Teens, Drugs, and Alcohol: What Parents and Caregivers Should Know

How Do You Know if Your Teen Is Addicted to Drugs and/or Alcohol?

Adolescents with substance use disorders experience a dependence on drugs/alcohol, physical, psychological, or both.

When someone has taken a substance for a while, their body has come to rely on it to feel normal. Their body gets so accustomed to drugs that if you do not use them for a while, physical symptoms begin to show up.

Consistent use over time affects the mind’s reward system so that other things that were once enjoyable, like eating a good meal or hanging out with friends, are not as impactful. Once a teen tries to quit, their mood is even more affected.

They must drink or take the drugs to maintain their “normal” self. They may use even more substances to get back to feeling like their normal self.

This cycle makes it even more challenging to quit. Their body is now used to functioning with the drug or alcohol in their system.

With psychological dependence, someone believes they need the substance to function.

They might believe they need a drink for specific situations, like to be social at a party or unwind after school or work.

They may also come to believe that they need to use the substance all the time and may feel they cannot survive without the drug and/or alcohol.

If someone is dependent on substances, withdrawal symptoms will start to appear when they are not taken. There are many symptoms of withdrawal, but not all individuals with addiction disorders experience the same symptoms.

Withdrawal symptoms can be mild or severe, depending on:

• How long they have been using
• What drug(s) they are taking
• Age
• Physical health
• Psychological characteristics
• Method of withdrawal

Other signs that may indicate that your child needs assistance:

• Isolation from family and friends
• Actively talking about drinking or drug consumption, or asking questions about drug or alcohol misuse
• Depression and hopelessness
• Irritability and/or aggression
• Irresponsibility and/or poor judgment in decision-making
• Abrupt behavior changes, e.g., sleeping and eating patterns
• Poor performance in school
• Suicidal thoughts
• Empty prescription bottles found, even when no one is sick

If your child is showing these signs and symptoms, it may be a sign of a substance use disorder.

What actions should you take after suspecting your teen is drinking or using drugs?

• Take a direct and nonjudgmental approach
• Ask questions and be curious with your teen
• Discuss the legal and health consequences associated with substance use
• Target the behavior rather than the person
• Check in periodically and continue ongoing conversations (have dinner together, talk while riding in the car)
• Monitor peer interactions (know where your teen is and who they are with)
• Reach out to a school counselor or mental health specialist if you feel the conversation is too difficult

How It’s Diagnosed—And Treated

To diagnose a substance use disorder, doctors ask their patients about the nature of their substance use—what is being taken, how much, and how often. They also want to know how misuse is affecting daily life. Is it impacting a job, relationships, or physical health?

Next, they may investigate other factors, such as personal and family history. Finally, knowing about any other mental health issues is also crucial to a substance use disorder diagnosis.

It is possible to receive effective and safe treatment. Treatment can help minimize the chance of relapsing into addictive behaviors in the future and can also reduce the severity of substance use disorders. It can be beneficial at any point in diagnosing a substance use disorder and can be tailored to a person’s needs.

Treatments vary depending on the type of disorder. Effective medications are available for some disorders, but often psychological treatments are combined with medication.

Treatment for co-occurring disorders may include a combination of medications, family therapy, cognitive behavior therapy (CBT), dialectical behavior therapy (DBT), exposure and response prevention therapy, and group therapy approaches.

There are a few more common treatment options.

Detoxification Treatment

This is a form of short-term treatment for people who are physically dependent on drugs or alcohol. Medical professionals monitor patients around the clock to ensure a safe and comfortable withdrawal. Detoxification may be necessary for people withdrawing from alcohol, benzodiazepines, and barbiturates, as the withdrawal symptoms can sometimes be fatal.

Inpatient or Residential Treatment

This type of treatment involves living short-term at a facility and participating in structured recovery services for a set period of time. Inpatient treatment can be helpful for people who prefer to be in an intensive, drug-free environment, removed from temptations or triggers. Both options provide supervised, structured settings with 24/7 monitoring. Inpatient stays are often utilized when the patient may be a danger to themselves or others.

Outpatient Treatment

Outpatient programs offer less structure because people do not live at the facility and receive treatment for shorter intervals of time. Patients are free to return home after treatment is complete. Outpatient treatment may consist of medication management, individual or group therapy, and family treatment, or a combination of these treatments. Treatment can occur several times per week or less often, especially for people in stable recovery.

Other treatment types may include group or individual counseling, relapse prevention services, medications, or incorporating self-help methods.

Relapse is common. This is an ongoing and chronic disorder for many.

Relapsing is not an indication of a failed person or a failed treatment. Rather, both parents and patients should see a relapse as a time for readjusting treatment needs and goals.

Before embarking on any treatment journey, it is important to contact your health care providers to seek help that is best suited for your or a loved one’s condition.

Increasing Awareness for Teens

Parents face a challenge when trying to discuss substance use with their kids. While the healthiest option is not to use drugs or alcohol, it’s impossible to control their every waking move. As such, there are ways to increase awareness and have a successful and open dialogue about substance misuse.

Get Their Perspectives Concerning the Use of Substances

Don’t be harsh when talking to them when clarifying misunderstandings. Let them be as open as possible with you and be sure to let them know you are listening.

Talk About Why They Should Never Take Drugs

Whether it is through personal anecdotes or other information, there are many stories out there that can strike a chord with your children. Discussing health complications of drug use is a good starting point for this conversation. Let them know there are other constructive activities to engage in if they are bored. If there are other mental health concerns, you can mention the impact that drug use has on other mental health conditions.

Ask Questions and Listen to What They’re Saying

Get to learn what social media and online websites are circulating in terms of information targeted to teens. What types of shows does your teen like to watch? What games are they playing? What are their friends saying? If they feel like their perspective is valuable, they may be more inclined to have an open dialogue instead of shutting down.

Avoid Lecturing

Shame is a big component of substance use. Minimizing shame when talking to your child will be very helpful. If your child has used a substance before or is currently using, get curious—and avoid scolding—about why they’ve tried things. Curiosity without judgment will help your kids feel less judged about their decisions and behaviors.

When talking about substance misuse, it’s helpful to include your child in the decision-making process. Team-based approaches help them learn to solve their problems and lets them know their voice is being heard. It can help you learn if—or how much—your child is struggling, if they need additional care, or if their health care providers should be involved in the conversations.

Devise Strategies to Avoid Peer Pressure

Discuss with them what a healthy friendship looks like. This may include talking with them about how to let go of friendships that require them to use drugs or drink to fit in or be accepted.

Explain Your Side of the Story

If you are using drugs or had used them in the past, how did you get into that? What are your regrets and the things you have learned? It can be hard for kids to see their parents as once being in their shoes, so by showing this side to them, you can allow for more transparent conversations.

Build a Strong Bond

A parent-child bond is the best way to convince them not to engage in drug or alcohol use. A genuine connection with your kids can make for better rule-following behaviors. By showing that you are willing to trust them without judgment, you can build a stronger bond.

If they manage to pull through, don’t forget to express appreciation toward them. Spend positive and meaningful time with them as they progress through recovery. If there is conflict in the home, parents can still try and engage in positive and impactful ways.

Recovery Is Possible—There Is Hope!

Yes, there is hope for adolescents using substances who develop addiction disorders. Many medications are effective for alcohol use disorder, opioid use disorder, and nicotine use disorder. Also, psychological treatments, often used in combination with medication, have been successful in treating addiction. The treatment also depends on the condition.

In addition to medications and therapy, successful recovery involves rebuilding a meaningful life. This process can be slow and challenging as people rebuild family and social relationships and begin to expand their roles in their communities.

The process can be difficult for people struggling with homelessness, financial instability, lack of social supports, or limited education.

While the end goal is abstinence, progress toward recovery happens in many ways and should be celebrated as accomplishments. The road to recovery can be long and challenging. Recognizing the small victories can help keep spirits and motivation levels high.

The recovery process can involve investing in new interests and social connections that provide meaning to one’s life. A successful recovery from substance addiction can include understanding that your problems usually are temporary. It is often helpful to focus on positive behaviors like:

• Creating realistic goals
• Being flexible
• Having a gratitude list
• Assisting people
• Working to transform your mindset for the better

Whether practicing these behaviors alone or with loved ones, positivity can be a powerful—and successful—component of the recovery process.

If you are overwhelmed by symptoms or negative thoughts that you suspect are related to an addiction, you should contact your health care team to discuss the possibility of a diagnosis. You can also contact a local mental health facility, like McLean, to get the help you need. You don’t have to struggle on your own—there is a path to recovery.

Contributors

Dana B. Sarvey, MD