Teens and drug abuse

The complex issue of drug abuse is often considered especially problematic for teenagers and young adults, in part due to the potentially stronger impact on still-developing biological and psychological systems. Drug abuse by young people can lead to numerous negative outcomes on both the individual and societal levels.

Drug Abuse

Teenagers and young adults who abuse drugs often display problem behaviors such as poor academic performance and dropping out of school. They are also at an increased risk of unplanned pregnancies, violence, and infectious diseases.

For most young people, the initial decision to take drugs is voluntary. However, the repeated use of substances such as alcohol, tobacco, and various illicit drugs can cause changes in the brain that affect one’s self-control and ability to make sound decisions. Drugs can also cause the brain to send intense impulses that trigger cravings for more of the substance. Because of this, drug abuse can in some cases result in addiction.

The teen brain is still developing, making the effects of drug abuse even more complex for this population. One area of the brain still maturing during adolescence is the prefrontal cortex, which enables a person to consider situations fully, make solid decisions, and keep emotions and desires under control. Because this critical part of an adolescent’s brain is still a work in progress, adolescents are at greater risk for poor decision-making (such as trying dangerous drugs or continued use). Also, using drugs while the brain is still developing may lead to profound and long-lasting consequences.

No single factor determines whether a person will become addicted to drugs. The overall risk for addiction is affected by the person’s biological makeup and their environment. It can even be influenced by gender or ethnicity, a person’s developmental stage, and the surrounding social environment (such as conditions at home, at school, and in the neighborhood). Scientists estimate that genetic factors account for 40 to 60 percent of a person’s vulnerability to addiction, including the effects of environment on gene expression and function.

Adolescents and persons with mental disorders are at greater risk of drug abuse and addiction than the general population, making drug abuse prevention programs for teens critically important. Alcohol, tobacco, and illicit drug abuse are reduced when science-validated drug-abuse prevention programs are properly implemented by schools and communities. Such programs help teachers, parents and other caregivers, and health care professionals shape teens’ perceptions about the dangers of drug abuse. While many events and cultural factors affect drug abuse trends, levels of abuse are reduced when teens and young adults learn that such abuse is harmful.

Commonly Abused Drugs

Drug use in teenagers and young adults shows considerable statistical variation between ages thirteen and nineteen years. Younger teens are generally less likely to use most drugs than older teens. An exception is the use of inhalants, which is seen more in younger teens and less in older ones, in part because inhalants are readily accessible to teens. An average home has between thirty and fifty products with abuse potential. Inhalants are inexpensive and are legal to buy and possess. Additionally, the perceived risk of use is low.

The most commonly used drug among teens in the United States and many other countries is alcohol, a trend that is considered closely linked to the widespread legality of alcohol for adult consumption. Young people may sometimes assume that drinking alcohol is safe because it is highly prevalent in society. Numerous studies have investigated the role of peer pressure in teen alcohol use.

According to the 2016 Monitoring the Future study funded by the US National Institute on Drug Abuse, marijuana surpassed nicotine and tobacco as the second most commonly used drug among tenth- and twelfth-graders in the United States for the first time that year. The trend toward decriminalization of marijuana and generally increasing social acceptance of the drug in the 2020s and early 2020s may have contributed to rising teen usage. The 2021 Monitoring the Future survey found that 7.1 percent of eighth graders, 17.3 percent of tenth graders, and 30.4 percent of twelfth graders reported marijuana use in the past year. (While these figures showed a decrease from 2020, the drop may have been attributed to data-gathering restrictions as a result of the COVID-19 pandemic.) The issue of marijuana use has often sparked strong debate, as many studies indicate it does not have the addictive potential of many other drugs, including legal ones such as nicotine and alcohol. However, many health experts have raised concerns over marijuana's potential impacts on young people in particular, and called for more research.

Use of traditional nicotine and tobacco products among teens steadily declined in the early twenty-first century, according to Monitoring the Future. However, the use of electronic cigarettes (also known as e-cigarettes or vapes, among other names) overtook traditional cigarette use among teens. In 2021, 12.1 percent of eighth graders, 19.5 percent of tenth graders, and 26.6 percent of twelfth graders reported vaping nicotine products in the past year. While research on the long-term effects of vaping was still limited, health professionals widely agreed that the major spike in teen vaping was a significant public health issue.

Any other drug with potential for abuse may be abused by teens and young adults. Categories include opioids (such as heroin, fentanyl, and various prescription medications), stimulants (cocaine, amphetamine, methamphetamine), club drugs (methylenedioxy-methamphetamine, flunitrazepam, gamma-hydroxybutyrate), dissociative drugs (ketamine, PCP and analogs, Salvia divinorum, dextromethorphan), hallucinogens (lysergic acid diethylamide, mescaline, psilocybin), and anabolic steroids. However, the rates of use of these drugs are fairly low among teens. In 2021, Monitoring the Future reported 4.6 percent of eighth graders, 5.1 percent of tenth graders, and 7.2 percent of twelfth graders used some type of illicit drug in the past year. Nevertheless, abuse of such drugs by teens often draws considerable public attention. The rise of the opioid epidemic in the 2010s also brought much scrutiny of how young people, like others, can be exposed to prescription medicines with high potential for abuse.

Drug Abuse and Its Effects on the Brain

Drugs contain chemicals that interfere with the brain’s communication system and change the way nerve cells normally send, receive, and process information. Drugs cause this interruption by imitating the brain’s natural chemical messengers and by overstimulating the reward circuit of the brain.

Some drugs (such as marijuana and heroin) have a structure that is similar to chemical messengers called neurotransmitters, which are naturally produced by the brain. This similarity allows the drugs to fool the brain’s receptors and activate nerve cells to send abnormal messages.

Other drugs, such as cocaine or methamphetamine, can cause the nerve cells to release large amounts of natural neurotransmitters or to prevent the normal recycling of these brain chemicals, which is needed to shut off the signaling between neurons. The result is a brain full of dopamine, a neurotransmitter present in brain regions that controls movement, emotion, motivation, and feelings of pleasure. The overstimulation of this reward system, which normally responds to natural behaviors linked to survival (for example, eating and spending time with loved ones), produces euphoric effects in response to psychoactive drugs. This reaction sets in motion a reinforcing pattern that “teaches” a person to repeat the rewarding behavior of abusing drugs.

As a person continues to abuse drugs, the brain often adapts to the overwhelming surges in dopamine by producing less dopamine or by reducing the number of dopamine receptors in the reward circuit. The result is a lessening of dopamine’s effect on the reward circuit, which reduces the abuser’s ability to enjoy the drugs, as well as the events in life that previously brought pleasure. This decrease compels the user to keep abusing drugs to bring the dopamine function back to normal; however, larger amounts of the drug will be required to achieve the same dopamine high—an effect known as tolerance.

Long-term abuse also causes changes in other brain-chemical systems and circuits. Glutamate is a neurotransmitter that influences the reward circuit and the ability to learn. When the optimal concentration of glutamate is altered by drug abuse, the brain attempts to compensate, which can impair cognitive function.

Brain imaging studies of people suffering from drug addiction show changes in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control. Together, these changes can drive an abuser to seek and take drugs compulsively despite adverse, even devastating consequences; this is the nature of addiction.

Treatment

Drug abuse is a treatable disease with many effective treatments available. Some important points about drug abuse treatment include the following: Medical and behavioral therapy, alone or together, are used to treat drug abuse. Treatment can sometimes be done on an outpatient basis, but severe drug abuse usually requires residential treatment, in which the patient sleeps at the treatment center.

Treatment can take place within the criminal justice system, which may help to prevent a convicted person from returning to criminal behavior. Furthermore, some studies show that treatment does not need to be voluntary to work. However, many observers have criticized the typical approach to drug abuse by the criminal justice system in the US and many other countries, arguing that there has historically been much greater focus on incarceration and other forms of punishment than on evidence-based medical treatment. Many advocates suggest these issues can be particularly detrimental for teens.

Addiction is a difficult disorder to treat, especially if diagnosed late into the condition, although remissions can be achieved in up to 60 percent of patients. Whether or not treatment works depends on the patient’s level of functioning at entry into treatment, premorbid functioning, comorbid conditions, and the support systems and resources available to the patient. Treating a substance abuser is not a hopeless process, but it can be a long and difficult one, similar to the treatment of any chronic disorder.

Bibliography

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