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What
is a 'drug'?
A drug
is any chemical that produces a therapeutic or non-therapeutic effect in the body.
Chemicals,
on the other hand, are a broad class of substances -- including drugs -- that may or may not produce noticeable effects in
the body. Many chemicals (such as tin, lead, gold) have harmful effects on the body, especially in high doses.
Most foods are not drugs. Alcohol is a drug -- not a food, in spite of the calories it provides. Nicotine is a
chemical that is also a drug. The group of "illegal" drugs includes dangerous chemicals that have only toxic actions,
such as inhalants.
Teenagers
and Drugs
Teenagers may be involved with
legal or illegal drugs in various ways. Experimentation with drugs during adolescence is common. Unfortunately, teenagers often don’t see the link between their actions
today and the consequences tomorrow. They also have a tendency to feel indestructible and immune to the problems that
others experience.
Using alcohol and tobacco at a young
age increases the risk of using other drugs later. Some teens will experiment and stop, or continue to use occasionally,
without significant problems. Others will develop a dependency, moving on to more dangerous drugs and causing significant
harm to themselves and possibly others.
Adolescence
is a time for trying new things. Teens use drugs for many reasons, including curiosity, because it feels good, to reduce stress,
to feel grown up or to fit in. It is difficult to know which teens will experiment and stop and which will develop serious
problems.
Who is At Risk?
Teenagers at risk for developing serious
alcohol and drug problems include those:
Teenagers abuse
a variety of drugs, legal and illegal.
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Alcohol
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Tobacco: Teens who smoke are three times more likely than nonsmokers to use alcohol, eight
times more likely to use marijuana, and 22 times more likely to use cocaine. Smoking is associated with a host of other
risky behaviors, such as fighting and engaging in unprotected sex.
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Prescribed
medications (such as Ritalin, Adderall, and OxyContin)
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Inhalants: Known by such street names as huffing, sniffing and wanging, the dangerous habit of getting
high by inhaling the fumes of common household products is estimated to claim the lives of more than a thousand children each
year. Many other young people, including some first-time users, are left with serious respiratory problems and permanent
brain damage.
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Over-the-counter
cough, cold, sleep, and diet medications (such as Coricidin)
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Marijuana:
About one half of the people in the United States have used marijuana, many are currently using it and some will require
treatment for marijuana abuse and dependence.
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Stimulants:
The possible long-term effects include tolerance and dependence, violence and aggression, malnutrition due to suppression of appetite. Crack, a powerfully addictive
stimulant, is the term used for a smokeable form of cocaine. In 1997, an estimated 1.5 million Americans, age 12 and older, were chronic cocaine
users.
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Club drugs: This term refers to drugs being used by teens and young adults at all-night dance parties
such as "raves" or "trances," dance clubs, and bars. MDMA (Ecstasy), GHB, Rohypnol (Rophies), ketamine, methamphetamine, and LSD are some of the club or party drugs gaining popularity. Because some club
drugs are colorless, tasteless, and odorless, they can be added unobtrusively to beverages by individuals who want to intoxicate
or sedate others. In recent years, there has been an increase in reports of club drugs used to commit sexual assaults.
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Depressants: These are drugs used medicinally
to relieve anxiety, irritability, tension. There is a high potential for abuse and, combined with alcohol, effects are
heightened and risks are multiplied.
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Heroin: Several sources indicate an increase in new, young
users across the country who are being lured by inexpensive, high-purity heroin that can be sniffed or smoked instead of injected.
Heroin has also been appearing in more affluent communities.
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Steroids: Anabolic steroids are a group of powerful compounds closely related to the male sex
hormone testosterone. From 1998 to 1999, there was a significant increase in anabolic steroid abuse among middle-schoolers.
The use of illegal
drugs is increasing, especially among young teens. The average age of first marijuana use is 14, and alcohol use can
start before age 12. The use of marijuana and alcohol in high school has become common.
Drug use is
associated with a variety of negative consequences, including increased risk of serious drug use later in life, school failure, and poor judgment which may put teens at risk for accidents, violence, unplanned and unsafe sex, and suicide.
Warning Signs of
Teen Substance Abuse
Physical
Emotional
-
personality
change
-
sudden
mood changes
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irritability
-
irresponsible
behavior
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low self-esteem
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poor judgment
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depression
-
general
lack of interest
Family
-
starting
arguments
-
negative
attitude
-
breaking
rules
-
withdrawing
from family
-
secretiveness
School
-
decreased
interest
-
negative
attitude
-
drop in
grades
-
many absences
-
truancy
-
discipline
problems
Social problems
Some of the warning
signs listed above can also be signs of other problems. Parents may recognize signs of trouble but should not be expected
to make the diagnosis.
Consulting a
physician to rule out physical causes of the warning signs is a good first step. This should often be followed or accompanied
by a comprehensive evaluation by a psychiatrist or mental health professional.
Substance Abuse Treatment
Parents can
help through early education about drugs, open communication, good role modeling, and early recognition if problems are developing. If there is
any suspicion that there is a problem, parents must find the most appropriate intervention for their child.
The decision
to get treatment for a child or adolescent is serious. Parents are encouraged to seek consultation from a mental health professional when making decisions about substance abuse treatment for children or adolescents.
Parents
and families must be informed consumers and should be involved in their child's recovery. Here are some important things
to consider:
No
single treatment is appropriate for all teens.
It is
important to match treatment settings, interventions, and services to each individual's particular problems and needs.
This is critical to his or her ultimate success in returning to healthy functioning in the family, school, and society.
Effective
treatment must attend to the multiple needs of the individual -- not just the drug use.
Any associated
medical, psychological, social, and cognitive problem must be be addressed.
Remaining
in treatment for an adequate period of time is critical for treatment effectiveness and positive change.
Each person
is different and the amount of time in treatment will depend on his or her problems and needs. Research shows that for
most individuals, the beginning of improvement begins at about 3 months into treatment. After this time, there is usually
further progress toward recovery. Length of stay in a residential program can range from 8 to 18 months, depending
upon the individual's willingness and commitment.
Counseling
(individual and/or group) and other behavioral therapies are critical components of effective treatment.
In therapy,
teens look at issues of motivation, build skills to resist drug use, replace drug-using activities with constructive and rewarding
behaviors, and improve problem-solving skills. Behavioral therapy also facilitates interpersonal relationships and the teen's ability to function in the home and
community.
Addicted
or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way.
Because
addictive disorders and mental disorders often occur in the same individual, individuals should be assessed and treated for
the co-occurrence of the other type of disorder.
Medical
detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use.
Medical
detoxification safely manages the acute physical symptoms of withdrawal associated with stopping drug use. While detoxification
alone is rarely sufficient to help addicts achieve long-term abstinence, for some individuals it is a strongly indicated precursor
to effective drug addiction treatment.
Treatment
does not need to be voluntary to be effective.
Strong motivation
can facilitate the treatment process. Sanctions or enticements in the family, school setting, or juvenile justice system can increase significantly both treatment entry and retention rates and the success of
drug treatment interventions.
Recovery
from addiction can be a long-term process and frequently requires multiple episodes of treatment.
As with other
chronic illnesses, relapses to drug use can occur during or after successful treatment episodes. Addicted individuals
may require prolonged treatment and multiple episodes of treatment to achieve long-term abstinence and fully restored functioning.
Participation in self-help support programs during and following treatment often is helpful in maintaining abstinence. Parents should
ask what aftercare treatment services are available for continued or future treatment.
Information provided
by the American Academy of Child and Adolescent Psychiatry (AACAP) and the National Institute of Drug Abuse.
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Substance Abuse
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 survey taken in 1995, two-thirds of all of the 12th grade students interviewed
said that they felt that they had to choose whether or not to use drugs before they graduated from high school. In studies
done in 1998 and 1999, 56 percent of 12 to 17 year olds reported that marijuana was easy to get and 72 percent of this group
reported that alcohol was very easy to obtain. By the time they are 17 years old, 56 percent of adolescents state that they
know a drug dealer.
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.
From the National Institute of Health:
The
1999 MTF marks the third year in a row that illicit drug use among 8th, 10th, and 12th graders remained stable or decreased
in some cases. The few statistically significant increases involved the use of Ecstasy, anabolic-androgenic steroids, and
alcohol.
The percentage of 12th graders who had ever used Ecstasy
increased from 5.8
in 1998 to 8.0 in 1999; the percentage who had used Ecstasy in the past year increased from 3.6 in 1998 to 5.6 in 1999; and
the percentage of 12th graders using Ecstasy at least once in the past month prior to being surveyed increased from 1.5 in
1998 to 2.5 in 1999.
The percentage of 10th graders who had ever used anabolic-androgenic steroids increased
from 2.0 in 1998 to 2.7 in 1999; the percentage who had used in the past year increased from 1.2 to 1.7, and from 0.6 to 0.9
for past month use. The percentage of 8th graders who had used anabolic-androgenic steroids in the past year increased from
1.2 in 1998 to 1.7 in 1999, and from 0.5 to 0.7 for past month use.
The remaining statistically significant increases involved 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 Substance Abuse?
Symptoms of 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: AD(H)D, 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 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:
- Age, developmental stage, and maturity
- Values and culture
- Gender
- 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
- 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:
- Naltrexone: alcohol dependency and opiate dependency
- Methadone: heroine addiction
- 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 Treatment After Detoxification:
- Identify underlying co-occurring disorders and treat disorders
- Psychotherapy
- 12-Step type programs like Alcoholics Anonymous
- Group Therapy
- Behavior Modification
- Cognitive Therapy
V. I suspect that my child is abusing substances.
What
do I do now?
Professionals to Seek Out
- See your physician or pediatrician
- Consult with your clergy to assist in spiritual
and practical guidance
- Consult with an educational consultant to help
you find the right program
for your child.
- Consult with a therapist or counselor.
- Consult with an Educational Advocate to help
you with your current school
situation
- Consult with an Educational Consultant to find
the right program for your child.
Find out more about Educational Consultants
Programs
- Inpatient: hospitalization
- 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.
- Day Treatment
- Residential Programs
a. Therapeutic Residential 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. Therapeutic Wilderness 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 self0esteem. 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.
courtesy of the National Youth Network
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