Identifying and Treating Teenage Substance Abuse                                                 By Susan Adams, M. Ed. 9/2l/09   This article is written for MES and appears only on my web site   Objective:  The objective of this article is to identify signs of teenage substance abuse, to differentiate from adult substance abuse, and to make some treatment suggestions.   Summary:  Teenagers in the United States today experience the realities of adulthood at earlier and earlier ages, often with painful results.  When there are no understanding adults to ease the emotional pain, teens may turn to liquids, pills, or powders to ease the pain.  This article presents a discussion of the symptoms of teenage substance abuse and a description of possible treatment options.   The causes of teenage substance abuse are complex and range from genetics and childhood behavior to attitudes and family issues.  The good news is that stopping substance abuse early gives teens a chance to mature into healthy adults.  Those kids who don't use chemicals at all cope much better with the difficult struggles of growing up. This makes great sense since we know, at this point, that all chemicals impair judgment and that some such as alcohol, cause or worsen depression.   The first step in preventing or arresting teen substance abuse is to know the risks and warning signs.   Researchers agree that five to ten percent of the population carries a genetic predisposition for developing chemical dependency.  Studies of children adopted at birth show that those born to alcoholic parents are three to five times more likely to become alcoholics themselves.  There are many such studies that prove that alcoholism and drug addiction are sometimes passed down through the genes.   For this reason, when a family seeks help for teenage substance abuse, a family history is critical.  The family can speed treatment by examining their own history to find, in case they don't know, if anyone died of cirrhosis of the liver or other problems related to substance abuse.  There is no shame here.  The information is vital to treating the teen patient.   It is also important to remember that parents are the most important role models for their children.  If parents drink excessively or carry a high tolerance for those who do, their children are likely to develop skewed ideas about average consumption of alcohol.  The children may likely become substance abusers themselves.   Studies also show that teens from single-parent homes are more prone to abuse drugs and alcohol as are teens who live with chaos on a regular basis.  Such examples of chaos and disorder are parents who fight much of the time or don't enforce the rules for their children.  Close-knit families in which parents provide structure and consistency and monitor children's activities are less likely to have substance-abuse problems.   Most teens go to great lengths to hide substance abuse problems.  Certain changes in behavior, even among young children, may point to current or future substance abuse, especially for kids with  a family history of addiction.   Young children who tend to be aggressive, hyperactive, or antisocial have a much higher rate of addiction in later years.  Problems with learning and attention deficit disorders have been linked with later substance abuse problems.  This because these children feel "different" at school.  The disabilities affect their self-esteem.  They may use substances to feel bigger, better, less sensitive to teasing.  They also usually seek other kids who are like themselves and use substances to cope with peer rejection. Research also shows that kids are more likely to use substances if they have friends who believe that the substances reduce tension or aid in social acceptance.   Once teens begin to use substances, their lives become more and more unmanageable.  They may have  trouble following rules at home, school, or work.  They tend to avoid their families and spend long hours away from home or in their room.   The more they use the harder it is to keep the secret.  Signs that substance abuse has gotten out of control include running away from home, legal problems especially related to possession or sale of drugs, and the total inability to function at school or work.   You can tell a lot about teenagers by looking at their peer groups.  If your teen's friends think that using substances is "cool" your teen is likely to think so too.  Adolescence is a time when kids struggle to find out who they are while desperately seeking  approval from contemporaries.   If kids start using chemicals on their own, they are likely to find a peer group who use as well.   Maintaining strong family ties during adolescence is the most important prevention you can take.  Be sure to find time to talk to your child daily.  Get to know your child's friends through hosting parties and sleepovers and use this time to get to know the parents of their friends as well.  This helps you to feel less isolated and allows for support and sharing of ideas and values between parents.  This makes parenting of adolescents easier.   After all your precautions, what if you suspect a problem?  The first thing to do is to let your teen know that you are concerned. Then find a good treatment specialist.  You want a specialist who is used to dealing with these problems.   The specialist will help you to determine how serious the problem might be.  This means to differentiate between experimental usage and chemical dependency.  Find a specialist who shares your values and beliefs.  There is no such thing for teens as "moderate consumption" so you need a specialist who understands this.   It is important for the specialist to request total abstinence during the evaluation period.  This will yield a lot of information.  Teens who resist this request have much more serious problems, while teens who comply without protest, are much more likely to avoid long lasting problems.   If your teen does have a problem with chemical dependency, the specialist will offer reassurances that the problem is treatable. The treatment ranges from outpatient therapy in conjunction with AA (Alcoholics Anonymous or NA (Narcotics Anonymous) to inpatient treatment with those groups being available on an inpatient campus.   Unfortunately, recovery from addiction is harder for adolescents than for adults.  Teens have not developed fully physically or emotionally and a substance abuse problem handicaps their ability to respond to the realities of recovery.  Also, substance abuse interrupts normal growth and development which results in developmental delays.  These must be addressed during treatment.   Youth makes another problem in recovery as well.  The denial is higher and more difficult to penetrate because the extreme consequences of substance abuse have not been felt as with adults.  Parents of substance abusers find this the most difficult aspect of treatment.   The first step after finding a specialist is to separate the teen from the substance abusing environment.  This is where decisions are made as to outpatient therapy or an inpatient experience.  Adolescent support groups come in to play here--AA or NA.  All teens undergoing treatment for drug abuse should have periodic unscheduled drug screens. Full-blown addictions require intensive inpatient treatment.   The other aspect of treatment is family therapy.  The family needs to be involved in treatment.  The role of the substance abuser needs to be identified, the family dynamics understood, and the family members seen with the patient and alone.  This involvement makes recovery optimal for the teenage substance abuser.   Since teen substance abusers lack adult coping skills, they need to mature on two levels--that of emerging adults and as former users growing toward sobriety.  The goals for teenage substance abusers are the same as for adults.  That is to maintain sobriety and function fully in their lives.  With the help of therapy, family, and community support these goals are very attainable as the patient and family take one day at a time.