Magazine article Clinical Psychiatry News

Preventing and Addressing Substance Use in Teens

Magazine article Clinical Psychiatry News

Preventing and Addressing Substance Use in Teens

Article excerpt

Adolescent substance use is a big, difficult issue. Marijuana, cigarettes, and alcohol are endemic to many high schools.

One approach to addressing this problem is to educate parents about which children might be at higher risk for substance use. For example, most teenagers are at some risk and need to be watched for any high-risk "activities, especially drinking and driving or riding in a car with a friend who has been drinking. If parents begin to see a serious problem - take it very seriously. We must talk with patients and parents.

Other kids might be at slightly higher risk in high school, based on their achievements. For example, a good athlete who joins the varsity team in 9th or 10th grade, or the talented 9th grader who lands the lead in the high school play, tends to spend more time with juniors and seniors. They get invited to parties and events outside their peer group. While trying to "keep up," they might be more vulnerable to problematic substance use. The difference between a 14-year-old and a 17-year-old is enormous, and the peer pressure of being with seniors is considerable.

Recognize that some kids start high school already predisposed and at quite high risk for substance use problems: a patient with biologic or genetic risk factors; a patient with untreated depression or anxiety; and/or an adolescent with attention-deficit/hyperactivity disorder (ADHD) are examples.

Left unaddressed, these kids are predisposed to earlier and more serious substance use. Some children with genetic and/or biological risk factors begin drinking heavily before their 14th birthday. In contrast, the typical age of onset for alcohol use includes some experimentation at 15 or 16 years that becomes binge drinking for some a year or two later.

Biology predisposes some adolescents to nicotine addiction or heavy use of marijuana or alcohol. While adolescent brains are in development and experience the expected stress of puberty and building an identity, some teenagers' brains may be more susceptible to addiction than others. In addition, genetics and environment can play a role. If there is a strong history of alcoholism in the family or if a parent is a recovering alcoholic, discuss with parents how their past might influence how they treat their teenager. Advise them what information should be shared to alert the teenager to the potential risks. It might help a child at age 12 or 13 to know that they might be especially vulnerable to the dangers of substance use, and this might well open up an avenue of communication and trust that could be helpful later. …

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