We live in a medicated society. Whether it is for health or sickness, energy or escapism, we exist in a world where we are encouraged to alter our realities through the use of chemical substances. In the U.K alone an estimated 1 in 12 adults are reported to have taken an illicit drug, with as many as 24% of 15 year olds reporting the same (NHS, 2017).
Adolescents are particularly vulnerable to the effects of drug and alcohol usage as their brains are still undergoing development which is not complete until early adulthood. As such, when seeking to support a teenager experiencing substance misuse, research indicates that early intervention provides the most positive outcomes (Carney & Meyers, 2012).
Mental Ill Health and Substance Misuse – Are they linked?
The substantial literature on the topic (Armstrong & Costello, 2002) suggests that in many cases young people engaged in substance misuse are self-medicating to remedy the effects of underlying mental health conditions. Further research (Moore et al, 2007) demonstrates that a causal relationship exists between specific drugs such as cannabis and emerging psychosis. Regardless of the direction of the correlation between substance misuse and mental ill health, it is evident that they are inexplicably linked.
Anxiety disorders, depression, bipolar disorder and attention deficit hyperactivity disorder were cited as the most common co-occurring mental health conditions in adolescents who misused substances (Deas & Brown, 2006). This presents valid concerns regarding the direction of treatment in young people with a dual diagnosis, as drug and alcohol usage can negatively impact the symptoms of a mental health condition.
When intervention is sought, it is imperative that mental health practitioners and substance misuse services should work together to devise a treatment plan which addresses each condition separately, as well as recognises the effect one may have on the other.
Below we have compiled a list of warning signs for drug use that all parents/carers and education professionals should watch out for in young people.
Possible Signs of substance misuse
- A decline in grades at school – For many teenagers drug and alcohol use can reduce their motivation engage in other areas of their lives, such as school.
- Changes in appearance – This could include poor personal/oral hygiene, as well as unexplained marks on the body due to intravenous drug use. Blood shot eyes or dilated pupils are additional indicators that a young person is under the influence of an illicit substance.
- Drug paraphernalia – Possession of items such as needles, rolling papers, pipes, flat mirrors or empty prescription medication packets are red flags regarding possible substance misuse.
- Changes in friendship groups – While adolescence is a period where frequent changes in peer groups occur, a shift to friendship groups which parents/carers are not aware of may be a sign that they are engaging in negative behaviours with those peers.
- Increased secrecy – To cover up their substance misuse many teens will begin to hide other aspects of their lives. You may notice frequent calls and texts from unknown sources or hushed conversations in the presence of adults.
- Unexplained weight loss/weight gain – Drugs such as cocaine & heroin typically suppress the appetite of users, while cannabis is thought to increase it resulting in weight gain.
- Changes in communication style – This may include becoming overly talkative for select periods of time or conversely slurring his/her speech.
- Withdrawal from social activities – Substance misuse can take control of a young person’s life, and they may begin to lose the motivation to participate in activities that they previously enjoyed.
While the above are possible indicators of substance misuse in children and young people, the list is not exhaustive. If you are concerned about a young person engaging in substance misuse, it is important to reassure them that they can confide in you without fear of judgement.
There is a stigma attached to substance misuse which adolescents are aware of. They may feel ashamed or embarrassed that they have lost control of their drug/alcohol usage. As such displaying compassion and understanding is key to ensuring they feel safe disclosing their substance misuse.
For more information on how to seek support for children and young people engaging in substance misuse please visit the following websites:
Armstrong, T. D., & Costello, E. J. (2002). Community studies on adolescent substance use, abuse, or dependence and psychiatric comorbidity. Journal of consulting and clinical psychology, 70(6), 1224.
Carney, T., & Myers, B. (2012). Effectiveness of early interventions for substance-using adolescents: findings from a systematic review and meta-analysis. Substance abuse treatment, prevention, and policy, 7(1), 1.
Deas, D., & Brown, E. S. (2006). Adolescent substance abuse and psychiatric comorbidities. Journal of Clinical Psychiatry, 67, 18.
Moore, T. H., Zammit, S., Lingford-Hughes, A., Barnes, T. R., Jones, P. B., Burke, M., & Lewis, G. (2007). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. The Lancet, 370(9584), 319-328.
Nation Health Service. (2017). Statistics on Drugs Misuse: England, 2017. NHS Digital.
Blog post written by: Princess Rose, Assistant Psychologist