Teens and Drug Use

Healthful Vitality | 12/04/2019 | By Sarah Schulze, MSN, APRN, CPNP | Teens and Drug Use

In closing out our series on teens and substance use, a closer look at harder substances is warranted. le us examine teens and drug use. Evidently, as many as 14% of high schoolers report having used an illicit substance or a prescription drug that wasn’t theirs by age 18. These students are more likely to experience physical or sexual violence and to be at risk for suicide (2). Notably, in 2016, drug overdose was responsible for 4.8% of all teenage deaths (2). Clearly, this is a problem that is not going away and needs to be addressed. Therefore, we will further discuss which substances are being used, associated risks, and what parents and health care providers can do to help teens avoid experimentation with drugs.

What kinds of drugs are they using?

Opioids are a class of drugs, usually prescription, that block certain signals in the brain. In fact, this makes them powerful pain relievers. However, the pleasurable (or high) sensation obtained also makes them a considerable risk for addiction. Commonly used opioids are codeine, fentanyl, hydrocodone, and oxycodone (1). Many adults become addicted after being prescribed these medications for a medical purpose. And then having difficulty weaning off of them when the initial diagnosis has resolved.

However, teenagers often come in contact with these medications through peers and parties, where the pills are sold and taken for recreation. Notably, statistics indicate a greater than 50% decrease in the use of these drugs by high schoolers in the last five years. However, there is still work to be done in spreading awareness regarding their risks (5). Besides, the risk of addiction, the most severe risk of opioid use is overdose. Often, these medications are taken in quantities or by routes that exceed the dose. To emphasize, these exceeded doses are able to be metabolized by the body, leading to confusion, vomiting, unconsciousness, decreased respiratory rate, and often death (1). 

Opioid users

Unfortunately, prescription opioid users usually develop a tolerance over time and will often look for other methods to achieve a high. These sometimes results in heroin use. To clarify, heroin is an illegal and highly addictive substance that activates the same receptors as opioids. It can be smoked, snorted, and injected. And as much as 25% of users will become addicted after just one use (1). Indeed, the high from heroin lasts about 4-5 hours and quickly leaves users needing frequent hits of the drug to feel normal. Truly, as tolerance builds, more and more of the drug is needed, and the risk for overdose increases. While the overall use of heroin is low in school-age children. Besides, it is on the rise, up to 1.9% of children ages 12 and older have ever used it in 2018, as opposed to 1.7% in 2015 (5). 

Stimulant use

Stimulant use has emerged in recent years. It is as a problem amongst teenagers as well. Moreover, many teens have prescribed medications to treat attention deficit disorders. However, these medications have a high street value. And are often sold to others who abuse the medications. Indeed, stimulants increase alertness and energy and improve cognitive function. Undoubtedly, students will often use them to stay up all night studying or for improving test performance. Some teens just like the energetic high feeling they get. Consequently, over time, they can develop a dependency on that feeling as the body produces less dopamine on its own and requires the medication to feel normal (1). 

Benzodiazepines or “benzos” are a group of drugs that are typically used for short term treatment of anxiety. However, these meds are often sold and used to achieve a state of relaxation or “buzz” effect. Some teens take the tablets by mouth. However, some will even crush and snort the medications to increase the effect. The mental and physical dependence on these drugs develops quickly. And there is a high abuse potential for even those who are prescribed for the medication (1). 

Other drugs use

There are many other drugs that teens may be using. For example, meth, LSD, Ecstasy, cocaine, and sleeping pills, though these are all more common in individuals 25 years and older. As with any of the above drugs, the risks of negative consequences and addiction are high. And their use should be screened for at routine pediatric appointments and in conversations with parents.  

Teens and Drug Use: Health Risks

The risk of poor outcomes with these types of drugs is high, and there are many areas of concern to consider. One of the most significant risks is the potential for substance abuse as a lifelong issue. Notably, as many as 9 out of 10 adults with a substance abuse problem had their initial experience with drugs before the age of 18. And those who first used before age 15 have a seven-fold risk of drug abuse in adulthood compared to those who waited to age 21 (3).

Declining school performance and in increased rates of dropping out

Substance use and abuse typically result in declining school performance and in increased rates of dropping out, making future income potential low, and increasing the risk of poverty and continued substance abuse. Encounters with law enforcement over the use of illegal substances can further damage a record and potential of future success (4).

Mental impairment, decreased concentration, and poor judgment

Mental impairment, decreased concentration, and poor judgment all increase the risk of injury, either through driving under the influence, mishandling of weapons and firearms, or risky behaviors resulting in falls or drowning. Drug use also increases the likelihood of engaging in high-risk sexual behaviors, increasing the risk of STDs, unwanted pregnancy, and sexual assault (4).

Drugs also alter the chemistry of the brain and can increase the risk of or exacerbate enduring mental health conditions, such as, anxiety and depression (4)

What parents and healthcare professionals can do?

Prevention is a critical factor in reducing the number of teenagers who use and become addicted to drugs. As with nicotine and marijuana use, frequently open and honest conversations are a great starting point. Find out what your child knows and thinks about drug use and if they have any friends who use it. Understand that teens most at risk for drug use and abuse are those with poor parental supervision, substance use by parents, mental illness, childhood trauma, and poor academic achievement. Protective factors include a positive parent/child relationship, clear rules, and expectations with established consequences, family support, and school connectedness (2).

Healthcare professionals should take the opportunity to caution against the risks of addiction and overdose as well as the risks of violence and injury that comes with drug abuse. Monitoring for changes in behavior, screening questionnaires that indicate a potential problem, and urine drug testing when necessary (with consent) should all be part of routine practice when working with adolescents. If this education is started early on in a provider-patient relationship, it may open the door to discussion and obtaining help when needed later on (2).

Conclusion

Indeed, the teenage years are a time of self-discovery and experimentation. While drug use is not as common as other risky behaviors, it is dangerous enough to warrant staying abreast of current trends in drug use and knowing how to talk to teens about these issues. With rising awareness, the prevalence of teen drug use is lower than what it used to be, and hopefully, this trend will continue.

References:

1. Addiction Center. (2019). Common types of drugs. Retrieved from: https://www.addictioncenter.com/drugs/
2. Centers for Disease Control and Prevention. (2019). High risk substance use among youth. Retrieved from: https://www.cdc.gov/healthyyouth/substance-use/index.htm
3. Center on Addiction. (2017). Teen substance use. Retrieved from: https://www.addictioncenter.com/benzodiazepines/
4. Mayo Clinic. (2019). Teen drug abuse: Help your teen avoid drugs. Retrieved from: https://www.mayoclinic.org/healthy-lifestyle/tween-and-teen-health/in-depth/teen-drug-abuse/art-20045921
5. National Institute on Drug Abuse. (2018). Monitoring the future survey: high school and youth trends. Retrieved from: https://www.drugabuse.gov/publications/drugfacts/monitoring-future-survey-high-school-youth-trends

Author:

Sarah Schulze is a board-certified Pediatric Nurse Practitioner. She earned a B.S. in Nursing from Indiana State University and an M.S. in Nursing from the University of Illinois at Chicago.

(Related Article: Teens and Marijuana Use)