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In the United States, substance use and dependence are among the most common causes of adolescent morbidity and mortality (Sussman et al., 2008). Substance misuse with teenagers can lead to numerous social, economic, physical, and legal consequences such as poor academic performance, job instability, teenage pregnancy STD/STI transmission, incarceration, and death, either through overdose or through accidents under the influence, such as drunk driving (Sussman et al., 2008). In terms of psychological impact, adolescents abusing substances are more likely to develop disorganized thinking, and interferences with problem-solving abilities and emotional functioning which can also lead to social isolation and depression (Sussman et al., 2008). 

Identifying Risk Factors: Environmental, Social, and Biological Influences

There are multiple factors that influence substance abuse such as environmental variables such as neighborhood and accessibility to substances, social variables such as parental or peer substance use, personality traits such as impulsivity, anxious tendencies or sensation seeking, etc. (Sussman et al., 2008). Another impactful aspect of substance misuse in adolescence is the neurological changes that happen during this time. Between childhood and adolescence, risk-taking behavior increases due to the influence of puberty on the brain’s socio-emotional system i.e., how children begin to understand their own identity, and the development of their relationships with friends, family, partners, in conjunction to this self-discovery (Steinburg, 2011). Puberty also increases reward-seeking, which is enhanced by the presence of peers (Steinburg, 2011). Fortunately, this increase in risk-taking behavior declines into adulthood as changes in the brain’s cognitive control system improve self-regulation and the prefrontal cortex hits full maturity at the age of 25 (Steinburg, 2011). Therefore, mid-adolescence is the time of peak vulnerability to risky behavior. 

Defining Substance Use Disorder (SUD): DSM-V Criteria and Severity

According to the DSM-V TR, substance use disorder is a “cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems” (2022). It varies in severity: 2-3 symptoms being mild, 4-5 symptoms being moderate and 6 or more symptoms being severe (American Psychiatric Association Publishing, 2022). Diagnostic criteria vary slightly depending on the substance, but it includes a persistent desire to use, unsuccessful effort to control use, continued use despite failure to fulfill obligations, etc. (American Psychiatric Association Publishing, 2022).

Approach to Treatment: Strategies, Conversation, and Formal Intervention

Many teens who experiment with substances resolve potentially destructive patterns of use without formal intervention. However, if you do suspect that your child has SUD, the first step to helping them would be informing yourself on what their substance use looks like. It can be helpful to have a conversation with your child about the impact of substance use on themselves, how it is affecting their daily life and relationships. Encouraging teenagers to speak about their experience increases their awareness of the cognitive and behavioral effects of substance abuse and helps break the stigma that often comes with substance dependency (Lander et al., 2013). If it becomes evident that your child would benefit from treatment, you may consider facilitating a formal evaluation or referral here at Protected Roots Integrative (PRI) Treatment Center (Lander et al., 2013). Once a substance use problem has been identified, we will create treatment plans using interventions that include butare not limited to cognitive behavioral therapy (CBT), psychoeducation, and contingency management (Interventions for Substance Use Disorders, 2018).

References

American Psychiatric Association Publishing. (2022). Substance Related and Addictive Disorders. In Diagnostic and statistical manual of mental disorders: DSM-5-TR (pp. 544–666). essay.

Effective health care program. Interventions for Substance Use Disorders in Adolescents: A Systematic Review | Effective Health Care (EHC) Program. (2018, October 29).

Lander, L., Howsare, J., & Byrne, M. (2013). The impact of Substance Use Disorders on families and children: From theory to practice. Social Work in Public Health, 28(3–4), 194–205.

Steinberg, L. (2011). Adolescent risk taking: A Social Neuroscience Perspective. Adolescent Vulnerabilities and Opportunities, 41–64.

Sussman, S., Skara, S., & Ames, S. L. (2008). Substance Abuse Among Adolescents. Substance Use & Misuse, 43(12–13), 1802–1828.

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