Is substance abuse related to adolescence trauma

Introduction

Substance abuse among children and adolescents is a growing concern, with studies showing that alcohol, tobacco, and cannabis are the most commonly used substances among this age group. The Adverse Childhood Experiences study has shown a correlation between traumatic experiences and the likelihood of substance use in adolescence or adulthood (Hunt, Slack, and Berger, 2017; Heradstveit et al., 2020). This paper will explore the signs and symptoms of substance abuse in children and adolescents, the addiction's etiology, and the systemic and environmental factors that affect human development and behavior. The article will also discuss ethical and culturally relevant strategies for promoting resilience and optimum development and wellness. It will provide evidence-based counseling strategies and techniques for prevention and intervention concerning substance use in adolescents.

Signs and Symptoms of Substance Abuse in Children and Adolescents:

Substance abuse among adolescents is a concerning issue highlighted in recent studies. Adolescents are found to be particularly vulnerable to substance use, with alcohol, tobacco, and cannabis being the most commonly used substances. The UN drug report has shown a drastic increase in the use of cannabis among adolescents in the last decade, with a significant proportion perceiving it as not harmful (Hunt, Slack, and Berger, 2017; Nebhinani and Singh, 2022).

Furthermore, the Monitoring the Future study in the United States indicates that alcohol is the most widely used substance among adolescents, with over 50% of 18-year-olds reporting lifetime alcohol use. Cannabis and cigarettes also have a significant presence among this age group, with 45% and 31% of adolescents reporting their use, respectively. The Health Behavior in School-aged Children survey for European nations and Canada also shows a high number of current alcohol and tobacco users among 15-year-olds. One in five 15-year-olds (20%) have reported being drunk twice or more in their lifetime, and almost 1 in 7 (15%) had been drunk in the last 30 days (Nebhinani and Singh, 2022). Additionally, according to literature from the United States, e-cigarettes or vaping is also prevalent among adolescents as a mode of tobacco use. This information is crucial to be aware of and to take necessary actions to address the issue of substance abuse among adolescents (Nebhinani and Singh, 2022; Heradstveit et al., 2020).

Etiology of Addiction

In recent years, the etiology of addiction has been widely studied, particularly regarding substance use among children and adolescents. Studies have shown that gender plays a role in substance use, with girls being more likely to drink risky amounts of alcohol while boys tend to engage in regular binge drinking. Additionally, regular smoking and cannabis use is higher in boys than in girls. It is also observed that with increasing age, the use of all three substances (alcohol, cigarettes, and cannabis) becomes more frequent (Frobel, Grafe, Meigen, et al., 2022).

The connection between socio-economic status and substance use during childhood and adolescence is unclear. However, studies have consistently shown that cigarette use is more prevalent among individuals from lower socio-economic backgrounds. Additionally, research has found that substance use, particularly cannabis, alcohol, and cigarettes, can lead to behavioral and psychological issues in adolescence and young adulthood. Attention Deficit Hyperactivity Disorder also increases the likelihood of alcohol and cigarette use in childhood and adolescence. Furthermore, early onset of substance use is linked to more behavioral problems than those who start using later. Substance use also negatively impacts the quality of life for children and adolescents, possibly due to addiction. (Frobel, Grafe, Meigen, et al, 2022).

Systemic and Environmental Factors in Substance Use Disorder: The Interplay of Biology, Psychology, and Society

Systematic and environmental factors play a significant role in human development, functioning, and behavior, as well as the effects of crises, disasters, and trauma on diverse individuals. One such factor is biological factors, specifically substance use at an early age, which generally interferes with ongoing neurodevelopmental changes and induces neurobiological alterations that further augment the risk of Substance Use Disorder (SUD). Adolescents tend to have greater impulsivity because of a lesser control of the prefrontal cortex (PFC) over subcortical and limbic urges. Hormonal changes in an adolescent's body and environmental stress lead to increased substance use vulnerability (Frobel, Grafe, Meigen, et al., 2022).

Social and psychological factors also contribute to substance use and addiction. Predisposing risk factors such as adverse life events, including child sexual or physical abuse, attention deficit hyperactivity disorder, conduct disorders, other externalizing disorders, parental substance abuse, criminal history, excess use of screens, social media or pathological internet use, parenting issues like permissive, authoritarian, neglectful parenting, family issues, and so on may lead to early-onset drug use. According to the World Drug Report (2021), marginalization in society, poor socio-economic status, and low education levels predispose toward drug use and associated adverse consequences. Experimentation, curiosity, and a tendency to succumb to peer pressure come naturally to this age group. Peer influence is a huge factor in substance use behavior, especially among adolescents (World Drug Report, 2021).

On the other hand, protective factors such as strong parental attachment, association with well-resourced communities, and psychological well-being have been associated with less risk for substance use-related problems. There is a consensus that having good affective experiences, communication, authoritative parenting, secure attachments during early childhood, and future orientation improves emotional development and mental health and prevents the risk of drug use (Frobel, Grafe, Meigen, et al., 2022).

Promoting Resilience in the Face of Adverse Childhood Experiences: Ethical and Culturally Relevant Strategies for Optimal Development and Wellness across the Lifespan

A substantial body of research has linked childhood maltreatment and adverse household characteristics to several adult chronic diseases and health risk behaviors. However, studies examining the early effects of Adverse Childhood Experience (ACE) exposure are lacking. It is found that exposure to childhood adversity is strongly associated with internalizing and externalizing behaviors in children at age 9. The studies have observed that increasing counts of ACEs are associated with increased behavioral problems, and there is a stronger connection between ACEs and externalizing behaviors than internalizing behaviors (Hunt, Slack, and Berger, 2017).

It is also found that only at higher levels of ACEs (3 or more) is exposure to these adversities significantly more likely to result in a child displaying the amount of internalizing or externalizing behaviors warranting professional attention. Furthermore, it is observed that Black children and children of mothers who hold a high school degree or lower are the most likely to have been exposed to multiple ACEs. Yet, there were no differences in exposure by gender (Hunt, Slack, and Berger, 2017).

It is critical to consider cultural and socio-economic differences when studying ACEs and behavioral problems in children. The research suggests that it is crucial to identify ethical and culturally relevant strategies for promoting resilience, optimum development, and wellness across the lifespan. By understanding the impact of ACEs, effective interventions can be developed to promote resilience and help them to reach their full potential (Hunt, Slack, and Berger, 2017).

Prevention and Intervention

In this section, we highlight four evidence-based programs for preventing and intervening in substance use among adolescents: Functional Family Therapy (FFT), Lifeskills Training (LST), Positive Action (PA), and Good Behavior Game (GBG). FFT is a selective program targeting at-risk adolescents referred by various systems and has a predictability rating of 100%. LST is a universal program for middle school students that teaches personal self-management, social skills, and drug resistance skills and has a predictability rating of 63%. PA is a universal program that focuses on positive actions leading to positive feelings and has a predictability rating of 94%. GBG is a universal program that rewards appropriate behavior in the classroom and has a predictability rating of 76%. PFS is a targeted program for at-risk middle school-aged children to reduce problem behavior and drug use by improving family management and communication skills (Hsiung, Patel, Hundal, et al., 2022).