What is adolescent Substance Use Disorder?
Many people think that substance use issues are defined by whether or not a person can stop using. While this is certainly a factor, it is not the most significant one. As clinicians we are looking to see how a person’s substance use has infiltrated and impacted different areas of their life including school, work, family life, friendships, extracurricular activities and more.
“Control” can be a highly misinterpreted word when attempting to understand addiction. One of the strongest motivating factors for a teenager during this phase of development is individuating and having the freedom to make their own choices and do their own thing. When a normal teen is faced with the loss of freedom as a consequence for using drugs and alcohol, their response will be to clean up their act. They will likely do this with a fair amount of ease.
When teenager is willing to sacrifice or compromise their freedom in order to protect drug or alcohol use it can indicate a larger problem with substance use. This is how loss of control manifests itself in Substance Use Disorders.
Is this normal teenage rebellion or something more?
So many parents become twisted and tormented by confusion and unanswered questions about their child’s behavior. This angst is often laced with bits of denial as well as a lack of education about addiction, greatly hampering their ability to be objective about the situation. Fear is not a foundation for effective decision making. Turning to a professional at this point can be critical in impacting the outcome of the situation for the entire family system.
Parents often show up with a laundry list of different behaviors they have witnessed in their child over the past several months. They are able to recognize the acting out or rebellion, but often fail to see the underlying pattern of substance use that coincides with these behaviors. When the use of drugs or alcohol in any context (using, seeking, being around a friend that uses, selling, etc.) becomes a common denominator, it is an indication that it may be time to seek outside help.
What influences adolescent substance use?
There are many factors that can influence adolescent substance use. Culture plays a significant role as a factor influencing substance use. The very first thing I usually ask parents is what the teen’s friendship circle looks like. Who are they spending most of their time with and what are they doing during that time? A teen that is not using drugs and alcohol, in general, will not want to spend most of their time with friends that do. Are they involved in sports, hobbies or extracurricular activities of any kind? What they do and who they do it with, in large part, creates their culture.
The younger a person is when they start using substances, the higher their chances of addiction. According to the National Institute on Alcohol Abuse and Alcoholism individuals who “begin drinking before age fifteen are four times more likely to become alcohol dependent at some time during their life” compared to those who have their first drink at twenty or older. According to the National Institute on Drug Abuse teens who “begin using marijuana before age eighteen are four to seven times more likely to develop Marijuana Use Disorder” than those who were introduced after the age of eighteen.
Genetics also play a big role in influencing substance use disorders in teenagers. If there is a family history of addiction of any kind, an individual is approximately fifty percent more likely to develop a substance use disorder at some point in their life. It is very important to remember that addiction is a biologically based disease. Informing a teen of their family history and their potential vulnerability to the disease will be to their advantage.
Parenting as a Protective Factor
The point of presenting to your child as a united front cannot be stressed enough. The relationship between parents, whether married or divorced, serves as the underlying foundation for the entire family system. Any crack in that foundation will be recognized by the child as instability and weakness. While power is struggling with a kid is never encouraged, maintaining our personal power and our role as the parent/parents is dire.
Focusing on how we are showing up in the relationship rather than on the content of what is happening with the child is key. It’s very tempting to get hooked into the details of the drama that is going on with the child. This will get us nowhere. In general, it’s not about what you were interacting with your child about but rather, how you are choosing to respond.
It’s so easy to get triggered when dealing with a teen that is acting out. They know exactly how to push our most sensitive buttons. The minute that anger starts rising up within us is also the minute we begin losing power. Children, and particularly teenagers, do not respond to the words that come out of our mouths but rather, to the energy behind them. Once we recognize this we can start making choices that will affect a different outcome.
As parents, we want to recognize a cry for help from our child. Adolescents communicate differently than adults and may not come forward with a direct request for help. It’s important to read between the lines and trust our instincts. Realize that they are the kids and are relying on us to be the adults. If all signs are pointing toward a problem then don’t wait for more evidence to stack up. Not reaching out for help will always be more regrettable then reaching out unnecessarily.