SUBSTANCE ABUSE AND ADOLECENTS Abstract The aim of this essay is to highlight the causes and consequences of substance

abuse among adolescents. Substance abuse is the repetitive and injurious usage of alcohol and drugs. The causes of substance abuse are related to biological, environmental and psychological perspectives. It has been found that genetics, care giving from parents, neighborhood, peers and psychological disorders such as anxiety and depression are predictor of substance abuse. The underlying consequences of substance abuse are behavioral problems (such as involvement in unprotected sexual activities, risky driving) physical health problems (such as cardiovascular diseases (CVDs) and cancers) and poor academic performance. Proper environment and affection provided by parents can reduce most of the risk of substance abuse. Keywords: substance abuse, adolescent

SUBSTANCE ABUSE AND ADOLECENTS Substance abuse is defined as injurious and repetitive usage of drugs and alcohol (Nebraska Department of Health and Human Services NDHHS, 2007). Substance abuse is also known as Substance Use Disorder (SUD) (Dass-Brailsford, & Myrick, 2010, Thatcher & Clark, 2008) and Non-medical Use of Prescription Drugs (NMUPD), usage of a psychotherapeutic drug for experiencing or feeling it caused which was not prescribed (McCauley, 2010). The first part of the following paper looks at the causes and followed with consequences There are so many causes attributed to substance abuse however this particular study looks at (a) biological causes such as genetics (b) Environmental causes such as parental maltreatment, neighborhood and peer influences (c) posttraumatic events and (d) psychological disorders. Biological causes: Genetics is the study of how genes pass on the characteristics from one generation to the other. Studies show that genetics play important role in developing substance abuse (as cited in Feldstein & Miller, 2006; Agarwal & Lynskey, 2008). However there is no single gene responsible for substance abuse but multiple genes are accountable for it (Agarwal & Lynskey, 2008) In a twin study done by Fowler et al. (2007), it was found that the genetic variations play significant part in speeding up the progression of heavy substance abuse after the initiation. Environmental causes: Family plays a great role in ones life. There have been studies showing that parents who are substance abusers may form a negative impression on their kids and make them substance abusers unintentionally. A study done by Nuno-Gutierrez, Rodriguez-Cerda and Alvarez-Nemegyei (2006) using interview and questionnaire design showed association between family problems and alcohol abuse. Kaufman et al. (2007) found in a longitudinal study that maltreated children started alcohol usage 2 years on average prior to the control children. Moreover they also they also found that maltreated children were seven times more vulnerable to start alcohol consumption by the age of 12 than control children

SUBSTANCE ABUSE AND ADOLECENTS Another environmental cause is attributed to the neighborhood in which the child is raised. Problem Behavior Theory and The social Ecology Model suggest that poor factors in the neighborhood can enhance the prior onset of substance abuse. (as cited in Burlew et al. 2009). Burlew et al. (2009) found that unconstructive neighbor and minimal supervision from parents can boost the initiation of substance abuse. But proper supervision from parents can safe their kids from the affect of poor neighborhood. Another most influential environmental factor in the progression of substance abuse is Peers, however peers have distinct role as compared to parents (Thatcher & Clark, 2008). According to SimonsMorton and Chen (2006) there are two mechanism explaining how peers can affect substance abuse (i) influence, where peers who are drug abusers can affect ones behavior and (ii) selection, where individual looks out for similar minded peers. Influence is multidimensional: it can either encourage or discourage substance abuse behavior. However it is difficult to find out if substance abuse is caused due to influence of peers or peer selection. A study done by Cornelius et al. (2007) shows substance abuse is predicted by the attachment with peers involved in deviant behavior. A strong relationship was found between the affiliation with being friends with substance abusers and substance abuse (Thorlindsson & Bernburg 2006). It was also found that there is a negative relationship between taking parts in social clubs and sport activities and affiliation with substance abusing peers. A research done by Vervaeke, Deursen and Korf (2008) by interviewing 106 Ecstasy users in Amsterdam found that 81% of participants were peer influenced to initiate the Ecstasy use. Psychological causes There are many psychological disorders that lead to substance abuse and Post Traumatic Stress Disorder (PTSD) is one of them. PTSD is defined as stress caused due to past traumatic event s of life. Study shows that alcohol and other drug abuse may be directly attributed to child maltreatment (Thatcher & Clark, 2008). This may be due to the individuals efforts against anxiety and depression caused by traumatic incidents to self-medicate oneself. Another study done by McCauley et al. (2010) examined the

SUBSTANCE ABUSE AND ADOLECENTS relationship between Non-Medical Use of Prescribed Drugs (NMUPD). The study found that traumatic events are important factors causing NMUPD. Events like sexual abuse (69%) and physical abuse (75%) were found to be associated with NMUPD. The theoretical construct have been made linking the relationship between substance abuse and traumatic events. These constructs are known as Negative Reinforcement Models and Self Medication Hypothesis is one of it. It suggests that one seeks support from drugs and other substances to avoid or to reduce the negative effects of past traumatic events (McCauley et al. 2010) Another psychological disorder which found affiliated with substance abuse was depression. In a study done by Chinet et al. (2006) found negative relationship between depression and substance abuse, a drop off in substance use was followed with drop off in depression. Another study found that substance abuse was predicted to untimely onset of depression. Studies also show relationship between smoking and alcohol with depression and anxiety (Saban, Flisher, & Psych, 2010) Another psychological cause that is found to be associated with substance abuse is coping. Drinking to cope is a response to avoid, run off or reduce negative emotions by using alcohol. In another research social anxiety was found to be related with drinking to cope motives. It is a common belief among people who drink to cope that alcohol reduces dysphoric mood. (as cited in Cooper et al. 2008). In a study done by Bonn-Miller, Vujanovic, Feldner, Bernstein and Zvolensky (2007) it was found that internalizing behavior problems like PTSD, anxiety and depression were related to the use of cannabis for coping. However in todays stereotypic society homosexuals and bisexual people face more stress and suffer from great depression than any other individual. Subsequently to cope with high level of stress and emotional distortion and soreness, Lesbian, Gay and Bisexual (LGB) people may start substance abuse. Though substance abuse may provide temporary relief but they may practice substance abuse at greater level and even build substance abuse dependency (Weber, 2008). Furthermore, these psychological disorder caused by stereotyping against LGB people may increase the risk of suicide among LGB people

SUBSTANCE ABUSE AND ADOLECENTS (ODonnell, Meyer & Schwartz, 2011). Studies show that LGB individuals, while abusing alcohol look at their sexual orientation negatively. They abuse alcohol as avoidant coping skill which cuts them off from anxiety and humiliation thus provides social comfort (as cited in Weber, 2008). Substance abuse may help an individual as a source of pleasure and self medication, however the consequences of substance abuse are severe and fatal. An individual with substance abuse may face the following consequences. Risk-taking behavior Studies show that substance abuser are highly involved in risk-taking behavior. studies show that people who are engaged in substance abuse activities are also involved in unprotected and unhealthy sex (VanDevanter, 2011; Pearson et al. 2008; Cardoso & Verner, 2007). Such risk taking behavior can cause fatal diseases like HIV/AIDS and other sexually transmitted diseases (STDs). Another common risktaking behavior among adolescents is risky driving. Study shows high correlation between binge drinking and alcohol consumption with traffic crashes and risky driving behavior (Valencia-Martin, Galan, & Rodrguez-Artalejo 2008). These risk taking behaviors can cause serious medical conditions such as HIV/AID and may even lead to death. Behavioral problems Substance abuse not only causes risk-taking behavior but puts an individual in life threatening situations. Studies have found that smoking can lead to Lung Cancer (Improgo, Scoeld, Tapper, & Gardner, 2010), Pancreatic Cancer (Tranah, Holly, Wang, & Bracci, 2011) and Prostate Cancer (Huncharek, Haddock, Reid,& Kupelnick, 2010). Homicide Sometimes these risk-taking behaviors may take up serious forms like homicide and suicide. A study shows that 139 homicides were attributed to alcohol consumption, 48 to drugs and 152 to alcohol and/or drugs in England and Wales per year (Shaw et al., 2006). Another studies also show close

SUBSTANCE ABUSE AND ADOLECENTS relationship between alcohol consumption and homicide (Darke, Duou, & Torok, 2009; Razvodovsky, 2008). Suicide It is found that suicidal tendency among substance dependent people specially alcohol abusers is 60-120 times more than a non-substance dependent person (as cited in Valadez et al., 2009). Another study shows that the range of attempted suicide among substance dependent people at least once in a lifetime is 35.5% - 41.7% (Evren & Evren, 2006).

Health problems Substance abuse also has adverse effect on our cardiac system. Study shows that usage of tobacco increases the risk of coronary heart disease (CHD). Another study shows that the risk of cardiovascular disease is dose relatedthe more the tobacco, the more the disease. The lethal effects may include high blood pressure, increased level of fats in blood and increased risk of congestive heart failure and stroke (Mukamal, 2006) Alcohol substance is found be related with liver disorders (O Shea, Dasarathy, & McCullough, 2009) Study shows that intoxicants from substance abuse may interfere with the proper liver function and can affect the absorption of amino acids. It was also found that alcohol consumption affects the Vitamin A level in the body (Lieber, 2008). Substance abuse also has an adverse effect on the development of brain. Since adolescent brain is not fully developed until the individual is not in adulthood, they are at high risk of abnormal brain development which may affect decision making skills and memory. Researchers have found that the volume of hippocampus (memory function) of a teen alcohol abusers is comparatively smaller than nonalcohol abusers. Moreover they also found that changes in the level of neurotransmitters are attributed to nicotine intake (as cited in Jack OConnell, 2009)

SUBSTANCE ABUSE AND ADOLECENTS Academic performance Apart from physical and mental consequences of substance abuse there have consequences noted on academic performance. A study done by Williams et al. (2007) using African American sample found that GPA was correlated with marijuana use. Legal consequences Substance abuse may also have legal issues. Most of the countries have strict rules on substance abuse. If caught violating those rules an individual may suffer life imprisonment and thousands of dollar of penality. Discussion Substance abuse is one of the major problems in our society which has wide and adverse effect on human health and society. To reduce the substance abuse and cut down its negative effect parenting substance abuse should be reduced. Children learn from their parents and family is considered as the first learning place for children. Parents should avoid substance abuse at home or in front of their kids so that they do not learn substance abuse and can be protected from second hand substance abuse. Secondly parents should provide comfort and care to their children and they should not be maltreated. Studies show that maltreatment is one of the predictors of substance abuse (Sanctis et al., 2008; Scannapieco 2007). Thirdly parents should avoid their childrens exposure to negative and unconstructive neighborhood as such neighborhoods can induce substance abuse (Burlew et al. 2009). Lastly parents should make their childrens involvement in social clubs and sports activities which reduces the risk of substance abuse (Thorlindsson & Bernburg, 2006) According to Erik Eriksons psychosocial development there are eight stages of development. During infancy babies develop trust or mistrust towards parents. According to Erikson trust arises from physical comfort and sensitive care from caregiver resulting in attachment. If babies are well treated and parents are sensitive to their signals and are consistently available to respond to the infants needs, they develop secure attachment. However if babies are not treated well, not responded to their needs, having

SUBSTANCE ABUSE AND ADOLECENTS little physical contact, inconsistency in care giving, lack of affection with babies and physically abuse they also develop avoidant, resistant and disorganized attachment with their parents along with mistrust. In order to stop individuals suffering from psychological disorders like PTSD, anxiety and depression to initiate substance abuse, families and friends should provide social support and comfort. Counseling sessions must also be provided if necessary. There are numbers of rehabilitation centers for drug and alcohol abusers where they can find proper treatment to overcome their addiction and start a whole new healthy life Awareness should be provided from the basic developmental stages at schools and community so that the risk of substance abuse can be reduced. However adolescent with curiosity must be given a chance to explore things under adult supervision. Although there are laws against substance abuse however there is a vast need of law enforcement so that a healthy and constructive environment can be formed. Future studies should particularly look at the curiosity element among adolescent with regards to substance abuse. Moreover there is need of clear picture of what motivates adolescent for substance abuse peer selection or peer influence. Implication of this study could be a way of creating awareness in people about the causes and consequences of drug abuse and how it can be overcome. It can also be used to overcome stereotyping against LGB people. At last substance abuse is a harmful practice within our societies. It can be triggered from small stimulus but can have life threatening and devastating consequences. Families, friends and community as whole can fight against substance abuse by providing good care and affection and by imposing laws so that other people do not get motivations to abuse substances.