Substance Abuse and Addictions

by Marianne Cook, LICSW, Clinician, Harvard University Mental Health Service

Teen alcohol and drug use remains a significant problem in our society. According to recent nationwide studies, about 43 percent of teenagers report having had at least one alcoholic drink in the past month. The numbers are particularly high among older high school students: about 46 percent of juniors and 51 percent of seniors. Approximately 25 percent of teenagers report binge drinking—i.e. consuming more than five drinks in a row over a short time period—at least once in the past month. About 20 percent of teens report having used marijuana at least once in the past month. In regard to other illicit drugs, about 7 percent of students reported using cocaine at least once in their lifetime; 3 percent for heroin; 12 percent for inhalants (e.g. glue or paint); 9 percent for hallucinogens (e.g. acid): 6 percent for ecstasy; and 6 percent for methamphetamines (e.g. speed or crystal meth). Abuse of prescription medications is on the rise, with about 1 in 5 teenagers reporting that they have used a prescription medication to get high.

Substance use can damage every organ in the body. Many substances lead to permanent impairment in brain functioning. Substance use can cause blackouts, vomiting, fainting, breathing difficulties, coma, and even death. Because alcohol and other drugs decrease inhibitions, teen substance use is linked with an increased risk of suicide and homicide. Teenagers who use substances are more likely to be victims of violent crime, to be killed in substance-related car accidents, and to engage in sexual activities at an earlier age.

So what can parents and professionals who work with adolescents do to prevent them from engaging in substance use?  Below are some important tips:

• Establish and maintain good communication. Research has shown that children are more likely to delay using substances if they have a strong and supportive relationship with an adult. Ask questions about the child’s thoughts and feelings. Show interest in his or her activities.
• Beginning in the middle school years, initiate brief conversations about the risks of substance use.  (Short frequent conversations are more effective than one big lecture.) Ask the child what he or she thinks about substance use. The child may balk at these discussions, but be persistent. Treat the child with respect. Be open to feedback and to differing opinions.
• Talk about peer pressure—this is a strong force among teenagers. If the child has difficulty withstanding peer pressure, discuss ways to say No. Remind him or her that it is always possible to leave an uncomfortable situation. Make sure that the child has money and access to phone numbers of trusted adults so he or she can do so. Teach the child never to accept a ride from somebody who has been using alcohol or drugs.
• Help the child brainstorm other ways to manage tough feelings besides turning to alcohol or drugs. This is particularly important if the child displays symptoms of depression, anxiety, bipolar disorder, or other mental health issues, as this can increase the risk of substance use. Consider getting help from a professional if mental health is a significant problem.
• Monitor your medicine cabinet. Keep it locked if possible, and make an inventory of its contents. Both prescription and non-prescription drugs can be used to get high—cold medicines, painkillers, sleeping pills, etc. If you are no longer taking a medication, consider throwing it out.
• Set the example. If you tell the child not to use substances but you reach for a beer or a bong whenever you’re stressed out, the child will not believe your words and will instead follow your example. This does not mean you cannot have a glass of wine with friends at a dinner party, but just be aware of what messages you are sending with your actions.

The information in the article above was drawn from the following sources:

• Children Now (2009). Talking with kids about alcohol and drugs.
• Eaton, D., Kann, L., Kinchen, J., et al. (2005). Youth risk behavior surveillance. From Centers for Disease Control web site: www.cdc.gov/mmwr/preview/mmwrhtml/ss5505a1.htm
• KidsHealth (2008). Kids and alcohol.
• Substance Abuse and Mental Health Services Administration (2005). National survey on drug use and health.
• Substance Abuse and Mental Health Services Administration (2008). Talk with your child.

Additional Sources of Information

• From the Substance Abuse Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services, a series of “Video Vignettes” including: Talk about Alcohol with Your Teen (video), Before a Teen Party, Talk about Alcohol (video), and Set Rules for Your Children About Alcohol, Tobacco, and Illegal Drugs.
• From Children's Bureau of the U.S. Department of Health and Human Services Administration on Children, Youth and Families, published in 2009: Protecting Children in Families Affected by Substance Use Disorders.
• Donald F. Cutler Prevention Center/FCD (Freedom from Chemical Dependency), located in Newton, MA, is the leading international nonprofit provider of K-12 onsite drug education and substance abuse prevention services for schools across the United States and around the world. The site includes links to resources for students, parents, and educators.
• The Resource Library of the Regional Center for Healthy Communities (RCHC) maintains a collection of materials on Substance Abuse and Prevention and related subjects which is available to residents of Metrowest communities.
• National Center on Addiction and Substance Abuse at Columbia University (CASAColumbia) publishes an annual National Survey of American Attitudes on Substance Abuse. A full list of their publications is available at CASA Books, Field Guides and Reports.CASA also maintains an online Resource Center.