TEEN DRUG ABUSE

What is drug abuse?

As defined by the Diagnostic and Statistical Manual of Mental Disorders, drug dependence is a negative pattern of using a substance that leads to a number of problems, which may include needing more of a drug to get intoxicated (tolerance), difficulties that occur when the effects of the drug wear off (withdrawal), using more of a substance or for longer time than intended, and other life problems because of their use of a drug or drugs. Five stages of drug use have been identified. The first stage is described as access to drugs but no use thereof. In that stage, minimizing the risk factors that make a teenager more vulnerable to using drugs are an issue. The second stage of drug use ranges from experimentation or occasional use to regular weekly use of substances. The third stage is characterized by youth progressing to further increasing the frequency of using one or more drugs on a regular basis. This stage may also include the teenager either buying, stealing, or drug dealing to get drugs. In the fourth stage, adolescents have established regular usage, have become preoccupied with getting intoxicated ("high"), and have developed problems in their social, educational, vocational, or family life as a result of using the substance. The final and most serious fifth stage of drug use is defined by the youth only feeling "normal" when they are using. During this stage, risk-taking behaviours like stealing, drug dealing, engaging in physical fights, unprotected sex, or driving while intoxicated increase and they become most vulnerable to having suicidal or homicidal thoughts.

What are the causes and risk factors of teen drug use?
Family risk factors for teenagers engaging in drug abuse include low parent supervision or communication, family conflicts, inconsistent or severe parental discipline, and family history of alcohol or drug abuse. Individual risk factors include any history of physical or sexual victimization, learning or emotional problems, difficulty managing impulses, emotional instability, thrill-seeking behaviors, and perceiving the risk of using drugs to be low.

What are the dangerous effects of drug use in teens?

Just a few of the many dangerous effects of drug use in adolescents include:

Drugs of any kind decreases teens' ability to pay attention.

The younger a person is when they begin using drugs the more likely they are to develop a substance-abuse problem and the more likely they are to relapse into drug abuse when trying to quit.

Juveniles who use drugs are more likely to have unprotected sex, sex with a stranger, as well as to engage in sexual activity at all.

Substance use can cause or mask other emotional problems, like anxiety, depression, mood swings, or hallucinations (for example, hearing or seeing things). Either of those illnesses can result in death by suicide or homicide. Anabolic steroids have been associated with impotence in boys and men, clitoral enlargement in girls and women, as well as baldness, stunted growth, heart attacks, strokes, liver disease, cancer, acne and infections, including HIV/AIDS in both sexes.

Depending on how the body takes in and processes each kind of drug, substances of abuse can affect virtually every one of the body's systems. Examples of this include permanent brain damage associated with inhalants, heart attack or stroke from stimulants, halted breathing from sedatives. Any of these problems can result in death.

What are the symptoms of drug abuse in teens?

Some of the most common symptoms of drug abuse in teenagers include lying, making excuses, breaking curfew, staying in their room, becoming verbally or physically abusive toward others, having items in their possession that are connected to drug use (paraphernalia), the smell of drugs (for example, solvent smell of inhalants, marijuana smell) on them, mood swings, stealing, and changes in friends. Examples of paraphernalia include matches, rolling papers, and pipes for drugs that are smoked, multiple pill bottles for substances that are in pill form, mirrors for drugs that are snorted, and needles, syringes, and items that can be used as tourniquets for drugs that are injected. In addition to those more behavioural symptoms, loved ones can look for the physical symptoms of drug intoxication and withdrawal. Given the complexity of those symptoms and how much they depend upon the specific drug being

abused, loves ones are advised to have their family member evaluated medically and/or psychiatrically if substance abuse is suspected for any reason.

What is the treatment of drug intoxication?

Supporting the substance-abuse sufferer medically is the approach to managing most drug intoxications, since many substances of abuse can affect bodily functions (for example, heart rate, blood pressure, breathing rate). In addition to close medical monitoring, doctors usually have the individual assessed psychiatrically, since drugs are associated with everything from impaired judgment to severe aggression, assaultive behavior, and even suicidal and homicidal behaviours. Some medications are available to specifically counteract the effects of drugs. For example, naltrexone is used to counteract the effects of opioid intoxication. Blood pressure medications may be administered to patients who are suffering from high blood pressure associated with stimulant intoxication and with withdrawal from depressants. Fluids are often administered to those who have become dehydrated, and cooling blankets are given to those whose temperatures have become dangerously high, as may occur with Ecstasy.

What are treatments for drug addiction?

There are few medications that are considered effective in treating drug addiction. Those are currently limited to the treatment of alcohol, opioid, and nicotine addiction. Please read the Alcohol and Teens article for information about the medications that manage alcohol addiction. Effective medication treatment for other addictions is primarily limited to address addiction to opiates and nicotine. Methadone, levo-alpha acetyl methanol (LAAM), and buprenorphine hydrochloride are non-sedating, non-intoxicating opiates that treat opiate addiction by preventing symptoms of withdrawal from heroin and other opiates. Naltrexone blocks the effects of opiates and is therefore useful in both treatment of overdose of opiates and in longer-term treatment. Nicotine addiction is often medically addressed by medications that replace nicotine in the form of patches, gum, or nasal spray. Buproprion, which was originally found to be an effective antidepressant, has been found to decrease patients' cravings for nicotine. The National Institute of Drug Abuse (NIDA) recommends that treatment of substance abuse: be readily available when the addicted person is ready to enrol; be tailored to the complex, multiple and changing needs (for example medical, mental health, social, legal, and family) of each

individual; and consider the use of medication treatment when appropriate and include random drug testing. There are numerous individual treatments for drug addiction in teens. Relapse prevention uses methods for recognizing and amending problem behaviours. Individualized drug counselling specifically emphasizes short-term behavioural goals in an attempt to help the individual reduce or stop the use of drugs altogether. Some such programs include drug testing. Twelve-step programs like Narcotics Anonymous are individualized drugcounselling methods. Motivational enhancement therapy encourages the teen to increase their desire to participate in therapy. Stimulus control refers to a treatment method that teaches the person to stay away from situations that are associated with substance abuse and to replace those situations with activities that are contrary to using drugs. Urge control is an approach to changing patterns that lead to drug use. Social control involves family members and other significant others of the addict in treatment. Family interventions for drug addiction that tend to be effective for teens include multidimensional family therapy (MDFT), group therapy, and multifamily educational intervention (MFE). MDFT has been found to be quite effective. Longer-term residential treatment of three to five months that addresses peer relationships, educational problems, and family issues is often used in treating substance abuse in teens. For youths in the first stage of drug use, where they have not yet used drugs, preventative measures are used. Therefore, limiting access to drugs, addressing any risk factors of the youth or family, as well as optimal parental supervision and expression regarding expectations is often recommended. The approach to those who have experimented with drugs is not minimized by mental-health professionals, since infrequent use can progress to the more serious stages of use if not addressed. Therefore, professionals recommend that the youth be thoroughly educated about the effects and risks of drugs, receive fair but firm limits on the use of substances, and that the user be referred for brief counseling, a self-help group, and/or family support group. Teens that have progressed to the more advanced stages of drug addiction are typically treated intensively, using a combination of the medication, individual, and familial interventions already described above.

How can parents prevent drug use?

Clear communication by parents about the negative physical, emotional, and functional effects of drugs, as well as about their expectations

regarding drug use have been found to significantly decrease substance abuse in teens. Adequate parental supervision has also been found to be a deterrent to drug use in youth. Specifically, parents knowing how, where, and with whom adolescents socialize, as well as limiting their children's access to substances that can be abused have been associated with less teenage drug use. Limiting the amount of alcohol, cleaning solutions (inhalants), prescription, and over-the-counter medications that are kept in the home to amounts that can be closely monitored and accounted for has also been found to decrease substance abuse by teens. Family focused abuse-prevention programs have produced reductions in adolescent drug abuse. Among ethnic minorities in the United States (for example African Americans, Hispanic, Native and Asian Americans), those who strongly identify with their communities and cultures have been found to be less likely to experience risk factors for using drugs compared to their peers who are less connected to their communities and cultures. Therefore, incorporation of a cultural component to drug abuse prevention programs may enhance the effectiveness of those programs. Moreover, teens 15 to 16 years old who use religion to cope with stress tend to use drugs significantly less often than their peers who do not use religion to cope. Alcohol, and other drug, use has been found to occur most often between the hours of 3 and 6 p.m., immediately after school and prior to parents coming home from work. Teen participation in extracurricular activities has therefore been revealed as an important measure in preventing substance abuse in this age group.