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substance abuse in adolescence articles

There is increasing evidence of a rise in substance abuse among British adolescents. A survey of British 15- to 16-year-olds found that almost half had tried illicit drugs at some time. While most children who experiment with illicit drugs do not go on to habitual abuse of drugs, the earlier the onset, the more persistent the habit becomes and some will become substance dependent as adults. While a proportion of illicit drug-abusing children go on to adult dependence, there are significant differences in the pattern of abuse among adolescents and adults.

Children with conduct disorders are more likely to misuse drugs. The risk is increased in children with conduct disorder and hyperactivity. Adult role models and peer group drug use have a strong influence on adolescent drug abuse. Inhaling organic solvents is particularly associated with adolescent abuse and social adversity. There is some evidence to suggest that multiple drug use is more common among adolescents than adults with an irregular pattern of abuse rather than chronic use. As a result, dependence among adolescents in relatively uncommon.

While substance misuse is more likely to respond to early treatment in adolescence, motivation in accepting treatment can be poor. It is often the concern of others which leads to referral. There is an increased risk of suicidal ideation and attempted suicide with children, not uncommonly first presenting following an episode of deliberate self-harm. Drug use is a major risk in completed suicide. Among adolescent females involved in drug misuse, affective symptoms are likely to be more common while, in males, conduct disorders predominate. As adolescent drug abusers do not readily present themselves for treatment, an assertive approach needs to be adopted usually involving other agencies such as probation, social services and education. Although alcohol dependence is uncommon, in cases where dependence has developed, detoxification is required. Detoxification for dependence on other illicit drugs follows the same programme as in adults. Individual counselling in primary care settings using the brief intervention techniques have shown significant reduction in alcohol misuse.

Family influences play a significant role in the onset and progression of drug misuse; and family therapy approaches using techniques such as the multi-dimensional family therapy have been shown to be beneficial. Group therapy involving peers based on the Alcoholics Anonymous model helps in providing support and relapse prevention.

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