Alcohol and Drugs Abuse in Adolescence

Experimentation with alcohol and drugs during adolescence is common. Unfortunately, adolescents 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 has negative health effects while 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. It is difficult to know which teens will experiment and stop and which will develop serious problems. Adolescents at risk for developing serious alcohol and drug problems include those:

• who are depressed
• who feel like they don't fit in or are out of the mainstream
• who have low self-esteem, and
• with a family history of substance abuse

Adolescents abuse a variety of drugs, both legal and illegal. Legally available drugs include alcohol, prescribed medications, inhalants (fumes from glues, aerosols, and solvents) and over-the-counter cough, cold, sleep, and diet medications. The most commonly used illegal drugs are marijuana (pot), stimulants (cocaine, crack, and speed), LSD, PCP, opiates, heroin, and designer drugs (Ecstasy). 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.

Moms and dads can prevent their kids from using drugs by talking to them about drugs, open communication, role modeling, responsible behavior, and recognizing if problems are developing.

Warning signs of teenage alcohol and drug abuse may include:

• Emotional: personality change, sudden mood changes, irritability, irresponsible behavior, low self-esteem, poor judgment, depression, and a general lack of interest.
• Family: starting arguments, breaking rules, or withdrawing from the family.
• Physical: Fatigue, repeated health complaints, red and glazed eyes, and a lasting cough.
• School: decreased interest, negative attitude, drop in grades, many absences, truancy, and discipline problems.
• Social problems: new friends who are less interested in standard home and school activities, problems with the law, and changes to less conventional styles in dress and music.

Some of the warning signs listed above can also be signs of other problems. Moms and dads may recognize signs of trouble and possible abuse of alcohol and other drugs with their adolescent. If you have concerns you may want to consult a physician to rule out physical causes of the warning signs. This should often be followed or accompanied by a comprehensive evaluation by a youngster and adolescent psychiatrist or mental health professional.

Substance Abuse Treatment for Kids and Adolescents: Questions to Ask

Many kids and adolescents use alcohol and other drugs. Some develop serious problems which require professional treatment. Examples of treatment include inpatient units, outpatient clinics, twelve step programs, and dual diagnosis units for individuals with emotional and substance abuse problems.

The decision to get treatment for a youngster or adolescent is difficult, and moms and dads are encouraged to seek consultation from a youngster and adolescent psychiatrist when making decisions about substance abuse treatment. Other psychiatric disorders often co-exist with substance abuse problems and need assessment and treatment.

When substance abuse treatment is recommended, moms and dads can obtain the information they need by asking the following questions from professionals:

1. As my youngster's problem improves, does this program provide less intensive/step-down treatment services?
2. Based on your evaluation, does my youngster have other psychiatric problems in addition to the substance abuse problem? If so, will these be addressed in the treatment process?
3. How long will this phase of the treatment process continue? Will we reach our insurance limit before treatment in this phase is completed?
4. How will my youngster continue education while in treatment?
5. How will our family be involved in our youngster's substance abuse treatment -- including the decision for discharge and the after-care?
6. How will the issue of confidentiality be handled during and after treatment?
7. If this treatment is provided in a hospital or residential program, is it approved by the Joint Commission for the Accreditation of Healthcare Organizations (JCAHO)? Is this substance abuse treatment program a separate unit accredited for youngsters of our son's age?
8. What are the credentials and experience of the members of the treatment team, and will the team include a youngster and adolescent psychiatrist with knowledge and skills in substance abuse treatment?
9. What treatment approaches does this program use regarding chemical dependency; detoxification; abstinence; individual, family, and group therapy; use of medications; a twelve-step program; mutual-help groups; relapse prevention; and a continuing recovery process?
10. What will treatment cost? Are the costs covered by my insurance or health plan?
11. When my youngster is discharged from this phase of treatment, how will it be decided what types of ongoing treatment will be necessary, how often, and for how long?
12. Why do you believe this treatment in this program is indicated for my youngster? How does it compare to other programs or services which are available?

Severe substance abuse and chemical dependence in adolescence may be a chronic and relapsing disorder. Moms and dads should ask what treatment services are available for continued or future treatment.

If questions or doubts persist about either admission to a substance abuse treatment program or about a denial of treatment, a second opinion may be helpful.

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