My own realization that adolescents could indeed be addicted to drugs and
alcohol developed once I began working with young people in the mid-1980s.
When I was first hired to work with the teenage addicts and alcoholics on the
adolescent unit of an inpatient psychiatric hospital, I did not think that teenagers
could really be addicted. Unlike the adults with whom I had been working for
years, young people simply could not, in my mind, have had enough time to
develop a full-blown addiction to chemicals. I thought that it took years to
become truly hooked, and that these youngsters were simply too young. Was I
wrong!

I learned, for one thing, that these adolescents had often been using drugs
and alcohol since they were eleven or twelve. If they came into treatment at age
seventeen or eighteen, they may have been using and abusing drugs and alcohol
for seven or eight years. This was almost half of their young life. I now know
that some children start abusing alcohol (the cheapest and easiest drug to get)
at around age eight or nine. In fact, some have been exposed to alcohol and
drugs in utero because their parents were users or addicts; some are introduced
to alcohol as infants when parents or caretakers use it to soothe the child, such
as by rubbing alcohol on the child's gums when he or she is teething; and some
begin their abuse of drugs and alcohol as small children when they are given
sips of booze or tokes of marijuana because an adult finds it amusing to see the
effects. By junior high school, many young people are abusing alcohol and other
drugs on a regular basis, especially on weekends. By high school, adolescents
who are chemically dependent often have a reputation among their peers as
being a drug abuser, a "burnout," a "pot head," or some other such derogatory
and degrading term.

In determining whether someone is an addict, it is often helpful to distinguish
among use, abuse, and addiction. In fact, there appears to be a continuum of
chemical abuse, starting from abstinence on the one hand and extending to
addiction on the other hand. Typically, a person progresses from abstinence, to
use, to abuse, and finally to addiction. As the person becomes increasingly
dependent, it becomes harder and harder to stop using and abusing. Addicted
people have less and less freedom to choose not to use the addictive chemical.
Finally they are enslaved to the substance; they "have a monkey on their back."
The teenage burnouts were not addicts when they first used drugs or alcohol.
For most, the progression was relatively gradual; in other words, it took months
or years to move from abusing alcohol to abusing marijuana, and longer still
until they found cocaine or heroin.

Dependence usually creeps up on a person. In some ways, the addict is the
last to realize how dependent on drugs and alcohol he or she has become. In
our treatment program, finding the level of the adolescent's dependency was
usually the first order of business. We asked the adolescent's parents about their
child's drug and alcohol abuse and most often found that the parents had been
worrying, nagging, confronting, and begging the teenager to stop for a long

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