Identity formation is a developmental milestone for adolescents, and their identities are constructed and re-constructed through their interactions with others and contextual factors in their environment. When considering adolescents with substance use disorders (SUD), often this developmental milestone is misappropriated, misunderstood, and misrepresented. The purpose of this article was to explore how adolescents with substance use disorders form identity and construct a sense of self. Firstly, we explored the identity formation and reconstruction of 20 female adolescents with SUDs based on an in-depth grounded theory methodology (GTM) which included a situational analysis (SA). Secondly, we offered a theoretical model to explain identity construction and reconstruction of adolescents with SUDs that emerged from this research. We conclude this article with practical implications for treatment, and care of adolescents with SUDs.