From Adolescent Substance Experimentation to Addiction

Although adolescence has always been a time of great transition, many older adults today may have trouble appreciating just how different adolescence has become. High school students today have extensive substance use experiences. For instance, based on federal studies, about 75% have tried alcohol (with 50% drinking regularly), 38% have tried marijuana, 20% have tried cocaine, 50% have had sexual intercourse and 50% have tried cigarettes (with 20% smoking regularly).  These numbers show us that most adolescents today face a range of choices that their parents may not have realized even existed.

Despite the large numbers of adolescents who are exposed to substances and other addictive behaviors, most adolescents do not develop addiction problems. For most adolescents substance use is better described as “experimentation” rather than addiction.  Only a few adolescents develop problems of such magnitude that addiction treatment (typically outpatient treatment) is needed. Even fewer adolescents progress to the level that alcohol and drug rehab is needed.
Nevertheless, it is sensible for our society to be concerned about adolescent substance experimentation, and to provide assistance in reducing the number of individuals who progress from experimentation to addiction.  It is probably not realistic to prevent experimentation. Programs which aim to prevent experimentation may do more harm than good, but the outcome of such programs will depend on variables like family norms and the adolescent’s connection to the family. A strong connection to a family that provides many incentives not to use drugs might often prevent experimentation. However, how many families can provide this situation in an era of so many temptations? What costs would be required to maintain this situation?
For many years one of the leading efforts to prevent addiction has been the DARE program (Drug Awareness and Resistance Education). DARE is usually presented to elementary school students.   Unfortunately, the DARE program has not been shown to be effective in accomplishing its goal of preventing later substance use. One of the problems with DARE may be that, in emphasizing how tempting drugs are and how their use is illegal, that use may be glamorized to an age group that can find satisfaction in being rebellious.
If we are going to be successful in addressing adolescent addiction, we need to recognize how it is different than adult addiction. A major difference is that although a significant adult addiction may take years to develop, in an adolescent addiction can develop in 12 to 18 months.  Adolescent addiction also “looks different” than adult addiction because adolescents tend to use smaller doses at a lower frequency of use. Therefore, even though adolescent addiction can develop rapidly, it can be harder to detect.  In addition to not being misled by lower dose and frequency, when considering the possibility of adolescent addiction it is important to consider the following factors. Does the adolescent have
  1. Less interest or lower grades in school
  2. Deteriorating family relationships
  3. Diminished appetite
  4. Unexplained blocks of time
  5. Personality changes (acting out of character)
  6. Changes in peer group, especially if new friends include drug users
  7. Increased frequency of symptoms/illness (aches, runny noses)
  8. Major changes in parent-child relationship
It is immediately obvious that many adolescents will have all eight of these “symptoms,” which are often part of the dramatic life changes that can occur during normal adolescent development. There is no definitive rule for determining substance involvement, but concern should increase as more of these signs are present, even without known substance use. Substance use in combination with the above signs is cause for greater concern, especially if use is occurring alone. Adolescent drug experimentation is typically a social event and solitary use may be indicative of a substantial problem.
If addiction treatment occurs, it is important to consider the non-12-step treatment options available. Not many adolescents are willing to label themselves as an addict or alcoholic for life. Resistance to treatment will likely be much less these labels can be avoided.
However, ideally addiction is prevented rather than treated. Parents play a crucial role in preventing addiction.  As a basic step, find occasions to have conversations regarding drug use. Create a neutral and open atmosphere for these discussions. Ask questions like “How much drug use do you think goes on at your school? What do you think makes drug use appealing to people? What do you find tempting about drug use?” Accept whatever answers your child gives you, and primarily focus on allowing your child to elaborate on his or her experience and beliefs. The occasional presentation by you of facts and your own opinions may be sufficient to help your child realize that substance use is a serious issue for anyone, especially for adolescents. If despite your best efforts substance problems are emerging, it may be time for professional consultation.