By: Steve Greenman, MA, LPC, NCC

Sam came into my office with fear in his eyes. His father had called me and stated he needed to find some help for his boy – all had not been right for a while. Sam was a freshman in college and had been doing outstanding in his studies. During the Christmas break, Sam had gone to a party and though he has smoked pot occasionally, he was about to experience drugs in a whole new light.

The mixture was LSD and Ecstasy – candy flipping. Being inexperienced with the drugs, he took five times the normal dosage and three months later, he was still dealing with side effects.

After the pleasurable effects of candy flipping, Sam dealt with unwanted after-effects, which typically occur two to three days after the drug use and are known as blues or suicide Tuesday:

• Depression, anxiety, panic attacks, paranoia
• Problems with sleeping
• Poor concentration
• Fatigue
• Loss of appetite
• Craving for the drug

But what made it even worse for Sam was not just the normal side effects but he had incurred possible brain damage with side effects still affecting him months afterwards: difficulty sleeping, erratic behavior, temper issues, balance and difficulty with light tracing.

Sam had to drop out of the following term and was struggling with holding a job and at times, dealing with simple reality. What began as an experimental night out with friends became a struggle to understand for the family: Would this be his new reality for the rest of his life?

Teen Dilemma

• In 1998, nearly 10 percent of adolescents (age 12 to 17) reported using an illicit drug at least once during the past month. About one in 12 youth (8.3 percent) in this age group are current (past month) users of marijuana, the most frequently used illicit drug, and 19.1 percent are current users of alcohol.
• More than half (55 percent) of our nation’s 12th graders have tried an illicit drug and more than one-quarter (29 percent) have tried a drug other than marijuana, such as cocaine, inhalants and heroin.
• Youth age 16 to 17 have the second highest rate (16.4 percent) of current illicit drug use in the country. The highest rate (19.9 percent) is found among young people age 18 to 20.
• It’s estimated that 400,000 adolescents are in need of substance abuse treatment
• Reports from eighth graders first use of substances by the fourth grade: alcohol 6.8%, cigarettes 7.3%, inhalants 3.6%, and marijuana 1.1%
•  Although consumption of alcoholic beverages is illegal for people under 21 years of age, 10.4 million current drinkers are age 12 to 20. Of this group, nearly half (5.1 million) engage in binge drinking, including 2.3 million who would also be classified as heavy drinkers.

Being Attentive

People who interact with adolescents in the home or community need to be alert to changes in an adolescent’s behavior and appearance that may signal substance abuse.

By recognizing the potential warning signs and symptoms of substance use, you may be able to get help for a teenager in need of treatment. The following behavior changes, when extreme or lasting for more than a few days, may indicate alcohol-related or drug-related problems and the need for further screening by a professional.

Sudden changes in personality without another known cause:

• Loss of interest in once favorite hobbies, sports, or other activities
• Sudden decline in performance or attendance at school or work
• Changes in friends and reluctance to talk about new friends
• Deterioration of personal grooming habits
• Difficulty in paying attention, forgetfulness
• Sudden aggressive behavior, irritability, nervousness, or giddiness
• Increased secretiveness, heightened sensitivity to inquiry

Consequences

Adolescents face unique risks associated with substance abuse. The use of substances may compromise an adolescent’s mental and emotional development by interfering with how young people approach and experience interactions. In addition, adolescents are at serious risk for a number of direct and indirect consequences, including the following:

• Delinquent Behavior—Adolescents who use marijuana weekly are six times more likely than non-users to report they run away from home, five times more likely to say they steal from places other than home and four times more likely to report they physically attack people.
•  School-Related Problems—Adolescent substance abuse is associated with declining grades, absenteeism from school and dropping out of school. Cognitive and behavioral problems experienced by teens abusing substances may interfere with their academic performance.
• Traffic Accidents—Nearly half (45 percent) of all deaths from traffic accidents are related to the consumption of alcohol and an estimated 18 percent of drivers age 16 to 20 (or 2.5 million adolescents) drive under the influence of alcohol.
• Risky Sexual Practices—Adolescents who use drugs and alcohol are more likely than non-using teens to have sex, initiate sex at a younger age and have multiple sex partners, placing them at greater risk for unplanned pregnancies and HIV/AIDS, hepatitis C and other sexually transmitted diseases.
• Juvenile Crime—Adolescents age 12 to 16 who have ever used marijuana are more likely at some point to have sold marijuana (24 percent vs. less than one percent), carried a handgun (21 percent vs. seven percent) or been in a gang (14 percent vs. two percent) than youth who have never used marijuana.
• Developmental Problems—Substance abuse can compromise an adolescent’s psychological and social development in areas such as the formation of a strong self-identity, emotional and intellectual growth, establishment of a career and the development of rewarding personal relationships.
• Physical and Mental Consequences—Smoking marijuana can have negative effects on the user’s mind and body. It can impair short-term memory and comprehension, alter one’s sense of time and reduce the ability to perform tasks that require concentration and coordination, such as driving a car. Evidence also suggests that the long-term effects of using marijuana may include increased risk of lung cancer and other chronic lung disorders, head and neck cancer, sterility in men and infertility in women.
• Future Use Disorders—The earlier the age at which a person first drinks alcohol, the more likely that person is to develop an alcohol use disorder. A person who starts drinking alcohol at age 13 is four times more likely to develop alcohol dependence at some time in his or her life than someone who starts drinking at age 20.

Treatment

Treating adolescents for substance abuse requires special consideration of the adolescent’s individual experience and how it affects the nature and severity of his or her alcohol or drug use. Understanding the adolescent’s situation will help explain why alcohol or drugs are used and how they became an integral part of his or her identity. Factors that need to be considered when tailoring treatment for adolescents include the following:

• Developmental Stages—Treatment for adolescents must address their unique developmental needs, which vary with the age of the client. Developmental features of younger adolescents are different from those of older adolescents. For example, older adolescents are more capable of abstract thinking and are more likely to openly rebel than younger adolescents.
• Ethnicity and Culture—Norms, values and health beliefs differ across cultures and can affect substance abuse treatment. For example, some cultural groups may consider treatment invasive; others may wish to involve the extended family. Treatment services need to be culturally competent and use the preferred language of adolescent clients and their families.
• Gender and Sexual Orientation—Factors that influence adolescent substance abuse and involvement in treatment differ by gender. For example, whereas adolescent girls more often have internalizing co-existing disorders such as depression, boys are more likely to have externalizing disorders such as conduct disorders. Effective treatment for gay, bisexual and transgendered youth includes helping them to acknowledge and accept their sexual identity.
• Co-existing Mental Disorders—Adolescents with substance abuse disorders are more likely than their abstinent peers to have co-existing mental health problems such as anxiety disorders, attention deficit-hyperactivity disorder and depression. In these teens, substance abuse may disguise, exacerbate or be used to “self-medicate” psychiatric symptoms. Without tailored treatment, co-existing mental disorders could interfere with the adolescent’s ability and motivation to participate in addiction treatment and could increase the potential for relapse.
• Family Factors— An adolescent’s family has a potential role both in the origin of his or her substance abuse problem and as an agent of change in the adolescent’s environment. Treatment should take into account family factors that increase risk for substance abuse problems in youth, such as any history of parental or sibling substance abuse problems or addiction; domestic violence; physical, sexual, or emotional abuse, and neglect. Whenever possible, parents should be involved in all phases of their adolescent’s treatment.

Parental Influence

Alcoholism and other drug addiction tend to run in families. Children of addicted parents are more at risk for alcoholism and other drug abuse than are other children:

• Family interaction is defined by substance abuse or addiction in a family.
• Families affected by alcoholism report higher levels of conflict than do families with no alcoholism.
• *A relationship between parental addiction and child abuse has been documented in a large proportion of child abuse and neglect cases.
• Children of addicted parents have a high rate of behavior problems.
• Children of addicted parents experience greater physical and mental health problems and higher health and welfare costs than do children from non-addicted families.

Encouragement

Adolescents who are in treatment or recovery need all the support they can get from their families and communities. Consider taking one or more of the following actions to support youth undergoing treatment for and recovery from substance abuse. Encourage schools to offer student assistance programs, counseling on substance abus, and confidential referral to treatment and recovery resources in the community.

• Encourage purchasers of health insurance to obtain comprehensive coverage for substance abuse and mental health services.
• Encourage treatment centers, schools, and community-based youth organizations to conduct support groups for children of parents who are addicted to alcohol and drugs.
• Encourage adolescents who have recovered successfully from addictive disorders to participate in community events that target their peers.
• Because alcohol and drug use among youth often occurs in groups, be aware that encouraging one young person to seek help may lead others in his or her social group to seek treatment.
• Encourage environmental changes in your community that promote recovery such as reducing the number of billboards advertising alcoholic beverages and holding alcohol-free recreational events.
• Encourage the participation of family members in all aspects of the treatment and recovery process for adolescents and foster the availability of family-centered support groups and other services that address the needs of the entire family.
• Be a positive role model for young people in treatment and recovery by not engaging in any illegal or unhealthy substance use.
• Get involved in organizations that to support substance abuse treatment and recovery programs for adolescents.
• Stay informed about available local resources for treatment and recovery and use this knowledge to help others.

Steve Greenman, MA, LPC, NCC is a counselor at Mental Wellness Counseling in Traverse City, MI. He specializes in helping families dealing with complex family situations, addictions, and transitions. Steve is also helping clients through the Intensive Recover Program, which helps with recovery treatment, alcohol treatment, and other addictions treatment. Contact Steve at 231-714-0282 Ext. 701