ADOLESCENT SUBSTANCE ABUSE

Effects of Substance Abuse on Adolescents

Courtney Sack, Mackenzie Seyer, Maggie Shabel, Annika Sainio
Global Health Perspectives
Missouri State University & Satakunta University of Applied Sciences

Effects of Substance Abuse on Adolescents

There are many different perspectives of health in the world today. The World Health
Organization defines health as a state of complete physical, mental and social well-being and
not merely the absence of disease or infirmity (Harness & DeMarco, 2016, p. 63). Healthcare
providers may define health in a different way such as being free of illness/disease, getting

ADOLESCENT SUBSTANCE ABUSE

enough sleep each night, having adequate nutrition to sustain basic energy needs, and being
physically active. Health also incorporates being mentally and socially stable. Overall, one must
be content with his or her life. In contrast, adolescents that abuse substances view health in a
different perspective. To these individuals, rather than just having the absence of an
illness/disease, they see health as using substances such as drugs and alcohol to help their mental
and social well-being. Many substance abusers use substances to mask the symptoms of
underlying conditions such as depression and anxiety, so in order for them to feel healthy, they
abuse the drug. If the abusers are unable to attain substances, they may go through withdrawal
symptoms, which present as symptoms of illness. Having different views on health affects the
way individuals live his or her life.
Concerns for Health Promotion and Prevention of
Disease
There are many different areas of concern for a nurse addressing health promotion and
prevention of disease in adolescents with substance abuse issues. One concern that is constantly
being brought up in this vulnerability group is mental health issues. Many adolescents that abuse
drugs and substances also have mental health problems. According to an article Principles of
adolescent substance use disorder treatment: A research based guide (2014), adolescents with
substance abuse issues may suffer from depression, anxiety disorders, ADHD, oppositional
defiant disorder, and conduct problems. Therefore it would be necessary for treatment of these
issues to be included with treatment of substance abuse. Nurses need to be proactive about
identifying mental health issues in this population so that the adolescents feel as though they
have dignity and can live a healthy lifestyle without drugs. The same article states that stress
plays a significant role in starting and continuing drug use as well as returning to drug use

ADOLESCENT SUBSTANCE ABUSE

(relapsing) for those recovering from addiction. Nurses can promote health with this by helping
the adolescent find ways to cope with stress differently than alcohol such as exercise, support
groups, meditation, or activities in the community. Helping adolescents solve issues with mental
health will give these individuals the strength to not rely on substances to feel better. The nurse
needs to promote identification and treatment of mental health problems simultaneously with
treatment for substance abuse.
Safety is another area of concern for the nurse for those individuals abusing drugs. Safety
concerns may include problems such as infection, organ damage, and/or safety on roads.
According to the National Institute on Drug Abuse (2012), drug abuse not only weakens the
immune system but is also linked to risky behaviors like needle sharing and unsafe sex. The
combination greatly increases the likelihood of acquiring HIV-AIDS, hepatitis, and other
infectious diseases. Cocaine, inhalants, nicotine, PCP, heroin, and marijuana may also cause
respiratory effects on an individual such as difficulty breathing and lung cancer. The National
Institute on Drug Abuse (2012) also includes that there are more deaths, illness, and disabilities
from substance abuse than from any other preventable health condition. Today, one in four deaths
is attributable to alcohol, tobacco, and illicit drug use. Nurses should educate adolescents on the
short and long term effects of drug abuse and what can arise from substances. One safety concern
is with drinking under the influence of drugs or alcohol. Drugs can impair an individuals ability
to drive safely. Marijuana may decrease motor coordination, cocaine and meth may cause
aggressive driving, and sedatives may cause drowsiness which can all lead to accidents. In 2011,
the number of 12th grade students who drove after using marijuana was 12.4%, other illicit
drugs was 2.4%, and alcohol was 8.7% (OMalley, 2013), demonstrating that unexperienced

ADOLESCENT SUBSTANCE ABUSE

drivers were on the road under the influence of drugs. Safety is a major concern for the nurse
with health promotion and disease prevention.
Access to health services is another area of concern for the nurse. There are many reasons
why an adolescent is not getting the care needed for the substance abuse. According to
Principles of adolescent substance abuse use disorder treatment: A research based guide (2014),
only 10% of 12-17 year olds needing substance abuse treatment actually receive any services
By far the largest proportion of adolescents who receive treatment are referred by the juvenile
justice system. Adolescents are not receiving the treatment they need for their substance abuse
and instead are only getting the services they need if they get in trouble with the law first. This is
not acceptable and nurses need to promote easier ways for adolescents to access treatment
centers and health services.
In a study consisting of nineteen adolescents who abused substances, the researcher
concludes that Adolescents are using drugs because they are manifesting depressive traits or
symptoms but cannot be fully diagnosed with a clinical depression. This researcher has found
that these adolescents go on to use illicit substances in an attempt to self-medicate their
symptoms (Taylor, 2011). These adolescents are not receiving the appropriate care for their
depression and therefore feel the need to abuse drugs to treat the illness. Nurses need to find
resources for adolescents to access that will help them get the treatment they need for health
conditions which will then help them with substance abuse. This vulnerability group may also
not have the money to seek treatment, not feel the need to seek treatment, be scared of being
judged for their substance abuse problem and withdrawal symptoms, or may not have access to
transportation to health services. Nurses should be an advocate for these adolescents and help
them seek community resources to help with treatment and health services.

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5
Rehabilitation

In laymans terms, rehabilitation means to restore to good health. Depending on the

reason for the rehabilitation, the way to restore health can vary; however, education and therapy
are primary factors that promote the restoration of health. Rehabilitation is a major component of
nursing when it comes to treating substance abusers. Numerous approaches are used to
rehabilitate adolescent substance abusers throughout the United States. Included in these
approaches are behavioral approaches, family-based approaches, addiction medications, recovery
support services, and treatment referral sources.
Behavioral approaches use therapists or trained clinicians to promote a change in the
negative behavior (substance abuse). They often use incentives to encourage the adolescent to
remain abstinent, such as setting goals for them to reach, and by doing so strengthen their
motivation to change. The therapist works closely with the adolescent to help them modify their
behavior related to drug abuse. The therapist may also incorporate the family by helping them to
improve their communication and interactions so the adolescent can enhance their ability to
handle stressful situations that may lead them back to abusing. Methods are also taught on how
to replace the substance abuse with constructive and rewarding activities. Behavioral methods
that have shown promise in helping with the rehabilitation process include group therapy,
adolescent community reinforcement approach, cognitive-behavioral therapy, contingency
management, motivational enhancement therapy, and the twelve step facilitation method. A
common finding in all of these methods is that active participation is needed from the adolescent
on their road to recovery (NIH, 2014).
Another way to work toward rehabilitation in the adolescent is through a family-based
approach. Family-based methods include Brief Strategic Family Therapy, Family Behavior

ADOLESCENT SUBSTANCE ABUSE

Therapy, Functional Family Therapy, Multidimensional Family Therapy, and Multisystemic

Therapy. Family therapy highlights the importance of engaging the family (which can include
parents, siblings, grandparents, and peers) in the treatment process. Problems other than the
substance abuse are addressed, such as communication, school, and peer networks. Inclusion of
the family is crucial, especially since the adolescent is most likely to be living with the parents or
other family member. Outpatient settings are the most common way family therapy is offered. It
is believed that family-based approaches are the best and most effective methods for treating
adolescent substance abuse (NIH, 2014).
Although there are several medications that can treat addiction to numerous substances,
none of them have officially been approved for use in teenagers by the FDA. The
neurobiological impact of these medications has not been studied thoroughly enough to
accurately say they are safe for use in people under the age of eighteen whose brains are still
developing. However, some doctors may still choose to prescribe medications to the adolescent
(especially the older teen) addicted to nicotine, alcohol, or opioids. Cannabis,
methamphetamine, and cocaine have no FDA-approved medications that treat addiction to them
(NIH, 2014).
After rehabilitation treatment has been done, the teens may benefit from recovery support
services. Services focus on reinforcing the gains the adolescent made throughout treatment.
Often, the support service is a weekly group for them to attend and receive encouragement from
others struggling with similar problems. The community setting enables the adolescents to
provide mutual support and share experiences, ensuring that they are not alone in their struggle.
Recovery support services include Assertive Continuing Care, Mutual Help Groups, Peer
Recovery Support Groups, and Recovery High Schools. These services are not substitutes for

ADOLESCENT SUBSTANCE ABUSE

treatment and should only be used as add-ons after initiation of a treatment regimen has begun
(NIH, 2014).
Rehabilitation for substance abuse must be tailored to the specific teen. Each person has
their own unique traits. In order to ensure successful change, the adolescents treatment plan
must be built around the specific person, considering their strengths and weaknesses. The age,
level of physical and psychological development, sex, relationships, community, culture, and
family and peer relationships must all be taken into consideration during the initial assessment.
In other words, the treatment plan must address the needs of the whole person, rather than just
focusing on his or her drug use (NIH, 2014).
In contrast to the United States, the rehabilitation system in Finland consists of a number
of separate and relatively independent subsystems. Substance abuse treatment and rehabilitation
is available in A-clinics and youth stations. There are specific substance abuse units, as well as
mental health services on psychiatric units for people struggling with substance abuse. Treatment
can be implemented in emergency departments in addition to detoxification units. Kela, a
provider of social security benefits in Finland, helps to both fund rehabilitation services and
provide income security, called Rehabilitation Allowance, during participation in rehabilitation.
To qualify for rehabilitation, you must have a medical certificate with information about your
illness and your need for rehabilitation. Most of the rehabilitation services available from Kela
are provided free of charge. Otherwise, drug treatment is the responsibility of the municipalities
which is regulated by the Act on Welfare for Substance Abusers, the Social Welfare Act, the
Mental Health Act, and a decree governing detoxification and substitution treatment for opioid
addicts. Specifically, social welfare provides specialized services needed to rehabilitate substance
abusers. However, drug treatment services are now becoming more prominent in primary health

ADOLESCENT SUBSTANCE ABUSE

care. Drug treatment is divided into five main categories: outpatient clinics, short term inpatient
care, long-term rehabilitation units, support services, and peer support activities.
There are specific outpatient services aimed at youths with drug abuse problems. These
services include an assessment, counseling (both individually and family), group therapy, and
referrals. Short-term inpatient care focuses on detoxification. It is provided in special rehab units
and the length of stay varies from one day to four weeks. Long-term rehabilitation incorporates
residential psychosocial treatment for drug users, residential services, and psychiatric services.
Support services include day-care centers and housing services. They help place the adolescents
in better living conditions and help them find employment to facilitate treatment and recovery.
Emergency clinics are able to provide immediate medical care for addicts requiring it.
At a global level, access to proper rehabilitation services is severely lacking in low and
middle-income countries (WHO, 2014). According to WHO, 15.3 million people have some sort
of drug use disorder in the world (2015). The world drug problem is threatening public health in
all the countries burdened by it. Alcohol, tobacco, and illegal drug use cause considerable
morbidity and mortality throughout the world (Wu, p. 5, 2010). Even when access to treatment
options is available, many people do not choose to be treated. Regrettably, while adolescents
and young adults are particularly likely to be active substance abusersthey are much less likely
to receive substance abuse treatment or to perceive a need for it (Wu, p. 8, 2010). Lack of
information on where to go to seek help, especially in low-income countries, is a major barrier
that is keeping abusers from seeking help. Due to the global substance abuse issue, there is a
need for research and policies from each nation in order to create a practical knowledge base for
the populations at risk. These policies need to incorporate preventative measures, screening,
risk-reduction, and rehabilitation for long-term recovery (Wu, p. 9, 2010).

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9
Health Services

There are many health services in the community in the United States for adolescents that
have issues with substance abuse. Services may include alcoholism treatment programs, centers
for behavioral change, drug rehabilitation centers. For adolescents that have problems with
substance abuse, it is important for them to have easy access since the adolescent may not have
transportation, free services for those that do not have health insurance or are homeless due to
drug use, and for the health service to be nonjudgmental of the problems that the individual is
experiencing.
In Springfield, MO one very important health service is Burrell Behavioral Health
institution that has a Youth Substance Abuse treatment program for those ages twelve to
seventeen that are having issues with substance abuse. The program has individual counseling,
family counseling, group education, therapeutic social interactions, and may include residential
treatments, day treatments, or outpatient services. The program accepts most insurances and also
Medicaid to help with the costs of the program. Heartland Center is another health service in
Springfield, MO as well as in Kansas City, and Southwest Missouri for the vulnerability group
that has services for outpatient substance abuse treatment, a medically monitored inpatient
detoxification program, and medication assisted treatment. At Heartland, they treat the whole
person, tailor treatment to each individual in the program, build positive relationships, and
empower individuals. Missouri has many Medicaid-funded and State-funded services including
Burrell Behavioral Health Care Center, Pathways Community Behavioral Healthcare, Family
Counseling Center, Community Treatment, Tri-County Mental Health Services, Preferred Family
Healthcare, and Comprehensive Mental Health Services (Missouri Department of Mental Health,

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10

2013). These health services are all over Missouri and are affordable for those with issues of
substance use.
Finland also has many resources for health services such as Eastern and Western
Substance Abuse Services/ Outpatient Clinic that treat harmful addictions, Hangonkatu 24- hour
withdrawal therapy and Toolo withdrawal therapy ward, and Aurinkoinen hymy which helps
mental health and substance abuse customers to cope in their daily lives, offers peer group
support and organizes interesting everyday activities (City of Helsinki, 2015). Health services
that are accessible and affordable are extremely important for adolescents with substance abuse
since so many adolescents are less likely to seek treatment by themselves.
Adolescents that are suffering from substance abuse may find support groups to be very
beneficial. Support groups may help specifically for substance use or for other issues such as
mental health issues of depression, anxiety, or PTSD. Alcoholic Anonymous groups are found all
over the world in both the United States and Finland. NAMI of Southwest MO has support
groups such as Five Stages of Recovery, Overcoming Depression, Wellness for Recovery,
Managing Panic, Anxiety, and OCD, Diagnosing and Awareness, and Body and Mind Wellness
(NAMI Southwest Missouri, 2015). These support groups are free and help with the mental
illnesses that may be involved with substance abuse.
Finland also has many health care services for adolescents struggling with substance
abuse. School health care is a popular service that is intended to ensure that all students grow,
develop, and live a healthy lifestyle. Mental health disorders and substance abuse may begin in
childhood and adolescence. Preventing substance abuse is a very important task for school health
services. A school nurses job is to promote both the individual and schools community health.
Health education in the schools help the students develop the skills to promote health and

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11

wellbeing (Tervekoululaninen). Identification of drug problems in adolescents is important

because these individuals are more influenced by treatment. Substance abuse treatment requires
the identification of predisposing and protective factors. Treatment should aim to take in account
the social environment and individual development of the adolescent. Means for the treatment of
substance abuse problems include speech input, identification of resources, monitoring use of
substances, motivational interviewing, outpatient treatment, inpatient treatment, and medications.
Outpatient treatment is the primary form of treatment for younger adolescents. Inpatient services
and medications are mainly used in those with severe substance abuse disorders. A significant
role is played by voluntary organizations for treatment of substance abuse (Ks. ToimintaSuomi
5).
Other services such as A-Clinics, detoxification units, youth centers, rehabilitation
centers, Jrvenp Social Hospital provide detoxification and psycho-social services for
substance abusers. Different municipalities in Finland vary in the quantity and quality of their
substance abuse services. Treatment should be started in the unit where the matter will be raised,
and the entire case network should be used appropriately. Treatment systems should be so clear
that even professional helpers are able to use different treatments for substance abuse flexibly.
There are many services for substance abuse in Finland that are accessible to adolescents.
Government and Nongovernment Organizations
There are several governmental and
nongovernmental organizations in the United States as
well as national organizations whose main focus is
providing prevention, treatment, and recovery resources
for adolescents who abuse substances. These

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organizations are helping address the community health
concerns regarding substance abuse within the
adolescent population. With their help, awareness is
being raised and facts are being given on adolescent
substance abuse.
One of these organizations is the Substance
Abuse and Mental Health Services Administration
(SAMHSA) which is an organization that actively
engages in the prevention of drug and alcohol abuse by
incorporating the cooperation of schools, families, faithbased organizations and workplaces. Their initiative
focuses on helping at-risk youth, youths in tribal
communities and children of military families to lead
healthy lives by avoiding the traps of substance abuse
and untreated mental illness. They offer different
resources and information on prevention, treatment, and
recovery programs to help adolescents and other age
groups who are either at risk or are already struggling
with substance abuse (SAMHSA, 2014). This
organization found that in 2012, there were about 23.1
million Americans aged 12 and older who required
treatment for substance use, resulting in significant costs
to families, employers, and publicly funded health

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systems. Because substance abuse issues are some of the
most difficult problems to prevent or reduce, a mixture of
prevention interventions is required to address substance
use issues in communities. Some of their prevention
strategies include creating environments that make it
easier to act in healthy ways. For example, offering
fewer places for young people to purchase alcohol, so
consuming alcohol becomes less convenient is one way
to help prevent alcohol/drug abuse. With these
prevention strategies in place SAMHSA found that the
prevalence of past 30-day use of alcohol, tobacco, and
marijuana declined significantly among both middle
school and high school students (SAMHSA, 2014).
Another organization is the National Institute on
Alcoholism and Alcohol Abuse and the National Institute
on Drug Abuse (NIDA) which are both part of the
National Institute of Health. There are specific
adolescent organizations that offer educational videos
and drug facts. Information and assistance are also
available for and about youth who live in a family where
alcoholism is present called PEERx (NIDA, 2015). The
NIDA uses the Monitoring the Future (MTF) survey to
keep track of trends regarding adolescent drug use. It

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measures drug use and attitudes among eighth, 10th, and
12th graders. In the 2014 survey it was shown that the
use of cigarettes, alcohol, and prescription medications
among adolescents has decreased since 2013 and
marijuana use has plateaued. The results are part of a
two-decade trend among the nations youth. What this
means is that the prevention efforts of the NIDA are
proving to be effective and it is now more important than
ever to continue educating adolescents as well as parents,
teachers, the community, and health care providers about
the harms of drug use among adolescents whose brains
are still developing (NIH, 2014).
The Drug Free America Foundation Inc. (DFAF)
is a drug prevention and policy organization committed
to developing, promoting and sustaining national and
international policies and laws that will reduce illegal
drug use and drug addiction. They work to reduce
adolescent substance abuse and support families
impacted by addiction. It features a referral hotline (1855-DRUGFREE) and a substance abuse treatment
facility locator for young people who need help or know
someone who needs help (Drug Free, 2015). A wellknown campaign that this organization uses is the Above

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the Influence campaign. It seeks to equip young people
with the self-confidence, strength and knowledge to rise
above the negative peer pressure associated with drugs
and alcohol. The campaign has Facebook and YouTube
pages for adolescents that provide tips and advice on
how to walk away from substance abuse and other bad
decisions and how to talk to friends who have chosen the
wrong path. From their website, adolescents can receive
answers from medical doctors and learn about several
different drug facts (ATI, 2015). DFAFs efforts have
helped parents, who have children that are abusing
substances, find ways to educate their children and get
them the help they need. It also offers ways for these
parents to cope with and handle the stresses they are
experiencing. Although there is not much statistical
information to prove that this organization is helping to
reduce the incidence of adolescent substance abuse, the
organization is still a valuable resource for individuals
who are dealing with these issues to utilize.
Lastly, the Foundation for a Drug-Free World is a
nonprofit organization that provides information about
drugs to adolescents in order for them to make educated
decisions to choose a drug-free life. Their Truth About

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Drugs campaign provides activities that promote a drugfree life in which adolescents can become involved.
Their website includes documentaries of real life events
and stories from individuals who used to abuse drugs.
This information can empower youth to make a decision
from the beginning to live a life free of drugs (Drug Free
World, 2015). The effects of this program have been
very influential. There has been increasing number of
young people who use these materials and in turn share
the truth about drugs with their friends and families.
More than 10,000 schools use the Truth About Drugs
material and curriculum, and about 1,200 organizations,
law enforcement and government agencies in 180
countries have joined with Scientologists to combat drug
abuse through this program. With its use, the global
Truth About Drugs program will continue taking steps
toward achieving a generation that will remain free from
the devastations of drug abuse.
Several other organizations exist that are helping
to improve the adolescent substance abuse issue. These
programs are very useful resources to use as preventative
measures and to provide treatment options to those who
are already struggling. Furthermore, substance abuse

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among adolescents has statistically been reduced with the
use of these organizations.
In comparison, Finlands social and health care
systems foundation has been implemented with the
support of the state on social welfare and health care on
the municipal level. Finland also has an extensive health
and social welfare field that produces both commercial
and free services works. Public health services are
distributed to primary health care and specialized
medical care. Primary health care is universally available
to all, forming the basis for the health system. One is
entitled to public health care or primary health care by
the municipal which includes medical treatment and the
necessary specialized medical care which is organized in
central hospitals. Municipalities are responsible for
providing social welfare and health care. They can
generate social and primary care services alone or form
municipal boards with each other. The municipality can
also buy services from another municipality or a private
service provider (Sosiaali-ja terveysministeri;
Jrjestelm vastuut) (MOL; Terveydenhuoltoalat).
Basic healthcare in Finland includes the
following: health counseling, medical care,

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rehabilitation, mental health services, dental care, school
health services, and occupational health care. For
students, municipality organizes school health care in
primary schools, secondary schools and occupational
schools, as well as health care services in health care
centers. School health care includes health checks
carried out by a doctor or nurse, health education, dental
care, as well as a psychologist and speech therapist
services (Kansanelkelaitos. 2012) (MOL;
Terveydenhuoltoalat)
In addition to the public sector, services are
produced by private companies. Private health care
compliments the public health services. Private health
cares share of the production in health services is
constantly growing when municipalities organize social
health services by purchasing them from private service
providers. Health services provided by companies can
offer alternatives to public services and increase
customer choice. Private health care services are
provided by private hospitals, clinics and doctors, private
receptions, private retirement homes, facilities for
mentally handicapped, rehabilitation centers and daycare centers, physical therapy institutes, laboratories,

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19

radiology institutes, private receptions for dentists, dental

clinics and ambulance companies as well as health spas
(MOL: Terveydenhuoltoalat) (AVI. 2015).
Municipalities pay for nearly all of the private services
including mental institutions and family therapy for
adolescents (Vyrynen, R. 2010). The most common
private health services in Finland include physical
therapy services, medical and dental practice activities,
and occupational health care (AVI. 2015).
The third sector, the non-profit associations, is private meaning it remains between the
public sector and families. It is a social sector whose characteristics are a non-profit economy,
organizations or social groups goals. Non-profit organizations are different from the private
(corporate) economy in the fact that it does not seek a profit (JK Humalajoki). The third sector's
basic tasks include representation of different population groups, influence and expertise,
volunteering and other assistance work, organization and implementation, providing social and
health services, as well as experimental and development activities associated with the abovementioned. Although the health care system works in Finland fairly equally, the third sectors are
still needed; it has a very significant contribution specifically to complement the activities
organized by the society.
Comparatively, Finland and the United States have similar health care systems when it
comes to overall healthcare. For example, the two countries both have publicly funded, privately
funded, and non-profit organizations in which adolescent substance abusers can find refuge.

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20

These organizations allow for various opportunities for prevention of substance abuse and for
adolescents who do abuse substances to receive help and become healthier individuals.
Theory
A helpful nursing tool that can be used to
improve the issue of substance abuse in adolescents is
Dorothea Orems Self-Care Deficit Theory. Within
Orems theory are three smaller, interwoven sub-theories.
The first of these sub-theories is the Theory of Self-Care,
which incorporates ten basic conditioning factors. These
include age, gender, developmental state, health state,
pattern of living, healthcare system factors, family
system factors, sociocultural factors, availability of
resources, and external environmental factors. Having or
not having these factors all influence the chances of an
adolescent becoming involved with substance abuse.
Primary prevention focuses on the education regarding a
topic. If education can be provided to adolescents
regarding the harmful effects and consequences of
substance use, then those factors that may increase their
chances of substance abuse will be of less significance.
Through education, the proper promotion of human
functioning and development within social groups can be
taught, including the importance of saying no to

ADOLESCENT SUBSTANCE ABUSE

substance use. Ultimately, the teenager will have a
higher chance of preventing hazards to human life,
human functioning, and human well-being and will be
able to care for himself or herself more efficiently.
Educating adolescents is the first step in reducing and
preventing substance abuse (Masters, 2012).
The second sub-theory is the Theory of Self-Care
Deficit. This part of the theory explains how individuals
can be helped when they are no longer capable of
completely caring for themselves. From a nursing
perspective, to help determine those individuals that
require our care, screening measures can be done to
identify those at a higher risk for substance abuse, as
well as screening for current or past use of substances,
thus providing secondary prevention. After identifying
these individuals, the third sub-theory, the Theory of
Nursing Systems, comes into play. This involves the
supportive-educative system where both the nurse and
the individual participate in self-care activities and the
responsibility of care gradually shifts from the nurse to
the individual. The primary purpose of the nurse is to
promote independence in the patients self-care abilities,
which will encourage the adolescent to complete

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22

treatment and help them abstain from abusing. In this

section of the theory, tertiary preventative measures are
involved when treatment options for the effected
individuals, such as rehabilitation and recovery
programs, are initiated (Masters, 2012). Orems theory
can play a major role in providing primary, secondary,
and tertiary prevention measures to adolescent substance
abusers.
Conclusion
Adolescent substance abusers view health as not
merely the absence of illness but as using substances to
help their mental and social well-being. The drugs may
help mask the symptoms of any underlying conditions.
Concerns for health promotion and prevention of disease
include mental health issues, safety, and access to health
services. There are numerous options for rehabilitation in
both the United States and Finland. It is of the utmost
importance to tailor the rehab choice to the specific
individual to ensure the best results. There are many
affordable and accessible health services for adolescents
that are going through treatment for substance abuse in
both the United States and Finland. These health services
include group education, counseling, and outpatient

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services. Although substance abuse among adolescents is
an issue in several countries, including the United States
and Finland, there are several programs in each country
that are used as prevention strategies and help in treating
individuals who are already struggling with substance
abuse. These programs have helped significantly in the
reduction of substance abuse among adolescents to help
them become healthier individuals. Despite all of these
measures taken to prevent and promote recovery in
adolescent substance abusers, it is still a prominent issue
in the United States, Finland and throughout the world.

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References

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Becker, S. J. (2013). Adolescent substance abuse: National trends,
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