Substance abuse disorder has a major impact on individuals, families, and communities as its effects are cumulative, contributing to costly social, physical, and mental health problems. Several factors can enhance the risk for initiating or continuing substance abuse including socioeconomic status. Additionally, quality of parenting, peer group influence, and biological/inherent predisposition toward drug addiction.
Adolescence is recognized as the period for the onset of behaviors and conditions that not only affect health limited to that time but also lead to adulthood disorders. Unhealthy behaviors such as smoking, drinking, and illicit drug use often begin during adolescence; they are closely related to increased morbidity and mortality and represent major public health challenges. Unemployment, poor health, accidents, suicide, mental illness, and decreased life expectancy all have drug misuse as a major common contributing factor.
Globally, tobacco use is the leading preventable cause of premature death and most adult smokers initiate smoking in adolescence. The prevalence of smoking in girls and boys varies across countries; 1 in every 10 girls aged 13–15 years and 1 in every 5 boys aged 13–15 years use tobacco. Smoking rates are generally highest in Europe and the Western Pacific regions. While cigarette smoking is decreasing among younger adolescents in most high-income countries (HICs) and in some low- and middle-income countries.
Approximately 4% of the global burden of disease is attributable to Substance Abuse Disorder. Alcohol consumption among adolescents and young adults is increasing globally. However, it is decreasing in most HICs in Europe and North America. Currently, the World Health Organization (WHO) European Region and WHO Region of the Americas report the highest proportions of drinkers among adolescents while the WHO South-East Asia Region and WHO Eastern Mediterranean Region have the lowest.
In general, men drink more alcohol than women, but the sex difference is smaller at a younger age. Cannabis use involves a decline in intelligence quotient scores before age 18 years and an increase in the risk of injury among adults. Unlike other substances, in many countries, boys and girls show similar prevalence of ever-using cannabis.
Recovery Interventions for Adolescents
The importance of evidence-based treatment methods rings as true for adolescents as it does for adults; however, adolescents seeking treatment for substance misuse or dependence often present unique issues that require special attention. For example, comorbidity is quite high among adolescents in treatment. A 2001 study found that 40.8% of adolescents in a public mental health treatment program also met the criteria for a substance use disorder. Treatment interventions that address substance use, as well as mental health issues, are ideal for this population.
Reviewers have determined that individual cognitive-behavioral therapy (CBT), motivational enhancement therapy (MET), multidimensional family therapy (MDFT), functional family therapy (FFT), and Cognitive Behavioral Therapy Group (CBTG) have “well-established efficacy” among adolescent patient populations.
The American Academy of Pediatrics also recommends that adolescent treatment outcomes could be improved by incorporating adapted versions of evidence-based treatments into nonclinical settings, such as schools and youth activities, in order to maintain positive attitudes and behaviors related to substance use and provide lower-intensity interventions for adolescents with substance use behaviors that do not necessarily warrant formal clinical care.
Preventing Adolescent Substance Misuse
Preventing drug and alcohol use and misuse among adolescents begins with setting a strong foundation in earlier stages of development. Social norms, or the perceptions and expectations adolescents have regarding the behavior of others. They play a significant role in whether adolescents consume alcohol or drugs.
Adolescents who have high levels of positive parental involvement are less likely to report substance misuse in adolescence. Similarly, children and adolescents whose parents consistently set clear expectations are less likely to engage in substance misuse.