This document discusses substance use among adolescents and teens. Some key points: - 31% of those under 21 binge drink once a month, 80% drink, 70% smoke, 47% use marijuana, and 29% use other drugs. 2 million aged 12-17 have tried huffing. - 25% of parents provide alcohol to their kids aged 12-20, and 25% allow drinking in the last 6 months. - 80% of juveniles 10-17 have a substance abuse issue, 75% also have a mental disorder, and 92% of those using test positive for marijuana. Only 3.6% of those needing treatment receive it. - Depression is more common in girls after pub

2. To feel
good
To feel
better
To have novel
feelings
sensations
experiences
AND
to share them
To lessen:
anxiety
worries
fears
depression
hopelessness
2

3. 





under 21 - 31% binge 1 x month
Drinking
80%
Smoking
70%
Marijuana
47%
Other Drugs 29%
Huffing
2 million age 12- 17 tried

4. 


American Medical Association (Aug 2005)
Found that 25% of parents provided alcohol
to kids between 12 – 20.
Found that 25% allowed their kids to drink in
the last 6 months.

5. PHYSIOLOGICAL
HISTORICAL
HISTORICAL
--previous history
previous history
--expectation
expectation
--learning
learning
DRUGS
--genetics
genetics
--circadian rhythms
circadian rhythms
--disease states
disease states
--gender
gender
ENVIRONMENTAL
ENVIRONMENTAL
--social interactions
social interactions
--stress
stress
--conditioned stimuli
conditioned stimuli
BRAIN
MECHANISMS
BEHAVIOR
ENVIRONMENT

6. 6

7.  Brain
Chemistry – Teen brains 23X more active.
 Intense experiences - emotionally
 Perception of Risk – adults scary –
kids reward
 Thinking and feeling disconnected
– more so in males.

8. 

Alcoholism: Clinical & Experimental
Research July 2004 O’Connor & Kasari
Children whose mothers drank while
pregnant - displayed symptoms of
depression even when the mother quit
drinking. Much more relevant for
daughters than sons. Girls with higher
levels of prenatal alcohol and mothers who
reported depression showed the greatest
number of depressive symptoms.

9. 


Journal of the American Academy of Child &
Adolescent Psychiatry
Teens reporting increased family arguments at 15
had increased risk of major depression.
Teens reporting family violence by 18 were more
likely to have a mental illness, A & D abuse
dependence, lower self esteem, and lower life
satisfaction by age 30. Also compromised health.

10. 
Major Findings were:
◦ 80% of all juveniles between 10-17 have a
substance abuse issue.
◦ 75% also have a mental disorder.
◦ Of those using - 92% tested positive for marijuana.
◦ Only 3.6% of those who needed treatment –
received it.

11.  Enhance
Motivation – Why
 Enhance
Insight – What to change?
 Enhance
Skills – How to change?
change?

12. Behavior – Danger Avoidance
Physiology/Health
Affective/Emotion
Social/Family
Cognitive – Educational and Vocatrional
Spiritual
12

13. 

SHASHI K. BHATIA, M.D., and SUBHASH C. BHATIA, M.D Journal of the
American Academy of family Physicians Jan., 2007
At any given time, up to 15 percent of
children and adolescents have some
symptoms of depression. Five percent of
those nine to 17 years of age meet the
criteria for major depressive disorder, and 3
percent of adolescents have dysthymic
disorder. The incidence of depressive
disorders markedly increases after puberty

14. 
By 14 years of age, depressive disorders are
more than twice as common in girls as in
boys, possibly because of differences in
coping styles or hormonal changes during
puberty.

15. 

Depression impacts growth and development,
school performance, and peer or family
relationships, and it can be fatal.
Major depressive disorder is a leading cause
of youth suicidal behavior and suicide.

16. 
Anxiety disorders are among the most
common mental, emotional, and behavioral
problems to occur during childhood and
adolescence. About 13 of every 100 children
and adolescents ages 9 to 17 experience
some kind of anxiety disorder; girls are
affected more than boys. About half of
children and adolescents with anxiety
disorders have a second anxiety disorder or
other mental or behavioral disorder, such as
depression.

17. 
Thus, it is true that most adolescents
normally engage in some delinquent
behavior, however, far fewer engage in a
pattern of delinquent behavior. The DSM-IV
states that the range of incidence of
conduct disorder in males is 6% to 16% with
urban areas showing a higher level. The
range for females is 2% to 9%. Symptoms of
conduct disorder are often seen in children
as young as 6 years old, however, by age
16, those who have conduct disorder will
have displayed its characteristic pattern of
unconcern for other’s rights and property
and deceit/manipulation.

18. 




Journal of Clinical Psychiatry (June, 2005)
An epidemiological study of 43,000 adults found a significant
association between abuse or addiction and addictive (APD)
personality disorder, conduct disorder, and adult (APD)
behavior.
This association was higher for women than men.
Dependence on tranquilizers, sedatives, marijuana, inhalants,
or hallucinogens were more likely APD.
Abuse of cocaine, alcohol, amphetamines, sedatives, or
hallucinogens more likely to have adult (APD) behavior.
We need to treat APD syndromes to reduce abuse.

19. 



WE HAVE NOT FOCUSED ON THE CORE
ISSUES.
WE HAVE FOCUSED ON WHAT WORKS FOR
US - “Wars on Drugs”
WE INVESTED IN DRUG TREATMENT ONLY
WE DID NOT TAKE INTO ACCOUNT THE
PERSONALITY AND EMOTIONAL
DEVELOPMENT

20. 1. Peer drug use
2. School suspensions
3. Law infringements
4. Truancy
5. Conflict with parents
6. Regular smoking
7. Lower school aspirations
8. More school failures
9. Health factors
10. Family History

21. 1.
2.
3.
4.
5.
6.
7.
8.
Aggressive Social Behavior
Delinquency
High Risk Sexual Behavior
Tobacco, Alcohol and Substance Use
Academic Failure
Depression
Truancy
Lack of Family Supervision

22. 


Cognitive behavioral approaches are more
structured and directive.
Cognitive behavioral approaches
consistently appear to be the most effective
treatment therapy for substance abusers.
Programs that include the cognitive
component are more than twice as effective
as programs that do not