Teen Substance Abuse: Signs & Factors - A Growing Concern

Introduction

Adolescence is a time of self-discovery. However, this journey is not smooth-sailing. Teenagers are often swayed by pop culture, media, their own urgent curiosity about the world and each other! These influences on teenagers can lead them to experiment with varying habits and behaviours, and one such area of experimentation is substance abuse. Curiosity about substances is natural for a teenager, but this can be a dangerous experiment for a developing mind to undertake. 

Substance abuse and its prevalence among teenagers in India (include statistics)

Substance use becomes problematic when it starts interfering with one’s life. A substance use disorder is characterized by one’s dependency on the substance and the disruption that its use may cause in one’s life. Commonly, substance abuse impacts one’s engagement in school or work, with friends and family, and in the long run, may impact one’s health. Substance abuse among teens may lead to missing school or poor academic performance, health issues, and conflict with family and friends. 

According to India’s ministry of social justice and empowerment, 148,00,000 adolescents between ages 10 and 17 use some substance. The most common substances that Indian teenagers use for abuse are opiods, with alcohol and inhalants being second most used. 

Consequences of substance abuse on teenagers' health, well-being, and future

While some experimentation during teenage is a part of healthy development, dependency on substances comes with many risks and adverse effects for teenagers. Some of the consequences of substance abuse on teenagers are: 

1. Decline in academic performance 
2. Poor physical health 
3. Mental health concerns such as increased anxiety and depression 
4. Dependency and withdrawal symptoms 
5. Other high-risk behaviour such as unsafe sexual practices and drunk driving 

It is important to note, however, that many of the “consequences” of substance abuse may be contributing factors to use as well. For example, if a teenager is struggling with anxiety, they may turn to substances to calm their nerves. Substance abuse is a complex issue which may be a way to cope with emotional distress, and at the same time, end up contributing further to distress. 

Addressing this growing concern

Teenage is often described as a tumultuous time. This is because during adolescence, one’s identity, sense of self and relationship with the world is rapidly developing. At the same time, one has a higher tendency to take risks and give in to peer pressure. 

To ensure healthy development of a growing mind, it’s important to have open dialogue about teen substance use. Educating teenagers about the ill effects of substance use can help them make informed choices and guard them against peer pressure. It’s also important for parents and educators to learn about the signs of substance abuse and offer help when needed. 

Factors Contributing to Teen Substance Abuse

The reasons why teenagers turn to substance abuse vary from peer pressure to individual factors to home environment. Teenagers are particularly influenced by their environment and are still learning how to set boundaries or communicate clearly. In fact, they are still learning who they are. Along this journey, the following factors put teenagers at a higher risk of substance abuse: 

1. Genetic factors such as a family history of substance use, which may also contribute to low parental supervision
2. Peer pressure 
3. Lack of connectedness with peers or feeling socially isolated 
4. Household or family dysfunction such as conflict at home
5. Abuse or trauma 

Substances Commonly Abused by Teenagers 

Cannabis

Cannabis or marijuana is known by many different street names - ‘pot’, ‘dope’, ‘marie jane’ or ‘hash / ganja’ are some common ones. It is most commonly smoked, but may also be consumed as edibles or oil. It is extracted from the cannabis plant and has two components - THC and cannabidiol (CBD). While the latter is used for medicinal purposes, substance abuse is mostly seen when marijuana high in THC is consumed. THC is a psychoactive substance which leads to mood and behavioural changes. According to NDDTC, about 31 million (2.8%) adolescents in India use cannabis, with about 2.5 million showing signs of dependency.  

Heroin 

Heroin is a derivative of opium, extracted from the poppy plant. While some opioids are used for medicinal purposes, heroin is an illegal substance that is used purely recreationally. It is highly addictive and is a cause of concern in many countries. For example, in the US, it is estimated that approximately 76,000 teenagers between ages 12 and 17 use heroin. In India, opioids are the most commonly used drug with approximately 40,00,000 teenagers using it, although it’s not clear how many of them use heroin vs other opioid derivatives. 

Heroin is either smoked, snorted or injected. While initially, it produces a feeling of relaxation, as the drug takes effect, it lowers breathing and heart rate, and slows down movement, often leading to the users passing out.  

Opium

Derivatives of opium include morphine, codeine, fentanyl, oxycodone and the controversial painkiller oxycontin. While opioid based painkillers are prescribed for pain management, it is a highly addictive drug which led to an addiction crisis in the US. According to the American Medical Association, approximately 13 to 19% of individuals who take prescription medication for pain end up getting addicted to them. 

Alcohol

Since drinking alcohol is deeply entrenched in our culture as a social activity, alcohol abuse often goes unrecognized. Many people have their first drink during teenage, and many activities during late adolescence and early adulthood are centered around alcohol.

According to CDC, approximately 17% of people who consume alcohol tend to binge drink, while 7% feel they drink heavily. However, in a culture where drinking is normalized, it is safe to assume that the official statistics are an underestimation. 

Alcohol inhibits responses and impacts decision making. Because of this, drinking leads to increased high-risk activity like drunk driving or unsafe sexual practices. Use of alcohol during teenage years amay also impact brain development, leading to impairment in executive functioning and memory. 

Inhalants (e.g., glue, paint thinners)

Inhalants are common household products like paint, glue, thinner or gasoline that are sniffed on in order to get a ‘high’. Their addictive nature comes from the fact that they stimulate the reward center in the brain, giving an instant feeling of euphoria. However, use of inhalants can lead to changes in appetite, loss of interest in activities, slurred speech, runny nose, confusion and tiredness. Since inhalants are readily available, their use is fairly common. 

Using a cocktail of drugs 

There is a growing trend of mixing different substances among teenagers and young adults. Commonly, partygoers smoke pot, consume alcohol and sometimes, cocaine in one night. Another example of dangerous mixing of drugs is what’s called ‘South Asian Cocktail’. It is a common drug cocktail in which a mix of opioids, benzodiazepines and antihistamine is adminitered via an injection. Another common cocktail is something called ‘Happy Water’ where MDMA, diazepam and ketamine are consumed together mixed in water.  

However, poly-drug use can be quite dangerous as it can lead to harmful interactions between the different substances. Mixing drugs may lead to increased risk of overdose, and adverse interactions such as psychosis, panic, and in some cases, heart attacks or failure. An additional danger of injectible drugs is the spread of HIV. 

Impact of Substance Abuse on Teenagers

At any age, substance abuse and dependence can be damaging. But the impact of substance abuse on teenagers can impede their life trajectory. 

1. It can derail their academic growth and performance. Substance abuse can interfere with academic performance, slowing down or derailing the child’s education
2. It can lead to health issues that may impact vital organs such as the heart, liver, lungs and kidneys
3. Some substances, including marijuana, may make them more vulnerable to developing episodes of psychosis and paranoia
4. It may also lead to difficulty in forming and maintaining relationships, including friendships and romantic partnerships 
5. When unchecked, long-term or addictive use of substances can also make it difficult to gain or maintain employment later in life 
6. Since a teenager’s brain is still developing, substance abuse may impact healthy brain development and lead to impairments in executive functioning

Prevention Strategies

Prevention of substance abuse in teens requires a holistic approach. Here are some strategies to consider: 

1.Parental guidance and open communication

As we have seen, lack of parental guidance and supervision is one of the risk factors for substance abuse among teenagers. For this reason, it’s important for parents to engage their teens in open dialogue about substances, the long-term and short-term impact of substance use, and how to cope with peer pressure. 

2.School-based prevention programs and skill-training interventions 

Schools are sort of like the second parent to adolescents. Schools can engage teenagers in life-skills training programs where they can educate the teenagers and well as help them cope. Schools may also want to collaborate with mental health professionals for conducting life-skills training. 

3.Community support groups and resources

For teenagers struggling with substance abuse, support groups can offer much-needed community and connection with others. Support groups can be a useful place to seek and offer support, and learn from each other’s journey. If there’s no support group in your area, you can always start one! If you’d like a support group led by a mental health professional, consider reaching out to a psychologist, psychotherapist or psychiatrist who may be able to help you. 

4.Early intervention and screening for mental health issues

Early intervention and screening can help prevent a substance abuse issue from escalating. If a teenager has used substances once or twice, engaging them in an intervention early on may help the use from escalating. It may also be helpful to consider early intervention for other mental health concerns such as anxiety or trouble adjusting at school. This can help facilitate a supportive and healthy environment for a teenager’s development. 

5.Addressing underlying social and economic factors

When it comes to prevention or treatment of substance abuse, it’s important to go beyond a symptom reduction approach and address the underlying social factors like adjustment with one’s peer group and home environment. While preventing and stopping use of substances is of utmost importance and urgency, it is necessary to go one step beyond and address the deficits in the teenager’s life. 

6.Public awareness campaigns and educational programs

Several organisations conduct public awareness and educational programs. For example, the UN conducted a youth-focused anti-drug awareness campaign in India. Ministry of social justice, and nasha mukt bharat bhiyan are some organisations that regularly conduct awareness campaigns. Additionally, awareness campaigns and educational programs are also regularly conducted in many schools and universities. It’s a good idea to encourage teenagers to participate in these. 

7.Policy changes like taxation, public consumption bans, and restrictions on advertisements for tobacco and alcohol (discuss their effectiveness) 

Policy changes can be helpful is reducing access. For example, in India, implementing a minimum age in pubs and bars has helped reduce underage drinking in public places. In the UK, tobacco products are sold only to adults above age 18. If such laws are implemented properly, they can be useful in reducing access and preventing teenage substance abuse. However, it’s important to keep in mind that while laws are in place, illegal sales to teenagers are still made in many places. This suggests that while policies can be helpful, they are not enough. 

Treatment Options

1.Counseling and therapy (individual, group, family)

Counseling and psychotherapy can help address underlying issues such as isolation, stress or peer pressure. Teenagers may benefit from both individual and group therapy. Group therapy can also help a teenager develop skills for social connection and community.  Since families play a pivotal role in both prevention and recovery, it is valuable to engage key family members in therapeutic work with teenagers. If you’re concerned about substance abuse, you can speak to a qualified mental health therapist on Mave Health’s therapy club. 

2.Rehabilitation programs (inpatient, outpatient)

In cases of severe substance abuse or dependency, treatments in a rehab center may be useful. Drug rehabilitation centers provide holistic care which involves medical care and treatment, community and support groups and individual therapy. Depending on severity and resources, one may opt for either inpatient or outpatient services. 

3.Medication-assisted treatment (e.g., opioid substitution therapy).

Taking medication for cessation of use may be necessary in some cases. A psychiatrist can help with medication-assisted treatment for substance abuse. Medications are commonly used for opioid use disorders and alcohol use disorders and may involve either taking a safer and regulated substitute for the purpose of weaning off, or medication to manage withdrawal symptoms.  

4.Alternative approaches (e.g., mindfulness, art therapy).

Alternative interventions such as mindfulness-based interventions and art therapy can be helpful when delivered in tandem with evidence-based approaches like psychotherapy. Mindfulness helps build self-awareness, and in cases of substance abuse, can help an individual understand their triggers, vulnerabilities and experiences related to substance use. Creative therapies such as art and music therapy can be helpful in expressing and internalized a more positive view of oneself.  

Aftercare and relapse prevention support.

Relapse prevention requires a good understanding of one’s triggers and vulnerabilities, along with a set of coping mechanisms for prevention of use. 

While counseling and therapy can help one understand one’s triggers and learn coping mechanisms, once treatment is over, it is the individual’s responsibility to continue implementing what one has learnt. 

However, since substance abuse is a complex issue, relapses are common. If a relapse occur, it’s important to avoid any feelings of failure and actively seek support. 

Highlight the need for specialized treatment centers and health professionals trained in adolescent substance abuse

Mental health is stil a developing field in our country, and specialised services are dire. When it comes to management of teen substance use, we still have a long way to go. We need more health care providers and treatment centers that not only understand substance abuse, but also adolescences and the intricacies of providing care to this vulnerable age group. 

Challenges and Barriers to Addressing Teen Substance Abuse

In addition to a dearth of specialised care, some other barriers to addressing teen substance abuse include: 

1.Stigma

While there is growing awareness of mental health, the idea that someone who needs mental health support and care is ‘ill’ or ‘mad’ still persists. In the case of substance abuse, this stigma is doubled up as the use of substances is considered to be shameful. This not only prevents open dialogue, but also reaching out for help when needed. 

2.Lack of education and awareness 

Much of the stigma around mental health and substance use comes from a lack of awareness. Addressing the gap in awareness about mental health, adolescence, substance use can help us take proactive measures for both, the prevention and treatment of substance abuse. 

3.Lack of resources 

Even when one is armed with knowledge, one may not know where to go for support. Or, one may find support unaffordable or inaccessible. This can be mitigated via a combinatio of things - availing funded services in government hospitals, accessing free resources online, and starting your own community or support group can help provide care even when resources are lacking. 

Conclusion

Teen substance abuse is a growing concern worldwide. Teenagers are vulnerable to substances abuse due to peer pressure, household dysfunction, psychosocial concerns such as isolation or trouble adjusting. The ease of access to drugs also contributes to the increasing use. However, by learning about it, and creating open dialogue about its impact, we can help prevent teenage substance abuse. 

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