McKesson Clinical Reference Systems: Pediatric Advisor 2002.1

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Teenagers may be involved with alcohol and legal or illegal drugs in various ways. Experimentation with alcohol and drugs is common. Unfortunately, teenagers often don't see the link between their actions today and the consequences tomorrow. They also have a tendency to feel indestructible and immune to the problems that others experience. Using alcohol and drugs at a young age increases the risk of using other drugs later. Some teens will experiment and stop, or continue to use occasionally, without significant problems. Others will develop a dependency, moving on to more dangerous drugs and causing significant harm to themselves and possibly others.

Adolescence is a time for trying new things. Teens use alcohol and other drugs for many reasons, including curiosity, because it feels good, to reduce stress, and to feel grown up or to fit in. It is difficult to know which teens will experiment and stop and which will develop serious problems. Teenagers at risk for developing serious alcohol and drug problems include those:

• with a family history of substance abuse
• who are depressed
• who have low self-esteem
• who feel like they don't fit in or are out of the mainstream.

Teenagers abuse a variety of drugs, both legal and illegal. Legal available drugs include alcohol, prescribed medications, inhalants (fumes from glues, aerosols, and solvents), and over-the-counter cough, cold, sleep, and diet medications. The most commonly used illegal drugs are marijuana (pot), stimulants (cocaine, crack, and speed), LSD, PCP, opiates, heroin, and designer drugs (Ecstasy). The use of illegal drugs is increasing, especially among young teens. The average age of first marijuana use is 14, and alcohol use can start before age 12. The use of marijuana and alcohol in high school has become common.

Drug use is associated with a variety of negative consequences, including increased risk of serious drug use later in life, school failure, and poor judgment that may put teens at risk for accidents, violence, unplanned and unsafe sex, and suicide.

Parents can help through early education about drugs, open communication, good role modeling, and early recognition of problems are developing.

Warning signs of teenage alcohol and drug abuse may include:

• Physical: fatigue, repeated health complaints, red and glazed eyes, and a lasting cough.
• Emotional: personality change, sudden mood changes, irritability, irresponsible behavior, low self-esteem, poor judgment, depression, and a general lack of interest.
• Family: starting arguments, breaking rules, or withdrawing from the family.
• School: decreased interest, negative attitude, drop in grades, many absences, truancy, and discipline problems.
• Social problems: new friends who are less interested in standard home and school activities, problems with the law, and changes to less conventional styles in dress and music.

Some of the warning signs listed above can also be signs of other problems. Parents may recognize signs of trouble but should not be expected to make the diagnosis. An effective way for parents to show care and concern is to openly discuss the use and possible abuse of alcohol and other drugs with their teenager.

Consulting a physician to rule out physical causes of the warning signs is a good first stop. This should often be followed by a comprehensive evaluation by a mental health professional.