Substance Abuse / Chemical
Dependence
What is substance abuse/chemical dependence?There are three different terms used to define
substance-related disorders, including the following:
- substance abuse
Substance abuse is used to describe a pattern of substance (drug) use
leading to significant problems or distress such as failure to attend
school, substance use in dangerous situations (driving a car),
substance-related legal problems, or continued substance use that
interferes with friendships and or family relationships. Substance
abuse, as a disorder, refers to the abuse of illegal substances or the
abusive use of legal substances. Alcohol is the most common legal drug
of abuse.
- substance dependence
Substance dependence is used to describe continued use of drugs or
alcohol, even when significant problems related to their use have
developed. Signs include an increased tolerance or need for increased
amounts of substance to attain the desired effect, withdrawal symptoms
with decreased use, unsuccessful efforts to decrease use, increased time
spent in activities to obtain substances, withdrawal from social and
recreational activities, and continued use of substance even with
awareness of physical or psychological problems encountered by extent of
substance use.
- chemical dependence
Chemical dependence is also used to describe the compulsive use of
chemicals (drugs or alcohol) and the inability to stop using them
despite all the problems caused by their use.
What substances are most often abused by adolescents?
Substances frequently abused by adolescents include, but are not limited
to, the following:
- alcohol
- marijuana
- hallucinogens
- cocaine
- amphetamines
- opiates
- anabolic steroids
What causes substance abuse/chemical dependence?Cultural and societal norms influence acceptable standards of
substance use. Public laws determine the legal use of substances. The
question of whether there is a normative pattern of substance use in
adolescence remains controversial. Substance-related disorders in
adolescence are caused by multiple factors including genetic
vulnerability, environmental stressors, social pressures, individual
personality characteristics, and psychiatric problems. However,
determining which of these factors are primary and which are secondary in
adolescent populations has not been determined. Most of the knowledge
available regarding substance use and abuse comes from studying adult
populations. A lack of research studying youthful substance use and abuse
leaves questions concerning how it differs from substance abuse in other
age groups unanswered.
Who is affected by substance abuse/chemical
dependence?Parental and peer substance use are considered two of the more
common factors contributing to youthful decisions regarding substance use.
Alcohol use among adolescents has increased during the last 10 years.
Some adolescents are more at risk of developing substance-related
disorders, including adolescents with one or more of the following
conditions present:
- children of substance abusers
- adolescents who are victims of physical, sexual, or psychological
abuse
- adolescents with mental health problems, especially depressed and
suicidal teens
- physically disabled adolescents
What are the symptoms of substance abuse/chemical
dependence?The following are the most common behaviors that indicate an
adolescent is having a problem with substance abuse. However, each
adolescent may experience symptoms differently. Symptoms may include:
- getting high on drugs or getting intoxicated (drunk) on a regular
basis
- lying, especially about how much they are using or drinking
- avoiding friends and family members
- giving up activities they used to enjoy such as sports or spending
time with non-using friends
- talking a lot about using drugs or alcohol
- believing they need to use or drink in order to have fun
- pressuring others to use or drink
- getting in trouble with the law
- taking risks, such as sexual risks or driving under the influence of
a substance
- suspension from school for a substance-related incident
- missing school due to substance use
- depressed, hopeless, or suicidal feelings
The symptoms of substance abuse may resemble other medical problems or
psychiatric conditions. Always consult your child's physician for a
diagnosis.
How is substance abuse/chemical dependence diagnosed?
A pediatrician, psychiatrist, or qualified mental health
professional usually diagnoses substance abuse in adolescents. However,
adolescent substance abuse is believed by some to be the most commonly
missed pediatric diagnosis. Adolescents who use drugs are most likely to
visit a physician's office with no obvious physical findings. Substance
abuse problems are more likely to be discovered by physicians when
adolescents are injured in accidents occurring while under the influence,
or when they are brought for medical services because of intentional
efforts to hurt themselves. Clinical findings often depend on the
substance abused, the frequency of use, and the length of time since last
used, and may include the following:
- weight loss
- constant fatigue
- red eyes
- little concern for hygiene
Treatment for substance abuse/chemical dependence:Specific treatment for substance abuse/chemical dependence will
be determined by your child's physician based on:
- your child's age, overall health, and medical history
- extent of your child's symptoms
- extent of your child's dependence
- the substance abused
- your child's tolerance for specific medications or therapies
- expectations for the course of the condition
- your opinion or preference
A variety of treatment programs for substance abuse are available on an
inpatient or outpatient basis. Programs considered are usually based on
the type of substance abused. Detoxification (if needed, based on the
substance abused) and long-term follow-up management are important
features of successful treatment. Long-term follow-up management usually
includes formalized group meetings and developmentally age-appropriate
psychosocial support systems, as well as continued medical supervision.
Individual and family psychotherapy are often recommended to address the
developmental, psychosocial, and family issues that may have contributed
to and resulted from the development of a substance abuse disorder.
Prevention of substance abuse/chemical dependence:There are three major approaches frequently used to prevent
adolescent substance use and abuse, including the following:
- school-based prevention programs
School-based prevention programs usually provide drug and alcohol
education and interpersonal and behavior skills training.
- community-based prevention programs
Community-based prevention programs usually involve the media and are
aimed for parents and community groups. Programs such as Mothers Against
Drunk Driving (MADD) and Students Against Drunk Driving (SADD) are the
most well known community-based programs.
- family-focused prevention programs
Family-focused prevention programs involve parent training, family
skills training, children's social skills training, and family self-help
groups. Research literature available suggests that components of
family-focused prevention programs have decreased the use of alcohol and
drugs in older children and improved effectiveness of parenting skills
that favorably affected their children's risk factors.
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