I. What is substance abuse?

First you take a drink, then the drink takes a drink,
then the drink takes you. – F. Scott Fitzgerald

In a recent study by the University of Michigan, 8th, 10th, and 12th graders across the country are continuing to show a gradual decline in the proportions reporting use of illicit drugs.

“The cumulative declines since recent peak levels of drug involvement in the mid-1990s are quite substantial, especially among the youngest students,” said U-M Distinguished Research Scientist Lloyd Johnston, the principal investigator of the MTF study.

The proportion of 8th graders reporting use of an illicit drug at least once in the 12 months prior to the survey (called annual prevalence) was 24 percent in 1996 but has fallen to 13 percent by 2007, a drop of nearly half. The decline has been less among 10th graders, from 39 percent to 28 percent between 1997 and 2007, and least among 12th graders, a decline from the recent peak of 42 percent in 1997 to 36 percent this year.

Among the substances abused are: alcohol, tobacco, marijuana, cocaine, opiates, “club drugs” (ecstasy, etc.). stimulants, hallucinogens, inhalants, prescription drugs, and steroids.

Drug and substance abuse among teenagers, is substantial. Among youth age 12 to 17, about 1.1 million meet the diagnostic criteria for dependence on drugs, and about 1 million are treated for alcohol dependency.

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From the National Institute of Health:

From 2006 to 2007, the percentage of 8th graders reporting lifetime use of any illicit drug declined from 20.9% to 19.0%.
Reported past year use among 8th graders declined from 14.8% to 13.2%.
Past year prevalence has fallen by 44% among 8th graders since the peak year of 1996.
Past year prevalence has fallen 27% among 10th graders and 15% among 12th graders since the peak year of 1997.

In 2007, 15.4% of 12th graders reported using a prescription drug nonmedically within the past year2. Vicodin continues to be abused at unacceptably high levels. Attitudes toward substance abuse, often seen as harbingers of change in abuse rates, were mostly stable. However, among 8th graders, perceived risk of harm associated with MDMA decreased for the third year in a row. Attitudes towards using LSD also softened among 10th graders this year.

Between 2005 and 2007, past year abuse of MDMA increased among 12th graders from 3.0% to 4.5%; and between 2004 and 2007, past year abuse of MDMA increased among 10th graders from 2.4% to 3.5%.

The remaining statistically significant increases involved teen alcohol use. The percentage of 10th graders who had been drunk in the past year rose from 38.3 in 1998 to 40.9 in 1999. Also, the percentage of 8th graders having 5+ drinks during the 2 weeks prior to being surveyed increased from 13.7 in 1998 to 15.2 in 1999.

Teenagers at risk for substance abuse include those with a family history of substance abuse, who have low self-esteem, who feel hopelessly alienated, as if they don’t fit in, or who are depressed.

II. What are the Symptoms of Teen Substance Abuse?

Symptoms of Teen Substance abuse include the following:

  • Sudden personality changes that include abrupt changes
    in work or school attendance, quality of work, work output, grades, discipline
  • Unusual flare-ups or outbreaks of temper
  • Withdrawal from responsibility
  • General changes in overall attitude
  • Loss of interest in what were once favorite hobbies and pursuits
  • Changes in friends and reluctance to have friends visit or talk about them
  • Difficulty in concentration, paying attention
  • Sudden jitteriness, nervousness, or aggression
  • Increased secretiveness
  • Deterioration of physical appearance and grooming
  • Wearing of sunglasses at inappropriate times
  • Continual wearing of long-sleeved garments particularly in hot weather or reluctance to wear short-sleeved attire when appropriate
  • Association with known substance abusers
  • Unusual borrowing of money from friends, co-workers or parents
  • Stealing small items from employer, home or school
  • Secretive behavior regarding actions and possessions; poorly concealed attempts to avoid attention and suspicion such as frequent trips to storage rooms, restroom, basement, etc.

Different substances lend themselves to different groups of symptoms. The most glaring symptom in all cases is a change, sometimes a radical one, in behavior.

Other physical signs of substance abuse are: slurred speech,
memory impairment, incoordination, and impairment of attention.

III. How is Substance Abuse diagnosed?

It is sometimes difficult for mental health practitioners to arrive at a diagnosis of substance abuse alone. There are a number of practical and empirical methods to determine substance use, among them being urine or blood testing. Another method to determine use is by interviewing parents, teachers, and other caregivers regarding the history of the patient, and the current behavioral aspects that the patient has been presenting.

A major problem in the diagnosis is the consideration of dual diagnoses. A dual diagnosis is given to any person who has both a substance abuse problem and an emotional or psychiatric disorder. In order for the patient to fully recover, they must be treated for both problems. According to statistics, at least thirty-seven percent of substance abusers also have a serious mental illness, and conversely, of all those diagnosed with a mental illness, twenty-nine percent also abuse either drugs or alcohol.

The most common co-occurrences are depressive disorder, anxiety disorder, and psychiatric disorders such as schizophrenia and personality disorders. But any of the emotional disorders: ADHD, Obsessive-Compulsive Disorders, Post Traumatic Stress Syndrome can lead its sufferers down the path of self-medication and substance abuse.

There are three categories of substance abuse:

A. Use: The occasional use of alcohol or other drugs without developing tolerance or withdrawal symptoms when not in use.

B. Abuse: The continued use of alcohol or other drugs even while knowing that the continued use is creating problems socially, physically, or psychologically.

C. Dependence: At least three of the following factors must be present:
a. Substance is taken in larger amounts or over longer periods of time than the person intended.
b. A persistent desire with unsuccessful efforts to
control the use.
c. Large periods of time spent obtaining, taking, or recovering from, the substance.
d. Frequent periods of intoxication or detoxification especially when social and major role obligations are expected (school, social situations, etc.)
e. Continued use even while knowing that the continued use is creating problems socially, physically, and/or psychologically.
f. Increased tolerance
g. Withdrawal symptoms
h. Substance taken to relieve withdrawal symptoms.

IV. How is Teen Substance Abuse Treated?

In cases of dual diagnosis, the recommended method is to primarily treat the symptomatic substance abuse and co-treat the disorder. Once stabilization is established, the full-fledged treatment for the mental disorder begins.

There are various factors that must be taken into account when considering treatment for substance abuse. Among these factors are:

  1. Age, developmental stage, and maturity
  2. Values and culture
  3. Gender
  4. Co-existing mental disorders. Without the correct treatment for the co-existing disorders, treatment for addition may not be effective because these disorders could interfere with the patient’s ability to successfully participate in an addiction treatment program
  5. Family Factors: Family factors that could increase the patient’s risks should be considered: it is considered important that parents and other family members play a large role in their family member’s treatment.

Organic syndromes may be a result of substance abuse, or independent of substance abuse.
A. Medication:
Medication varies with the manner of addiction. If a dual or
co-occurring diagnosis is made, medication is administered according to the co-existing disorder. Medications are given
along with other interventions. Medications that specifically treat substance abuse are:

  1. Naltrexone: alcohol dependency and opiate dependency
  2. Methadone: heroine addiction
  3. Wellbutrin: smoking and marijuana abuse

Medications
In order to begin treatment, the first thing the patient must do is detoxify. Detoxification can be done on an outpatient or inpatient basis, depending on the severity of the addiction.

Additional Methods of Substance Abuse Treatment After Detoxification:

  1. Identify underlying co-occurring disorders and treat disorders
  2. Psychotherapy
  3. 12-Step type programs like Alcoholics Anonymous
  4. Group Therapy
  5. Behavior Modification
  6. Cognitive Therapy
  7. Residential Treatment

V. I suspect that my child is abusing substances.
What do I do now?

Professionals to Seek Out

  1. See your physician or pediatrician
  2. Consult with your clergy to assist in spiritual
    and practical guidance
  3. Consult with an educational consultant to help
    you find the right program for your child.
  4. Consult with a therapist or counselor.
  5. Consult with an Educational Advocate to help
    you with your current school situation
  6. Consult with an Educational Consultant to find
    the right program for your child.

Find out more about Educational Consultants

Programs

  1. Inpatient: hospitalization
  2. Outpatient Treatment
    Patients must be seen regularly so drug or alcohol abuse
    can be monitored. Some patients combine outpatient treatment with a 12-step type program. Frequent drug testing is done. In addition, outpatient treatment may include outpatient detoxification, and alcohol or drug rehabilitation.
  3. Day Treatment
  4. Residential Treatment Center or Program

a. Therapeutic Boarding School
These schools are usually fully accredited schools with emotional growth programs. They stress holistic education: growth of the person through holding children responsible for their actions. There is no rehabilitation or physicians on staff.
Find out more about Residential Boarding Schools

b. Wilderness Therapy Program
A Therapeutic Wilderness program does not necessarily have academics; their goal can be to introduce the children to a different role. These programs use Outdoor Therapy to help build low self-esteem. They make obtainable goals for them to reach. The programs vary but they are about 6 to 8 weeks long. It is a very structured program with a goal of teaching the children coping skills and raising their self esteem. Children go from this program to mainstream back into their public school or attend a small structured boarding school.
Find out more about Therapeutic Wilderness Programs

c. Residential Treatment School
A Residential Treatment Program or School provides a full professional staff that includes therapists, psychologists, and psychiatrists. They also have a small academic program. Many of the children in the program have been recommended there by mental health agencies that make the placements. It is a highly structured environment whose emphasis is on treatment and learning coping skills and independent living. Chemical dependence education and rehabilitation is also provided. Outdoor therapy is sometimes used to facilitate building social skills and self-esteem. Recovery programs are also available. Residential Treatment schools are secure schools.

Article courtesy http://www.nationalyouth.com

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