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Adolescents, generally considered ages 11-21, all over America are exposed to drugs. It is not just a problem in the inner cities or urban areas. Adolescents in the US use illicit drugs (but not alcohol) more than adolescents in Europe. Teens do drugs for reasons including; to relieve boredom, satisfy their curiosity, self medicate depression and anxiety, to feel adult, for social acceptance, to improve their mood, to increase performance, succumbing to peer pressure. However, many adolescents reject alcohol and drug use despite apparent availability. The factors that seem to affect adolescent motivation to avoid alcohol and drug use include; positive adult role models, good relationship with parents, no experience of loss, separation or trauma in childhood, high self esteem, desire to do well in school, negative feelings about the use of alcohol or drugs, risk avoidance personality, above-average family income, living in a community that offers youth activities where drugs and alcohol are not tolerated, active in faith-based organizations where alcohol and drugs are rejected, attending schools with effective drug education programs.
The National Institute on Drug Abuse funds a project that studies changes in the behaviors, attitudes, and beliefs of American young people regarding substance use. This resource is known as the Monitoring the Future project. Over 50,000 students from 420 schools take part in the annual survey from eighth grade through twelfth. Monitoring the Future project statistics from 2017 show that over 50% of high school seniors have used an illicit drug or an inhalant at least once in their lifetime 37% of 10th graders, and over 23% of 8th graders have experimented with an illegal drug or inhalant.
While many adults, most of whom are parents, feel that experimentation is a normal part of growing up, and some parents did it themselves as adolescents, some things have changed since they were youths. The drugs have changed. A generation ago, some drugs; ketamine, MDMA were not widely available, and some drugs; spice, bath salts, etc. did not exist, while the most common drug used by adolescents, marijuana, is much more potent than it was a generation ago. (The National Institute on Drug Abuse says the potency of marijuana has been steadily increasing over the past few decades, but a level of 20 or 30 percent THC is even greater than the institute has reported in the past. As of 2012, it said marijuana confiscated by police agencies nationwide had an average THC concentration of about 15 percent.)
A generation ago addiction was not considered a medical condition. Today it is scientifically accepted that it is a disease of the brain with identifiable symptoms; however, it is not known why some can engage in drug use and not become addicted, and some become addicted. Research suggests that genetic factors predispose specific individuals, which explains why a family history of addiction to drugs or alcohol, leads to increased risk. Childhood trauma; neglect, physical and emotional abandonment, sexual, physical, and psychological abuse alters the brain chemistry of children, making them more at risk of addiction.
We now know more about how substance abuse physically changes the brain. Most importantly, we know the brain continues to develop until the early 20s. This means young people are at greater risk of the damage caused by drugs and alcohol, and the younger the person is, the more profound that damage can be. It should be a priority social policy to reduce adolescent drug and alcohol use. To develop effective drug education programs, it's important to understand the teen motivation to use or not use drugs or alcohol.
In 1982, First Lady Nancy Reagan uttered three words that became a clarion call for the adolescent drug prevention movement; “Just Say No”. (Lillenfeld, S. and Arkowitz, H. (2014). Why Just Say No Doesn't Work, scientificamerican.com). The drug education programs that were developed subsequently, centered around that phrase, have largely proved to be ineffective. Effective drug education programs are among the motivations previously listed (paragraph one) as contributing to adolescents rejecting drug use.
The first program that was based on Just Say No was the Drug Abuse Resistance Education program (DARE). From 1983 through today DARE is in schools across the country. A uniformed law enforcement officer goes to schools and teaches pre-adolescents through high school about the dangers of drug and alcohol use. It is currently in 75% of US school districts. A meta-analysis in 2009 revealed that students enrolled in the program were just as likely to use drugs as those that were not. (Lillenfeld) Two problems have been identified with the program. One was a lack of student participation in role-playing how to handle situations where drugs or alcohol are available or offered. Instructing students to “Just Say No” hasn't produced the desired results because adolescents often lack the interpersonal social skills to be able to refuse drugs when offered by peers. Another was that the program lasts months and studies indicate that effective programs have to continue over a period of years. Additionally, the course has been shown to backfire when it comes to alcohol and tobacco because, according to researchers Werch and Owen from the University of North Florida, instructors teach that the effect of these substances (which are legal for adults) are innocuous compared to other substances. (Lillenfeld).
Other studies on why drug programs fail to motivate adolescents to resist drugs and alcohol conclude that one of the reasons that affect DARE and other programs, is scaremongering doesn't work. “honesty is the best policy. Exaggerating the detrimental health effects of drugs like marijuana contributed to discrediting programs. Even changed the curriculum in 2001 a “fact sheet” claimed marijuana has no medical value, weakens the immune system, and causes insanity and lung disease-claims that are widely refuted by health experts” (Lopez, G. (2014) Why anti-drug campaigns like DARE fail, vox.com)
The same studies find that what is effective is linking abstinence to being independent and autonomous. Adolescents want to be thought of as adult and independent. Colorado, which has legalized adult use of recreational marijuana, is spending a portion of the tax revenue from the legal sales on an anti-marijuana use program for adolescents. It's called “Don't be a Lab Rat” and it is trying to convey the potential risks to youth without crossing the line into hyperbole. The basis of the program is that the effects on developing brains are not yet fully known and that adolescents that use marijuana are essentially offering themselves as “lab rats” to scientists who want to measure the drug's effects on the teen brain. (Lopez) This approach has earned mixed reviews, and it's too early to know if it will be effective.
A small study in 2001 considered the role that cultural values play in adolescent motivation to abstain from drug or alcohol use. The study focused mostly on marijuana and alcohol. Subjects were divided into two groups, those identified as African American and those identified as European American. Neither group identified alcohol as a drug. Both AA and EA subjects reported that the most common motivation for the use of marijuana was social needs; to fit in, to be popular, acquire friends, gain attention, and secondarily for enjoyment, liking the feeling of being high. Only the EA youth reported additional reasons of boredom, curiosity, problem-solving. The motivation to reject marijuana use fell along ethnic lines. EA subjects reported that they didn't use the drug because of social self-concepts. “They discussed different attitudes, low self-esteem, becoming a totally different person, getting knocked around, not being a good person to be around, and isolation from others as motivations for staying away from drugs. Conversely, only AA adolescents described both physical and psychosocial threats that originated from parents or drug resistance programs/ advertisement, such s messing up the brain, making the kidneys hard, making lungs black, making others smell bad, making people go crazy, making people get sick, hurting people, getting people into trouble, making people fight and making people do many other “stupid things”. Descriptions that seemed to fit into the “end Results” category (again only mentioned by AA youth) included not being able to find a job, getting into trouble, going to jail, and dying” (Barnett, J. Miller, M. (2001) Adolescents' Reported Motivations to Use or Not to Use Alcohol or Other Drugs, socialstudies.org)
Adolescents use or abstinence from drugs, and alcohol is strongly affected by the positive or negative influence of peers. “Research around the effect of peers on adolescent drug use and recovery suggests at least two different ways that peers influence one another. Peer contagion theory and iatrogenesis suggest that grouping high risk youth together could lead to a higher risk for drug use or relapse after initial cessation of use.” (Peabody, J. (2014). Positive Peer Support or Negative Peer Influence? The Role of Peers Among Adolescents in Recovery High Schools. NCIB)
Studies support the idea that having non using peers is predictive of sobriety among adolescents that used drugs or are in recovery from addiction. While some programs are based on adolescents in recovery supporting each other studies, have found that having a high-risk individual in the program can undermine the recovery of others. This is more of a danger with adolescents than adults in recovery. The study found that adolescents that relapse sometimes cause others to relapse. (Peabody)
Studies have shown that peers have more influence on adolescents than parents as a general rule. Adolescents and even young adults usually have a need to fit in and feel part of a group. Handling peer pressure is not difficult if the adolescent is surrounded by those with similar values. Late adolescence (18-21) is a time when many leave home and attend college and those that don't move out of their parent’s homes and set off on their own life. It is a time when they have more freedom and less supervision. (Regents of the University of California, (2019) How to Handle Peer Pressure, ucsc.edu)
There can be overt peer pressure such as friends telling you what to do or indirect peer pressure like seeing peers do shots at a party and being curious to try alcohol. It's important for adolescents to reflect on their values and try to avoid situations that they feel test their boundaries.
According to the Monitoring the Future study of 2015, carried out by the National Institute on Drug Abuse and the National Institutes of Health almost every fourth college student had used an illegal drug in the past month. While heavy drinking is common in college, recent trends show a decline of alcohol use, and marijuana use increasing, especially in states where it is available for medical or recreational use legally. College students in the late adolescence age group are motivated by self-medication, taking drugs to relieve anxiety, and the desire to enhance performance as well as social acceptance factors such as peer pressure. “The use of non prescribed stimulants (NPSU) include Adderall, Ritalin mostly for college students have found NPSU to correlate with instrumental motives and productivity-related demands” (Leon, K. (2017) To Study, to Party, or Both? Assessing Risk Factors for Non-Prescribed Stimulant Use among Middle and High School Students, Journal of Psychoactive Drugs
It was surprising to me to learn that some adolescents that would generally not be considered high risk of drug use are engaging in the use of non-prescribed stimulants. “there is growing concern over increasing rates of illicit prescription drug use among college students. Using semi-structured interviews with 22 college students who misused prescription stimulants, we find that they draw on conventional middle-class beliefs (e.g., success and moderation) to make sense of their drug use. They do this by creating identities as people who are focused on success and use stimulants only as a tool to perform their best. They use excuses and justifications rooted in middle-class values to create symbolic boundaries between themselves (as legitimate users) and others (as hedonistic users). This allows them to persist with their illegal behaviors while maintaining an identity as conventional citizens.” (Kerley, K. Copes, H (2014) Middle-class Motives for Non-Medical Prescription Stimulant Use Among College Students, Taylor and Francis Online)
Understanding the motivations to use or not use alcohol or drugs among adolescents is important if we want to develop programs and strategies to increase abstinence among those in this age group.With the risk of addiction and the fact that adolescent brains are still developing we should be trying to curb the use of alcohol and drugs among adolescents.
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