Child and Adolescent Mental Health
Substance Abuse / Chemical Dependence
There are three different terms used to define substance-related disorders, including the following:
- substance abuse
Substance abuse
is used to describe a pattern of substance (drug) use leading to
significant problems or distress such as failure to attend school,
substance use in dangerous situations (driving a car),
substance-related legal problems, or continued substance use that
interferes with friendships and or family relationships. Substance
abuse, as a disorder, refers to the abuse of illegal substances or the
abusive use of legal substances. Alcohol is the most common legal drug
of abuse. - substance dependence
Substance
dependence is used to describe continued use of drugs or alcohol, even
when significant problems related to their use have developed. Signs
include an increased tolerance or need for increased amounts of
substance to attain the desired effect, withdrawal symptoms with
decreased use, unsuccessful efforts to decrease use, increased time
spent in activities to obtain substances, withdrawal from social and
recreational activities, and continued use of substance even with
awareness of physical or psychological problems encountered by extent
of substance use. - chemical dependence
Chemical
dependence is also used to describe the compulsive use of chemicals
(drugs or alcohol) and the inability to stop using them despite all the
problems caused by their use.
Substances frequently abused by adolescents include, but are not limited to, the following:
- alcohol
- marijuana
- hallucinogens
- cocaine
- amphetamines
- opiates
- anabolic steroids
- inhalants
- methamphetamine
- tobacco
Cultural and societal norms influence acceptable
standards of substance use. Public laws determine the legal use of
substances. The question of whether there is a normative pattern of
substance use in adolescence remains controversial. Substance-related
disorders in adolescence are caused by multiple factors including
genetic vulnerability, environmental stressors, social pressures,
individual personality characteristics, and psychiatric problems.
However, determining which of these factors are primary and which are
secondary in adolescent populations has not been determined. Most of
the knowledge available regarding substance use and abuse comes from
studying adult populations. A lack of research studying youthful
substance use and abuse leaves questions concerning how it differs from
substance abuse in other age groups unanswered.
Parental and peer substance use are considered two
of the more common factors contributing to youthful decisions regarding
substance use. The age at which adolescents begin to use alcohol is
decreasing, with 25 percent of young people beginning to drink
before the age of 13, according to the CDC.
Some adolescents are more at risk of developing
substance-related disorders, including adolescents with one or more of
the following conditions present:
- children of substance abusers
- adolescents who are victims of physical, sexual, or psychological abuse
- adolescents with mental health problems, especially depressed and suicidal teens
- physically disabled adolescents
The following are the most common behaviors that
indicate an adolescent is having a problem with substance abuse.
However, each adolescent may experience symptoms differently. Symptoms
may include:
- getting high on drugs or getting intoxicated (drunk) on a regular basis
- lying, especially about how much they are using or drinking
- avoiding friends and family members
- giving up activities they used to enjoy such as sports or spending time with non-using friends
- talking a lot about using drugs or alcohol
- believing they need to use or drink in order to have fun
- pressuring others to use or drink
- getting in trouble with the law
- taking risks, such as sexual risks or driving under the influence of a substance
- suspension from school for a substance-related incident
- missing school due to substance use
- depressed, hopeless, or suicidal feelings
The symptoms of substance abuse may resemble other
medical problems or psychiatric conditions. Always consult your child's
physician for a diagnosis.
A pediatrician, psychiatrist, or qualified mental
health professional usually diagnoses substance abuse in adolescents.
However, adolescent substance abuse is believed by some to be the most
commonly missed pediatric diagnosis. Adolescents who use drugs are most
likely to visit a physician's office with no obvious physical findings.
Substance abuse problems are more likely to be discovered by physicians
when adolescents are injured in accidents occurring while under the
influence, or when they are brought for medical services because of
intentional efforts to hurt themselves. Clinical findings often depend
on the substance abused, the frequency of use, and the length of time
since last used, and may include the following:
- weight loss
- constant fatigue
- red eyes
- little concern for hygiene
Specific treatment for substance abuse/chemical dependence will be determined by your child's physician based on:
- your child's age, overall health, and medical history
- extent of your child's symptoms
- extent of your child's dependence
- the substance abused
- your child's tolerance for specific medications or therapies
- expectations for the course of the condition
- your opinion or preference
A variety of treatment programs for substance
abuse are available on an inpatient or outpatient basis. Programs
considered are usually based on the type of substance abused.
Detoxification (if needed, based on the substance abused) and long-term
follow-up management are important features of successful treatment.
Long-term follow-up management usually includes formalized group
meetings and developmentally age-appropriate psychosocial support
systems, as well as continued medical supervision. Individual and
family psychotherapy are often recommended to address the
developmental, psychosocial, and family issues that may have
contributed to and resulted from the development of a substance abuse
disorder.
There are three major approaches frequently used to prevent adolescent substance use and abuse, including the following:
- school-based prevention programs
School-based prevention programs usually provide drug and alcohol education and interpersonal and behavior skills training.
- community-based prevention programs
Community-based
prevention programs usually involve the media and are aimed for parents
and community groups. Programs such as Mothers Against Drunk Driving
(MADD) and Students Against Drunk Driving (SADD) are the most well
known community-based programs. - family-focused prevention programs
Family-focused
prevention programs involve parent training, family skills training,
children's social skills training, and family self-help groups.
Research literature available suggests that components of
family-focused prevention programs have decreased the use of alcohol
and drugs in older children and improved effectiveness of parenting
skills that favorably affected their children's risk factors.
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Online Resources of Child & Adolescent Mental Health
Disclaimer:
This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.
Last reviewed on 10/4/2006