Substance Abuse Treatment for Adolescents by stephan2


									                    Substance Abuse
                     Treatment for

Why it is not treating just
    younger adults
          Training Agenda
 What are   the trends in adolescent
  substance abuse? Nationally and Locally?
 How is adolescent substance abuse
  different from adult substance abuse?
 How are substance abusing teens different
  from non-using teens?
 What is substance abuse?
 Are there signs I can be looking for?
  Training Agenda (continued)
 Are   there gender differences in substance
 Once I identify the signs, then what do I
 If I have other questions, where do I go?
            National Statistics
 Alcohol is the leading cause of death for
  14-24 year olds
 Alcohol is the leading cause in
     • 40% of all suicides
     • 50% of all traffic accidents
     • 54% of all violent crimes
     • 60% of all Emergency Room admissions
     • 72% of all college rapes
     • 80% of all domestic crimes
            The “Average Kid”
            Nationally and Statewide

1.   Alcohol
2.   Marijuana (very close second)
3.   Nicotine
4.   Prescription medication
What Maine Teens
  in Treatment
         Northern Maine

Aroostook-     marijuana, alcohol
               and oxycontin
Piscataquis-   marijuana, alcohol
               and oxycontin
Penobscot-     marijauna, alcohol,
               and oxycontin
             Coastal Maine
Washington-      alcohol, marijuana and
Hancock-         alcohol, marijuana and
                      cocaine, heroin,
Waldo-           maijuana, alcohol,
                 methadone, oxycodone,
                      and other narcotics
Knox-            alcohol, marijuana,
                 oxycodone, oxcontin, and
                      other narcotics
              Central Maine
Lincoln-           alcohol, marijuana,
                   methadone and other
Kennebec-          marijuana, alcohol and
Sagadahoc-         marijuana, alcohol,
                   oxycontin, hallucinogens,
Androscoggin-      marijuana, alcohol and
                        heroin (crack and
 on the                       rise)
          Western Maine

Somerset-      marijuana, alcohol
               and oxycontin
Franklin-      alcohol, marijuana,
               and oxycodone
Oxford-        marijuana,alcohol
               cocain and heroin
        Southern Maine

Cumberland-   marijuana,
              alcohol and
York-         marijuana,
              alcohol, and
What has lost its “cool”?
Flips in State Problem Drug
     How the times have changed
        Public school teachers rate the top
               disciplinary problems

1940                        1990

   Talking out of turn        Drug Abuse
   Chewing gum                Alcohol Abuse
   Making Noise               Pregnancy
   Running in the halls       Suicide
   Cutting in line            Rape
   Dress-code violations      Robbery
   Littering                  Assault
   Reality or
In order to be an addict or
     an alcoholic, your
substance use must span
      several years.

    young people, it takes less time to
 For
 become addicted or dependent

 “Rock bottom” is very different for people-it
 is not about time, but about experience.
   Alcoholism and drug
addiction progress in similar
  ways in both adults and

 Teens’   Brains and organs are developing

 Early   onset

 Combination     of drugs
More than a ¼ of all alcohol
  consumed is by those
   under the age of 20

Drinking is more common in
the southern states than in
  the New England states

 New  England spends 22% more on
  alcohol than any other band of states in
  the United States
 2.18 gallons per person over 14
 It is harder to tell when an
      adolescent is having
difficulty with substance use
     than when an adult is
   Teens- determination of mental health or
    substance abuse issues
   Teens are developing and changing
   “life sucks” – very rarely come out and say
    why “life sucks”
   Societal norm? Rite of Passage?
   Exaggeration of problems, so it is hard to
    determine the true extent
Adolescents are more likely
 to use after quitting than
        adults are

 Adolescents   relapse at a much higher rate
 than adults
         42% of adolescents who complete
          inpatient treatment stay sober during
          a year of treatment compared to 66%
          of adults.
Parents and other adults
have a powerful impact on
adolescent substance use

 Developmental       stage
     identify themselves apart from the family-
      while still looking to family and other adult role
      models for direction in doing this
 Freud     believed in 2 stages
           Latency and Genital

 Erikson believed in 3 stages
        Industry vs. inferiority

        Identity vs. role confusion

        Intimacy vs. isolation
                So What?

 7-11  yo learn to succeed in their
  environment-if environment doesn’t allow
  that, child gives up
 12-18 yo build on earlier experiences to
  define self-if it can’t happen, identity,
  career and roles performed in adulthood
  must change
 18-25 yo desire strong relationships-if they
  don’t know self, have little to share
               Same Difference
Using Teens                   Non-Using Teens
   “stop where they start”      Develop within stages
   Have limited coping          Learning and testing
    skills                        out new coping skills
   “Chaos” is comfortable       Figuring it out is half the
   Must be “high” to feel        fun
    balance                      Occasional Adrenaline
   Thrill seeking to             rushes bring balance
    extremes-no                  Thrill seeking within
    boundaries                    boundaries set
Do we all “USE”
               “Stages” of use
 Stage    1- Potential for Abuse
     Do parents use?
     Do they have older siblings that use?
     Can they get it easily?
     Are there mental health issues?
     Has there been or is there abuse issues?
     Are their self-esteem issues? Do they feel like
      a “misfit”?
     Is there a family history?
     What is supervision like?
 Stage   2- Experimentation
     “Testing the waters”
     Asking lots of questions
     Trying to associate with others who have
     THIS IS A SHORT STAGE-you either like it
      and advance to next stage or stop
 Stage    3- Use to Preoccupation with Use
     Will start to possess paraphernalia
     Spends more time with friends that use
     Starting to see signs of poor grades, decrease
      in extra-curricular activities, increase in
      irritability, poor relationships with authority
      figures and friends that don’t use
 Stage    4- Addiction
     Compulsion to use substances
     Plans activities around substance use
     Will chose substance use over family or
      friends who do not use
     preoccupation with procuring
     Physically -signs of not eating or sleeping well
 Stage    5-Deterioration of Self
     Physically
     Emotionally
     Spiritually
     Intellectually
     Socially
     Financially
Is there a Problem?
      SIGNS – THE A B C’s

A   Academics and Activities?
B   Behavior?
C   Changes in Habits?
D   Demeanor and Mood?
E   Energy?
F   Friends?
Sometimes the signs are not as
      Some Physical Symptoms
   Bloodshot eyes            Weight loss
   Dull-looking/glazed       Constant desire for
    eyes                       junk food
   Watering eyes             Malnutrition
   Drowsiness                Some form of acute
   Manic/hyper behavior       acne
   Runny nose                Tremors
   Coughing                  Hallucinations
   Needle marks              Delusions
     Some Behavioral Symptoms
   Irresponsible behavior      Forgetfulness
   Argumentative               Lying
   Lack of motivation          Changes in speech-
   Solitary behavior            rapid, slowed, slurred
   Doesn’t want to be          Legal problems
   Non-participation
   New friends
              Other Symptoms
   Secretiveness               Use of mouthwash,
   Falling grades               mints, gum, PButter
   Truancy                     Odd small containers
   Car accidents               Charm necklaces
   Fascination with light      White specks on
   Auditory (hearing)           nostrils or clothing
    problems                    Frequent trips to the
   Use of eye drops             bathroom or locker
             Bottom Line

 Adolescents  perceive themselves as
 invincible. They can control everything. If
 they feel that you are trying to take control
 of there lives, they will minimize their need
 for that to happen….but secretly they want
 you to figure it out.
Does Gender play a role too?

           What Do They Do?
              By Gender

Girls                  Boys
 Alcohol               Alcohol
 Tobacco               Marijuana
 Prescription Drugs    Tobacco
                 Why do they do it?

   Girls                             Boys
       Their significant others          Their friends are using
        are using                         It heightens the
       They are trying to                 “nerve” factor
        escape trauma- past               They are trying to
        or present                         make others feel
       They are trying to feel            better about them
        better about
 So When Do We Do Something?
 As  an adult…always admonish use-NO
 If you have noticed any of the warning
  signs for more than a month
 If another adolescent, community member
  or a parent comes to you for help
 Obviously, if the adolescent comes to you
          What Do We Do?

 Check   with your school policy
 Increase your knowledge of the problems
  and the dangers
 Once you have ID’d the problem-consult
  with school or community counselor
 Really talk to teens-without judgment
 Look for ways drug and alcohol abstinence
  will benefit them
 Seek help-together
         Things to Remember
 Talk to the teen when they are not under
  the influence
 Speak in straight forward manner and
 Do not shame, blame or humiliate
 Describe your observations-focus should
  be on teen not you
 Start early, and keep it up
 Scare   tactics do not seem to work with
 Mentoring programs have not been proven
  useful in all situations
 DARE programs have not been proven

Michelle Inman LCSW, LADC
       Maine Office of Substance Abuse
       Adolescent Substance Abuse
       Treatment Specialist

   Statewide Information and
        Resource Center

        Other Helpful Resources…
   Substance Abuse and Mental Health Services
    Administration (SAMSHA)
   Center for Substance Abuse Treatment (CSAT)
   The Underage Drinking Enforcement Training
   Alcohol and Other Health Risks
   Drug interaction and information
   Drug and Prevention information
   Drug Prevention Best Practice
   Drug and Rave information

To top