OBJECTIVES: The purpose of this research is to determine if a 24-hour telephonic hotline is associated with lower post treatment relapse rates for adolescents treated for psychoactive substance use disorder (PSUD). METHODS: Subjects are 246 adolescents discharged from primary substance abuse treatment from 2005-2006. A total of 130 were discharged before implementation of the hotline and 116 were discharged after its implementation. The survey was based on a 234-item questionnaire. Response rate was 62%. Treatment records of adolescents completing the questionnaire were obtained so treatment outcomes from the questionnaire could be matched to variables contained in treatment records. A comprehensive data set was created from these two sources. Data are analyzed using three Cox regression models. The first model includes all 246 subjects using, as covariates, psychosocial and treatment characteristics associated with abstinence. The effects of the hotline (not available versus available) is compared by means of a stratification variable yielding two separate survival functions. Model two includes those without access to the hotline and model three includes those with access to the hotline. RESULTS: Model one indicates a better cumulative survival function for those with access to the hotline (Chi-square 46.9 p=0.085). In model two (Chi-square 53.2 p=0.025), boys and those diagnosed with alcohol abuse/dependence are 2.8 and 3.5 times more likely to relapse (respectively), and those on probation, those attending support groups and those with supportive friends, are 51.2, 82.1, and 10.7% less likely to relapse (respectively). In model three (Chi-square 49.3 p<0.000), gender, diagnosis of alcohol abuse/dependence, and probation status, support group attendance and peer-support were at parity. CONCLUSIONS: The telephone hotline is associated with lower post treatment relapse rates, may improve the odds that boys and those with alcohol abuse/dependence remain abstinent, and may lessen the influence of support groups and peer-support on abstinence.