Adolescent Chemical Dependency Presented by: Amy Armstrong MA, LAC

Statistics and Trends Drug use at an early age is an important predictor of development of a substance use disorder later. In fact, 15.2% of people who start drinking before age 14 eventually develop alcohol abuse or dependence compared to just 2.1% of those who wait until they are 21 or older. Tobacco, alcohol, and marijuana are the first addictive substances used. Thirteen percent of individuals with a substance use disorder began using marijuana by the time they were 14 years old. (NIDA, 2013)

Statistics and Trends Cont… National research reveals that 35% of high school seniors reported drinking alcohol, 21% reported using marijuana, and 11% reported smoking cigarettes within the past month. Within the past month, 3 out of 10 high school seniors report drinking some alcohol and one in six have engaged in “binge drinking” daily in the past few weeks. One in five adolescents report they have ridden in a car with a driver who had been drinking. Motor vehicle crashes are the leading cause of death for this age group. Cigarette smoking among teens is declining yet one in ten teens has smoked within the past month. By 12th grade, about half of all teens have abused an illicit drug at least once. The most common used drug is marijuana. (HHS, 2016)

Statistics and Trends Cont… Most Commonly Abused Drugs by High School Seniors (Other than Alcohol and Tobacco) Marijuana 36.4% Sedatives 4.8% Amphetamines 8.7% Tranquilizers 4.6% Synthetic Marijuana 7.9% Hallucinogens 4.5% Prescription Painkillers 7.1% MDMA (Ecstasy) 4.0 Cough Medicine 5.0% Salvia 3.4% (NIDA, 2013)

Colorado Adolescent Substance Abuse Facts Grades 9-12 19% of high school students have had alcohol for the first time before age 13 6% have driven a car while drinking and 22% have driven with a driver who was drinking 39% of high school students have used marijuana 9% have used inhalants one or more times 7% of high school teens have used pain relievers for non-medical purposes 5% of teens ages 12-17 needed treatment for alcohol use yet no treatment was received 6% of teens needed treatment for illicit drug use and received no treatment (HHS, 2013)

Risk and Protective Factors Risk Factors Protective Factors Early childhood aggressive behavior Lack of parental supervision Academic issues Undiagnosed mental health issues Poverty Drug availability/Peer Use Self-Control/Impulse Control Parental monitoring/involvement Academic competence Access to treatment Community Involvement Anti-Drug use policies

Principles of Adolescent Substance Use Disorder Treatment Early identification of adolescent substance use is critical Intervention is beneficial even if the adolescent is not addicted to a drug Routine annual medical visits can provide opportunities to discuss drug use Interventions and family pressure are important in getting adolescents to enter, stay, and complete treatment

Principles of Adolescent Substance Use Disorder Treatment Cont… Treatment should be tailored to meet the unique needs of the adolescent Treatment should not only focus on substance use but on the person as a whole Research based behavioral therapies are shown to be effective in addressing adolescent drug use Family and community involvement are important factors for successful treatment outcomes

Principles of Adolescent Substance Use Disorder Treatment Cont… Identification and treatment of existing mental health issues play a role in effectively treating substance use disorders in teens Issues of violence, child abuse, and suicide risk should be identified and addressed Drug use monitoring during treatment is important Testing for sexually transmitted diseases is crucial Length of treatment is an important factor

Treatment Approaches Cognitive Behavioral Therapy- Teaching teens to monitor feelings and thoughts that can trigger substance use Contingency Management- Incorporating immediate and tangible reinforcements for positive behaviors i.e engaging in treatment Motivational Enhancement Therapy- Utilizing motivational interviewing to resolve ambivalence Group Therapy- Offers peer support and positive social reinforcement Family Therapy- Incorporating family support while addressing issues with family conflicts and communication as well as living environment and other co-occurring behavioral issues

Treatment Approaches Cont… Twelve Step Facilitation Therapy- Engaging in support groups that stress the individual’s life has become unmanageable, that abstinence from drug use is needed, and that willpower alone cannot overcome the problem Medication Management- Several medications are available to treat addiction to opioids, alcohol, and addiction, although only preliminary evidence exists for the effectiveness and safety of these medications in people under 18. Medications include: Buprenorphine, Methadone, Naltrexone, Campral, Antabuse, and Bupropion Recovery High Schools- These programs allow adolescents new to recovery to be surrounded by a peer group supportive of recovery efforts and attitudes

References Monitoring the future national results on adolescent drug use: Summary of key findings. (2013). Retrieved from https://www.drugabuse.gov Adolescent substance abuse facts. (2013, July 19). Retrieved from http://www.hhs.gov