Substance Abuse

Surveys of older adolescents indicate that almost all (95 percent) try alcohol and about half have tried marijuana. Only a small minority of teenagers progress to substance abuse with the potential for addiction. Individuals who abuse one drug or substance are likely to abuse others as well. Adolescents with chronic illness, especially mental health, and disabilities have the potential to abuse alcohol and drugs.

Alcohol has two major problems for adolescents. Ingestion during pregnancy is associated with effects on the fetus and may result in physical malformations and mental retardation (fetal alcohol syndrome). The other problem results from risky behaviors accidents are often precipitated by alcohol. Alcohol results in more deaths of adolescents than all illicit drugs combined.

Illicit drugs (excluding marijuana) are used by up to 5 percent of adolescents. Cocaine and stimulants (especially amphetamines) are the most common.

It is important to recognize substance abuse disorders at an early stage. There is often a delay because the symptoms may be nonspecific and there may be medical or mental health problems which camouflage the substance abuse.

Urine or blood may be screened for drug metabolites. Urine test can reveal cocaine, methadone, amphetamines, diazepam, opiates, and barbiturates. Alcohol can only be tested in the blood or by breath test. It is controversial whether it is acceptable to perform drug testing without consent.

Management of alcohol and substance abuse problems is fraught with difficulty. Adolescents tend to deny that they have a problem. Therapy is expensive and motivation to succeed is often lacking.