Objective: Childhood and adolescence represent a critical period for the potential initiation of substance use, and thus it is important that child and adolescent psychiatry (CAP) residents learn to screen, assess, refer, and/or treat children and adolescents who have substance abuse diagnoses. Method: The authors conducted a survey by mail of directors from all accredited U.S. CAP residency programs in order to describe addiction training in their respective programs. Results: Seventy percent of program directors responded and indicated diverse addiction training experiences for their residents. Findings indicate that the majority of CAP residents are treating patients with substance use disorders in both years of training and in multiple treatment settings. Conclusion: The survey provides preliminary data for system-level constraints that merit additional consideration in order to potentially advance addiction training in CAP residencies.