Substance Abuse in youth today has reached crisis proportions. Several national and local initiatives have raised awareness to this epidemic. Awareness is the first step to prevention. Examining the factors that lead to these addictive behaviors can also help with primary prevention, identification and treatment of youth in our community.
Several areas of risk in the development of substance abuse behaviors can be identified. Addressing these areas of risk can provide the foundation for prevention and treatment.
The areas of risk include; cultural, interpersonal, psycho-behavioral and genetic.
Cultural factors include current legal standards and laws that seem to target the underprivileged and less fortunate, social norms that in many lower socioeconomic communities favor or “glamorize” substance use, economic deprivation that fuels unemployment, homelessness and lack of social supports and the general disorganization of the neighborhood and family.
Interpersonal issues in childhood leading to increased risk include inconsistent family rules and structure, aberrant family attitudes and behavior (parents who are abusing substances) and severe family conflict and abuse. In adolescence, risks include negative peer relationships (bullying or trying to “fit in”), severe life stressors (social and school) and association with abusing peers (“hanging out with the wrong crowd”).
Psycho-behavioral issues include age, environmental stressors and psychological factors such as co-morbid mental illness.
Finally, there is a growing body of research supporting the genetic predisposition of addiction and addictive behaviors.
So what can be done to intervene and work toward a model of prevention and not just treatment? Available substance abuse treatment programs, rehabilitation centers and use of medically assisted treatment have expanded to address the growing number of patients struggling with addiction.
More attention must be given to addressing the areas of risk before addiction takes over.
There are interventions for families, schools, religious organizations, community services and law enforcement agencies to consider in trying to support the healthy development of children and potentially decrease the risk of substance abuse.
Positive interventions may include a focus on the family and child’s living environment. Efforts to maintain a stable living situation and work to foster the caregiver – child bond are essential.
Promoting consistent adult supervision and discipline allow children to grow in a healthy environment.
This can be accomplished within the nuclear family or through community organizations that provide structure and purpose when the family may not have the resources to do so. By attending to this structure and consistency, children can be instilled with a purpose and increased motivation to achieve appropriate goals and encouraged to maintain socially appropriate behavior and relationships.
These social opportunities allow for positive peer interactions and the opportunity for exposure to drug free behaviors.
Finally, frequent and consistent community wide messages addressing the risk of substance abuse open the dialogue and uncover the secrecy of this addictive and deadly behavior.
L. J. Pezor, MD is the chief medical officer and child and adolescent psychiatrist at the Eastern Shore Psychological Services
in Easton, Maryland
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