Teens and substance abuse: Insights from the treatment field

Ever heard of K2 or Spice? How about “Roofie” or “Molly” pills? All are street names for the types of drugs teens may be encountering these days in their social circles.

The first two listed above, K2 and Spice, are types of synthetic marijuana - and can sometimes contain other additives that make them even more powerful. A “roofie” is better known as the “date rape” drug, and a “Molly” can be a concoction of chemicals that often contains methamphetamine. All can be dangerous enough when adults use them, but even more so when they get into the hands of kids. Other illicit drugs can come in candy form, such as lollipops or gummy bears, making them easy to conceal from parents. Add these substances to the plethora of alcohol and drugs already available on the market, such as prescription and synthetic opioids, and you have an increasing number of potentially life-altering temptations for teens.

According to the Center for Drug and Alcohol Programs (CDAP) within the Institute of Psychiatry at MUSC, one of the nation’s premiere facilities for treatment of substance abuse, there is cause for concern. “Alcohol and drug use among teenagers is on the rise,” states a brochure for the CDAP’s Adolescent Substance Use Skill Education Training program, also known as ASSET. And the earlier kids start using, the more problems they may encounter, such as academic and legal problems, health risks, poor psychological adjustment and more. There is also a greater risk of them becoming addicted to substances later in life.

The ASSET program, run by Viktoriya Magid, PhD, targets kids ages 12 to 18 and offers two ongoing care tracks - one for prevention and another for treatment - as well as assessments, drug screenings, medication management, teen coaching, and parent coaching. The Daniel Island News asked Dr. Magid to answer some questions to help offer insights on the treatment side of substance abuse. Below are her responses.

Q: What are you seeing in your practice? In your opinion, is the rate of drug use and abuse climbing, particularly among teens?

VM: We do see higher rates of prescription drug abuse among teenagers, as compared to previous decades. Mainly, availability has changed, because pain pills (opiates) and anxiety medicine (benzodiazepines) have been more readily prescribed to adults, and thus it’s easier for teens to get access to these drugs, which can be very addictive and dangerous.

Q: In your experience, what are some of the reasons teens try drugs?

VM: Adolescence is a period of risk-taking and trying new and often dangerous things. The adolescent brain isn’t fully developed until the mid-20s and thus teens tend to make impulsive choices and have a hard time thinking through the consequences of their actions. National data suggests that close to 60 percent of 12th graders report having consumed alcohol in the past year and about 35 percent report having smoked marijuana in the past year. Most teens report trying drugs to enhance an already positive experience (e.g., being at a concert), to fit in or socialize with their friends, and occasionally, to help them cope with stress, sad mood, or anxiety.

Q: Which teens are more apt to use drugs? What makes this age group so susceptible?

VM: We know that teens with a history of trauma, depression, and anxiety tend to use substances more frequently and more heavily. We also know that teens with a genetic history of addiction are more likely to start using at younger ages and develop problems with their use earlier on. However, the number one predictor of whether a teen uses drugs or not is whether his or her friends use drugs; social environment at this age determines most of their activities and interests.

Q: What are some of the warning signs that parents can look for?

VM: Warning signs of drug use among teens are tricky to spot because some of these signs can be very similar to the normal teenage behavior. Unexplained moodiness, unusual aggression, being secretive, avoiding parents, hiding phone, breaking curfew and lying about whereabouts, slipping grades, sudden change in friends can all point to something being wrong. Whether it’s substance use or another issue – a parent needs to intervene at this time.

Q: What is the best way that parents can help?

VM: Parents underestimate the widespread nature of drugs and alcohol among this age group. Parents also tend to be naïve to the age of onset of substance use. For example, the average age at which adolescents report trying alcohol is age 13 and the average age for trying marijuana is age 14. In part because of misperceived risk and in part because many parents do not know how to approach the topic, many families choose to ignore this issue altogether until later, when they are faced with a problem. The best approach to substance use is education and prevention. Open discussions about availability, risks and dangers of using, monitoring, and holding a firm zero tolerance policy in the house have all been linked to lower rates of substance use by teens.
But substance use prevention can begin as early as your child can talk. Parents of young children should begin now by teaching their little ones healthy coping skills in dealing with difficult emotions and promoting the idea that there are no “bad” feelings, thus allowing children to openly discuss their feelings. This sets the stage for open communication during adolescents. Having a special 10-minute check-in time with your child every night before bedtime creates a relationship of love and trust and allows the parent to notice any struggles early on.

Q: What treatment options are available to those seeking help?

VM: Various forms of help are available to those seeking help. Starting with preventive education classes (“Prevention Track” of the Adolescent Substance Use Skills Education Training/ASSET, which is a six-week class on drug education), outpatient individual and group therapy (“Treatment Track” of the ASSET program; 16 bi-weekly sessions that span eight weeks), and residential treatments. It is important to consult a professional to appropriately determine the correct level of care for a teen. Sending an adolescent to an inpatient or residential facility without previously trying outpatient services can be premature.

Q: Heroin use in particular has been called the “silent epidemic.” We just heard reports earlier this month about 174 heroin overdoses in six days in Cincinnati. What is your reaction to this news? Are you surprised? In your opinion, are we dealing with an epidemic?

VM: Heroin use has been on the rise in the Lowcountry as well. Nationwide, the number has gone up slightly, but is still hovering around one percent (of 12th graders who report using heroin in the past year). However, I have heard reports from my adolescent clients that heroin has become available at local schools and that is terrifying. With the recent rise of opiate pills abuse, it is not surprising that heroin use has been on the rise – it is cheaper and more potent than opiate pills (e.g., OxyContin, Lortab). The real epidemic, I believe, is the abuse of prescription pills. And, of course, alcohol. Alcohol has remained the most abused and under-noticed substance among teens. It kills more adolescents every year than any substance combined (whether directly or as a result of tragic accidents) and most of the drug overdoses have occurred because of simultaneous alcohol use.

Q: Which drug addiction (heroin, cocaine, marijuana, etc.) do you see most often?

VM: Most teens who are referred to the ASSET program have been using marijuana (around 80 percent) and alcohol (around 70 percent). These are comparable statistics with national averages. We also see many teens who have begun to experiment with prescription drugs (opiates, benzodiazepines, amphetamines) and have tried cocaine and even less often heroin.

Q: Is there anything else you would like to add that you think would be helpful for our readers to know?

VM: A word of caution should be made about adolescent-specific substances, such as cough medicine, sleep medicine, inhalants, and synthetic drugs. If a parent notices their child acting oddly but the child is passing home administered urine drug screens, it very well could be one of these substances.

To schedule an ASSET assessment, call (843) 792-5200. For additional information on the program, visit http://www.muschealth.org/psychiatry/services/child/asset.html.

Need help talking to
your kids?

The Substance Abuse and Mental Health Services Administration (SAMHSA) has created a mobile application designed to help parents talk to kids about underage drinking and drug use. The app is called “Talk. They Hear You.” Visit the link below for additional information:


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