Why adolescents use substances of abuse
Duhigg, D.
Adolescent Medicine State of the Art Reviews 24(2): 465-477
2013
ISSN/ISBN: 1934-4287 PMID: 24298759 Document Number: 16101
Adolescents use mind-altering substances for experimentation and for coping with emotions and cognitions that they are unwilling or unable to tolerate. 1 Unfortunately, they tend to use illicit substances in the presence of other adolescents or young adults who often do not have an accurate understanding of the consequences of intoxication. Myths and mistruths are shared and incorporated into ritualized use. Some are harmless, such as the belief that ecstasy (MDMA) causes somatic effects "by making your spinal cord bleed:' Others are fatal, such as the belief that opiates arc safe in overdose because they arc a prescribed medication. Adolescence is a period of great social and biological changes, and experimentation with behaviors and perception is common. the availability of abusable substances leads many to experiment with substance use. Intoxication provides a momentary change in perception of the internal and external world. In the case of substances of abuse, the experience is also filled with emotional salience. Unfortunately, adolescents discount the risks of substance use and often underestimate the potential sequelae of their pursuit of an altered state. Additionally, they are driven to seek out novelty, which itself can be intoxicating and reinforcing. The likelihood of developing a substance use disorder (SUD) is inversely proportional to risk aversion in adolescence. Ironically, intoxication tends to decrease risk aversion, making it both a means to its own end and a multiplier of risk exposure liability. An important example of this is the reduction of adolescent safe-sex practices while intoxicated. Other examples of life-altering behaviors facilitated by intoxication include theft, causing bodily harm, sexual imposition, vehicular accidents, and suicide attempts. In summary, adolescent substance use is associated with a variety of risks. Using a nonjudgmental and collaborative approach to treating adolescent substance users can yield positive results. Motivational interviewing and the adolescent community reinforcement approach are evidence-based, nonpharmacologic treatments for teens with substance use disorders.
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