Introduction
Adolescence is characterized by biological, mental, and social changes in every human life. Admittedly, the teenage age range consists of people from 10 to 19 years old. The large-scale process of socialization inherent in this biological period includes risky behaviors such as substance use and abuse. Ollendick, White, and White (2018) note, “26% of eight graders in the United States have tried alcohol, 16% have tried marijuana, 13% have tried cigarettes, and other 21% have tried other illicit drugs” (p. 445). These figures increase several times when studying 12th-grade students (Ollendick et al., 2018). And while overall statistics show a decrease in the number of unique and persistent cases of substance abuse in Western countries in general and in the US in particular, this problem is still extremely urgent. This harmful practice leads to mental addictions and physical dependences that are significant drivers of a large number of severe mental and physical illnesses. This work will examine the causes, types, symptoms, consequences, and diagnosis and treatment methods of substance abuse, as well as correlations between substance addiction and mental disorders.
Substance Abuse among Adolescents
The term substance implies both legal and illegal chemical compounds. According to Pagliaro and Pagliaro (2019), substances of abuse are “the abusable psychotropics are represented by three classes of psychotropics – psychodepressants, psychostimulants, and psychedelics” (p. 10). They are mainly presented in the form of alcoholic beverages, tobacco products and narcotic or stimulant substances. With a large dosage and constant use, these substances cause an irreversible degenerative change in the human body.
Causes of Substance Abuse among Adolescents
Causes of substance abuse among adolescents can be divided into social and genetic. Also, the average age range for the onset of abuse is from fifteen to eighteen years. Researchers have identified critical social causes such as the behavior and influence of surrounding peers, the need for socialization, a sense of “adultness,” as well as a “comfortable feeling” and stress absence during intoxication (Manoj Sharma, 2015). The paradox is that adolescents are often aware of the subsequent mental and physical effects of alcohol, cigarettes, and drug abuse. Genetic causes include features of substance metabolism and epigenetic modifications (Hines, Morley, Mackie, and Lynskey, 2015). According to Hines et al. (2015), “later stages influenced by epigenetic modifications brought about by substance use” (p. 128). Other causes include experiences with tragic events like sexual harassment or the death or incurable disease of a close relative or friend.
The Major Substances and Symptoms
The concept of a substance includes an extensive list of alcoholic beverages, smoking mixtures, and drugs. The most commonly used substances are cigarettes, smokeless tobacco, cigars, alcohol, marijuana, cocaine, inhalants, ecstasy, heroin, and methamphetamines (Manoj Sharma, 2015). Yet, the symptoms of their abuse are mainly general. Researchers note that common signs among adolescents are more-than-planned substance abuse, tolerance, withdrawal, interferences with life, and inability to stop (Rhemtulla et al., 2016). Although most adolescents avoid the development of mental and physical addictions, nevertheless, substance abuse still negatively affects the vital processes of the human body.
Consequences of Substance Abuse for Adolescents
Substance abuse during biological maturation primarily affects the work and processes of the brain. For example, alcohol use impairs mental versatility and other daily higher-order cognitive abilities (Whyte, Torregrossa, Barker, & Gourley, 2018). Also, substance abuse adversely affects the response inhibitors and increases overall sensitivity (Whyte et al., 2018). Also, a high percentage of ethanol in the blood violates the production of corticosterone, which is the primary hormone of stress, especially in adolescence (Whyte et al., 2018). This deficiency further leads to behavioral inflexibility and promotes the development of tolerance to substances (Whyte et al., 2018). Drug use leads to degeneration of the anterior and central regions of the brain, and also reduces the processes of neurogenesis (Whyte et al., 2018). The result of these operations is the deterioration of memory and the functions responsible for the ability to learn. These destructive processes are entirely reversible with the help of several advanced treatment methods.
Substance Abuse Treatment for Adolescents
Family Therapy Methods
Today, experts identify the three most effective methods for treating substance abuse. They are Family Therapy Methods, Cognitive Behavioral Therapy, and Motivational Interviewing or, in other words, Motivation Enhancement Treatment (Ollendick et al., 2018). According to Ollendick et al. (2018), Family Therapy Methods “can be classified into five major categories: behavioral systems, systems, functional, ecological, and educational” (p. 450). The first category is applied by identifying specific behavioral mechanics related to substance abuse among family members. Systems technique involves the restructuring of the basic principles of the interplay between family members. The functional class combines two methodologies that were fully described above. A distinctive feature of the ecological model is the application of all the previous methods, not only within the framework of one house but also in all social institutions that a teenager visits. Educational practice informs all family members about all aspects of substance abuse.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy involves several psychological approaches to adjust the thinking of a teenager suffering from substance abuse to develop skills related to overcoming, sociability, determination, and self-control. This treatment technique is divided into individual and group-based (Ollendick et al., 2018). In the course of conducting an assessment of the effectiveness of all substance abuse treatments, both categories of Cognitive Behavioral Therapy are equally useful in practical use.
Motivational Interviewing/Motivation Enhancement Treatment
This model combines the principles of an interview and a session of a psychotherapist in its structure. Its purpose is to use the mental resources of a teenager to develop an understanding of the problem of substance abuse and create behavioral resistance (Ollendick et al., 2018). In practice, such interviewing consists of a maximum of two sessions and serves as an introduction to treatment methods such as Family Therapy Methods and Cognitive Behavioral Therapy.
Substance Abuse Diagnosis of Adolescents
It is also essential to conduct an appropriate diagnosis of the adolescent to determine the degree of dependence, whether it is mild, moderate, or severe, and consumed substance. According to Gray and Squeglia (2018), the Screening to Brief Intervention “yields high sensitivity and specificity for identifying use and substance use disorders” (p.623). Also, specialists use the Brief Screener for Tobacco, Alcohol, and Other Drugs to determine the periodicity of usage of certain substances. These procedures are available in electronic form and can be performed by adolescents themselves in a short time. They allow you to quickly assess the degree of content of substances and the nature of substance dependence. Also, effective diagnostic methods are Car, Relax, Alone, Friends/Family, Forget, Trouble and Alcohol, Smoking, and Substance Involvement Screening Test (Gray and Squeglia, 2018). Global Appraisal of Individual Needs with the functions, mentioned above, makes it possible to consider the possible range of psychological diseases and the criminal potential of an adolescent.
The next step in the diagnosis of the type of an addictive component and related addiction disorder category is the clarification of the results in accordance with the 5th Edition of Diagnostic and Statistical Manual of Mental Disorders. This material makes it possible to make an accurate formal medical diagnosis. It is also necessary to include the main points of a functional analysis of adolescent behavior. According to Gray and Squeglia (2018), “the functional analysis framework is used to determine what antecedents and consequences are potentially modifiable to reduce the likelihood of ongoing problem behavior” (p. 624). Laboratory tests of blood and urine can support a substance abuse assessment. Patients can perform these procedures both in the medical institution and at home using specific drug test kits.
Adolescent Substance Abuse and Mental Disorders
Substance abuse among adolescents is indirectly and directly related to psychological issues. Researchers note, “adolescents with substance use disorders also have high rates of co-occurring mental illness” (“Common comorbidities,” 2018, para. 4). The most common cases of mental disorders with substance abuse are PTSD, anxiety disorder, panic attacks, bipolar disorder, psychosis, depressive and suicidal tendencies, and various personality disorders (“Common comorbidities,” 2018). Substance abuse teenagers also have an increased chance of developing schizophrenia (“Common comorbidities,” 2018). Some childhood psychiatric illnesses, such as attention-deficit hyperactivity disorder, and methods for treating them, through stimulant medications, are considered as risk factors for substance addiction in adolescence too (“Common comorbidities,” 2018). Researchers continue to study the correlations between mental disorders and substance dependence.
Mental Disorders as Cause of Substance Addiction
Mental diseases are one of the factors in the emergence of mild, moderate, and severe substance addiction. This is due to the practical component of medical treatment of these disorders that include medication program the purpose of which is to act directly on nervous system and processes of the brain. Drugs can have a positive effect on one group of syndromes but passively contribute to the development of others (“Common comorbidities,” 2018). Also, patients with mental disorders, especially adolescents, are subject to significant changes in brain activity. Researchers note “changes in brain activity may increase the vulnerability for problematic use of substances by enhancing their rewarding effects, reducing awareness of their negative effects” (“Common comorbidities,” 2018, p. 13). During the treatment process, patients may misuse prescribed and non-prescribed medications, which is also the cause of substance abuse indirectly associated with mental disorders. According to Hudgins, Porter, Monuteaux, and Bourgeois (2019), “reported prescription opioid misuse is common among adolescents and young adults” (p. 2). Another factor is the incorrect or inaccurate diagnosis made by a specialist, which leads to the use of addictive drugs.
Substance Addiction as Cause of Mental Disorders
Various substances also equally often have a negative influence on the development of mental disorders. Addictive substances act on the same areas of the brain that experience disturbances during mental and psychological diseases (“Common comorbidities,” 2018). For example, cocaine use worsens symptoms and enhances the development of the bipolar disorder (“Common comorbidities,” 2018). Addiction to marijuana, coupled with genetic tolerance leads to an increased chance of developing a psychotic illness in adulthood (“Common comorbidities,” 2018). Researchers also note a correlation between cigarette, cigar, and tobacco use, and the incidence of schizophrenia and depressive disorder among users (“Common comorbidities,” 2018). The bottom line is that various addictive substances are destructive or degenerative for certain parts of the human brain, which leads to mental disorders. Nicotine weakens the anterior zones of the brain, in particular the dorsal anterior cingulate cortex, which subsequently triggers a chain reaction with other parts of the brain (“Common comorbidities,” 2018). Further research will help develop methods and medications that can localize and minimize the adverse effects of addictive substances.
Conclusion
This work on the topic of teenage substance abuse and dependence explores the term addictive substance, reasons and signs of abuse, approaches to diagnosis and treatment, and interrelations with mental disorders. The identified causes are divided into two groups, one of them is social, determined by the environment, and the second is genetic, which is directly related to the biology of adolescents. Addictive substances are also divided into categories of alcohol and tobacco products and drugs. Symptoms can be identified and manifest both within the external environment and in the body of adolescents. The substances have the most destructive effect on the brain and its activities, in particular on the processes of quick thinking, memorization, and learning ability. Commonly recognized effective treatments for adolescent substance abuse are Family Therapy Methods, Cognitive Behavioral Therapy, and Motivational Interviewing/Motivation Enhancement Treatment. Diagnosis of such disorders is carried out using a number of tests, the degree of dependence is clarified using a medical manual and confirmed using electronic and laboratory tests. Also, competent researchers and neurologists note a clear cyclical relationship between substance abuse disorders and mental illness.
References
Common comorbidities with substance use disorders. (2018). Web.
Gray, K. M., & Squeglia, L. M. (2018). Research review: What have we learned about adolescent substance use? Journal of Child Psychology and Psychiatry, 59(6), 618-627.
Hines, L. A., Morley, K. I., Mackie, C., & Lynskey, M. (2015). Genetic and environmental interplay in adolescent substance use disorders. Current addiction reports, 2(2), 122-129.
Hudgins, J. D., Porter, J. J., Monuteaux, M. C., & Bourgeois, F. T. (2019). Prescription opioid use and misuse among adolescents and young adults in the United States: A national survey study. PLoS medicine, 16(11), 1-15.
Manoj Sharma, M. B. B. S. (2015). Substance Abuse in Adolescents: Implications for Research and Practice. Journal of Alcohol and Drug Education, 59(1), 3.
Ollendick, T. H., White, S. W., & White, B. A. (Eds.). (2018). The Oxford Handbook of Clinical Child and Adolescent Psychology. New York, NY: Oxford Library of Psychology.
Pagliaro, L. A., & Pagliaro, A. M. (2019). Child and adolescent drug and substance abuse: A comprehensive reference guide. New York, NY: Routledge.
Rhemtulla, M., Fried, E. I., Aggen, S. H., Tuerlinckx, F., Kendler, K. S., & Borsboom, D. (2016). Network analysis of substance abuse and dependence symptoms. Drug and alcohol dependence, 161, 230-237.
Whyte, A. J., Torregrossa, M. M., Barker, J. M., & Gourley, S. L. (2018). Long-term consequences of adolescent drug use: Evidence from pre-clinical and clinical models. Frontiers in Behavioral Neuroscience, 12, 83.