Approximately 37% of admissions to a recently developed program for first episode patients met criteria for substance abuse or dependence as well as criteria for one of the schizophrenia spectrum disorders. In this program the issue of substance use is addressed at the initial assessment and throughout the program. Several intervention strategies are integrated within the range of available psychosocial treatments. Additionally, we offer a specifically designed treatment strategy. This paper describes our 2-year experience with an integrated approach to reduce substance use in a specialized treatment program for individuals experiencing a first episode of psychosis.