where a person is an imminent danger to themselves or others, but this is a short-term crisis intervention, not a treatment plan.
My child is on my insurance. Can I use that to get them into treatment?
What if they refuse help?
This is the most painful scenario and it is common. You cannot force an adult into recovery. What you can do is set boundaries, stop enabling, get support for yourself, and be ready when they are ready. Research shows that the CRAFT method (Community Reinforcement and Family Training) is more effective at motivating a loved one to enter treatment than confrontational intervention or detachment.
How do I know if it is addiction or just 'being young'?
Experimentation is developmentally normal. Addiction is characterized by continued use despite negative consequences, inability to stop or reduce use, tolerance (needing more to get the same effect), withdrawal symptoms, and neglect of responsibilities. If substance use is causing problems in their life and they cannot stop, it has crossed a line.
What if they have a mental health condition too?
Co-occurring mental health conditions (anxiety, depression, ADHD, PTSD, bipolar disorder) are extremely common in young adults with substance use disorders. Treatment should address both conditions simultaneously. This is called dual diagnosis treatment. Treating one without the other typically leads to relapse.
Is marijuana really a problem? It is legal in some states.
Marijuana is not legal for recreational use in Georgia. More importantly, today’s marijuana products can contain 60-90% THC, compared to 3-5% in previous generations. High-potency THC is associated with increased risk of psychosis, particularly in young adults whose brains are still developing. If marijuana use is interfering with your child’s ability to function, it is a problem regardless of its legal status elsewhere.
How much does treatment cost?
Most insurance plans cover addiction treatment. Lanier Recovery Center accepts most major insurance and can verify your coverage before you commit to anything. For uninsured individuals, state-funded options and sliding scale programs exist. Call (470) 470-5697 for a free insurance check.
Need help?
If your young adult is struggling with substance use and you are not sure what to do next, call Lanier Recovery Center. Our admissions team understands the specific concerns parents face and can walk you through your options.
Call (470) 470-5697 for a confidential conversation.
Sources
- SAMHSA. (2024). National Survey on Drug Use and Health. U.S. DHHS.
- SAMHSA. (2024). Key Substance Use and Mental Health Indicators: 2023 NSDUH.
- National Center for Drug Abuse Statistics. (2025). Substance Abuse and Addiction Statistics.
- World Forum for Mental Health. (2025). Georgia Drug and Alcohol Statistics.
- Georgia DPH. (2022). Drug Overdose Mortality, Georgia, 2012-2021.
- Georgia Bureau of Investigation. (2024). Crime Statistics.
- Georgia General Assembly. (2014). HB 965: Georgia 911 Medical Amnesty Law. O.C.G.A. § 16-13-5.
- Georgia Code. O.C.G.A. § 37-3-41: Involuntary Evaluation and Treatment.
- Georgia Code. O.C.G.A. § 31-9-2: Consent for Medical Treatment.
- NIDA. (2020). Drugs, Brains, and Behavior: The Science of Addiction. NIH.
- CDC. (2024). Drug Overdose Deaths. National Center for Health Statistics.
- NAMI. (2024). Mental Health by the Numbers.
- Meyers, R. J., et al. (2002). Community Reinforcement and Family Training (CRAFT). J Substance Abuse Treatment, 23(1), 1-8.
- NIAAA. (2023). College Drinking Fact Sheet.
- Georgia DBHDD. (2025). Substance Abuse Prevention.
- Partnership to End Addiction. (2025). Resources for Parents.
- U.S. Department of Labor. Family and Medical Leave Act.
- CMS. Mental Health Parity and Addiction Equity Act. 42 U.S.C. § 300gg-26.
- America’s Health Rankings. (2024). Youth Illicit Drug Use, Georgia.
- SAMHSA. (2024). 2024 State Report: Underage Drinking Prevention, Georgia.
