Adolescence can be a challenging time for both the individual and the parents. This period of life is a time of numerous changes: emotionally, developmentally and biologically. The adolescent is exploring independence and new relationships. It is a time filled with both challenges and opportunities. For parents, this time can be filled with uncertainty and anxiety.
There can be a fine line between too much independence and not enough and normal adolescent behaviors and troublesome patterns. Parents today have many more challenges than generations before, particularly around substance use. States are quickly moving to legalize and decriminalize marijuana use. This has led to the belief that marijuana is harmless. According to the National Institute on Drug Abuse (NIDA), marijuana is the most used illegal substance among teens and about 22% of seniors report current use. Marijuana is particularly problematic during adolescence because the brain is still developing. Often the most common symptom from marijuana users is a decline in motivation. Brain imaging studies have shown a reduction in the neurotransmitter responsible for motivation in those that use marijuana regularly. In addition, there is a current epidemic, particularly among 18-24 years olds using prescription pain medications (opiates) and deaths are on the rise. Some studies have shown a progression from marijuana use to more dangerous substances which is coined the "Gateway Theory."
How to determine what is too much and what is "typical teen exploration" is difficult to determine. Talking to your child about drug use is not easy but crucial. A psychologist can asses the nature of the use and problems that are occurring to determine the level of risk. Motivational interviewing is an evidenced based therapy that is commonly used with teens since they are often resistant to change.
How to determine when substance use is a problem?
Adolescent substance use can look quite different from adult substance use. Adolescents do not have the years and years of use and consequences. You may notice some behavior, emotional and motivation changes and these signs are a good time to reach out for an evaluation. When substance use is not treated early on it may lead to significant brain changes, more serious and problematic addiction later in life, future and more severe legal problems and death. Youth substance-related deaths are on the rise. Because substance use is progressive, meaning it gets worse, it's best to treat it early before it becomes a severe problem.
Addiction can be simply defined as repeatedly continuing a behavior despite having negative consequences. The Diagnostic and Statistical Manual of Mental Disorders V (DSM-V) defines a substance use disorder as "a problematic pattern of using alcohol or another substance that results in impairment in daily life or noticeable distress." A person with a substance use disorder only needs 2 of the following 11 symptoms within 12-months. I have provided specific examples of adolescent substance use.
1) Taking the substance in larger amounts or for longer than you meant to (Your teen may have started with using at a party but now is using every weekend or they may have started with a very small amount and now have increased the quantity. Adolescents often believe that they do not have this symptom because they believe it was "by choice" that they chose to drink/use more often.
2) Wanting to cut down or stop using the substance but not managing to (Your teen may have told you that they will only drink/use at gatherings or on weekends but did not stick to this plan. Adolescents often believe they do no not have this symptom because they have not tried to stop and believe the periods of abstinence followed by a relapse were by choice.)
3) Spending a lot of time getting, using, or recovering from use of the substance (They spend much of their free time either alone or engaging with peers that are attempting to obtain alcohol/drugs, using alcohol and/or drugs, and/or recovering. They may frequently appear tired on the weekends, mornings or after school.)
4) Cravings and urges to use the substance (Frequent desire to use. they might say "I don't have cravings. I did it because it was there." or "because I wanted to." Adolescents struggle identifying their repeated use was due to an urge or craving because cravings precede the use and are out of their awareness.)
5) Not managing to do what you should at work, home or school, because of substance use (They are unable to or refuse to complete chores or take care of themselves and their belongings. This is easy to deem as normal adolescent behavior. However, you might notice a decline in their normal functioning. They might lose their job and begin to have poor grades or truancy at school. Often adolescents will make other excuses regarding these behaviors.)
6) Continuing to use, even when it causes problems in relationships (They continue to use despite knowing how much distress it's causing within the family. Sober friends might decrease contact. It is common for your teen to state that they don't have any problems in their relationships. This is often due to their social groups also using/drinking.)
7) Giving up important social, occupational or recreational activities because of substance use (They lessen or discontinue an after-school activity or sport they used to enjoy. They stopped hanging out with a particular friend. They might try to convince you that it's because they are just not into it anymore.)
8) Using substances again and again, even when it puts you in danger. (Driving or any other activity that would be unsafe under the influence of a substance.)
9) Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance (Teens will often say that a substance is helping. "Marijuana decreases my anxiety." Medical problems and mental health problems including insomnia can be caused or become worse by substances. Often people will wrongly assume that the substances are helping because they do in the short-term or during the duration of the "high." However, most substances decrease the brain's ability to provide important neurotransmitters. Substances also prevent adolescents from developing emotional maturity and learning to cope.)
10) Needing more of the substance to get the effect you want (Your teen will begin to increase the amount of the substance because the brain has adjusted to the dosage, known as tolerance.)
11) Development of withdrawal symptoms, which can be relieved by taking more of the substance (Withdrawal symptoms can include insomnia or hypersomnia, irritability, anxiety or mood swings.)