The current conceptual review highlights considerations surrounding the potential for non-beneficence and undue coercion within the practices of psychologists and other clinicians providing substance use treatment for youth. The potential for nonbeneficence and undue coercion is assessed at three key stages of treatment for youth with substance use disorders (SUDs): the informed consent process, maintaining confidentiality, and treatment planning. We explore these concerns as they relate to the ethical principles of psychologists as outlined by the American Psychological Association (American Psychological Association [APA], 2017), as well as pertinent state and national legislative guidelines. The paper culminates in actionable recommendations to resolve these inconsistencies in practice and emphasizes opportunities for professionals at all career stages to engage in ethical policy initiatives. These endeavors aim to reduce potential for undue coercion and nonbeneficence from psychologists treating youth with substance use disorders and to elucidate beneficial treatment pathways for youth navigating substance use challenges.