Teen Substance Abuse, Suicide, and Sexual Health Guide

Teenage Substance Abuse

Substance abuse is a serious legal and social problem in American culture that has plagued society with skyrocketing crime rates and overflowing prison systems. The substances in question include any mind-altering chemicals, including common illegal street drugs such as marijuana, cocaine, ecstasy, and designer drugs, just to name a few. Also included are misused legal substances, such as household chemicals or over-the-counter and prescription drugs used for the purpose of achieving mind-altering effects. Alcohol is also included, and is by far the most commonly used substance of abuse, excluding perhaps tobacco — which is rarely recognized properly as the drug that it is. The inappropriate use of these substances can easily spiral out of control for anyone who gets involved with them, taking control of their lives. When teenagers fall into habits of substance abuse, the negative and lasting effects can be particularly harmful because of the fragile state of the body and mind during this developmental period.

Although we all want to believe that our teenagers are the "good kids" who would never be involved in substance abuse, the statistics are staggeringly high, and all teenagers are being affected by substance abuse one way or another. Statistical studies show that seventy percent of all teenagers will try cigarettes, with close to half of them doing so before reaching high school. Cigarettes are considered a gateway drug because those who smoke are more likely to try other drugs as well. Alcohol is another gateway substance, having been used by almost all high school students at least once. Both substances are readily accessible with little enforcement of underage laws, and they are considered by popular culture to be cool and passively rebellious. Both alcohol and cigarettes lead to lasting physical damage, causing liver and lung disease and contributing to cancer. Alcohol carries further dangers: studies reveal that half of all teenage deaths from drowning, fires, suicide, and even murder are actually related to alcohol and alcohol abuse. As for other illegal substances, some studies show that as many as one third of all high school students have used illicit drugs at least once in the year preceding the study.

Most of the time, a teenager's first experience with alcohol or other drugs is simply for fun — often giving in to peer pressure on a dare or to fit in with other kids. Some teenagers never try drugs; others will try them once or twice and never use them again; while others will occasionally partake as a social habit. Many teenagers, however, become seriously addicted, perhaps because of a physical or mental predisposition to drug dependency. Teenagers who have a blood relative that is a drug addict or alcoholic may be particularly prone to addiction, as may those who have been surrounded by role models who drink heavily or use drugs.

It is important that parents, friends, and school workers are aware of the warning signs of substance abuse. This is a particularly important area for school counselors, who can educate others so that the community can work as a whole to detect and resolve substance abuse problems. Otherwise unexplained fatigue, headaches, or irritability may be signs that a teenager is dealing with a substance abuse problem. Others may show behavioral changes such as disinterest in friends or activities that used to matter to them. Physical problems that plague abusers may include digestive problems and sleep disorders like insomnia or narcolepsy. With drugs such as cocaine, amphetamines, or other stimulants, there may be sudden and drastic weight loss. A teenager on drugs may have trouble with memory or concentration and may lose interest in things that were previously of great importance. Mood swings, depression, and social isolation are also very common, as affected teenagers often become withdrawn from family and friends.

The reason it is so important for counselors to be involved is that they have training in recognizing warning signs of substance abuse in teenagers, as well as the background to approach those involved with sympathy and tactfulness. Drug dependence is treatable, and counselors can help recommend young people to specific rehabilitation programs and hospitals. When appropriate, having the teenager evaluated physically and mentally by licensed doctors may help determine whether drug use is occurring and what kind of assistance would be most appropriate. Talking to the teenager first is vital, however, to ensure you are not misinterpreting the situation and to make sure the teenager knows you care.

Ultimately, education of teenagers, teachers, parents, and the community as a whole is the only way progress can be made in preventing, recognizing, treating, and putting an end to teenage substance abuse problems.

Teenage Pregnancy

It is very difficult to find anyone who works with teenagers who has not had to deal with the issue of teenage pregnancy firsthand. Almost every high school teacher has had a female student struggle with this condition, and almost every teenager has had a friend or acquaintance forced into making the difficult decisions that accompany a teenage pregnancy. While teenage pregnancies may seem like a recent phenomenon, it is actually our cultural response that is new, not the pregnancy itself. Historically, the teenage years were the most common time for a woman to begin childbearing. As Western civilization began changing standards of when childhood ended and adulthood began, pregnancy before the legally defined adult age of eighteen became increasingly taboo. Today, sex education, over-the-counter and prescription contraception, and fear of STDs such as AIDS have completely changed the face of teenage pregnancy. Other factors — such as the abortion debate and women's rights to careers and independence — also play a significant role in how individuals and communities respond to a young girl's pregnancy.

Finding out that one is pregnant can be, and often is, a monumentally devastating occasion for today's teenage girl. So many questions must be answered. Should she keep the baby? Should she terminate the pregnancy? Should she place the baby for adoption — through an agency or privately with a couple? Should she tell the father? Does she even know who the father is? Should he have a say in the fate of the child? Should she talk to her parents, her teachers, her friends, or must this remain private? If she does not terminate the pregnancy, can she continue attending school? Should she stay at home, move in with the baby's father, or make an entirely fresh start somewhere new? In the most extreme cases, a teenager in crisis may even consider ending her own life to escape the situation. These questions illustrate the urgency of providing early and compassionate support.

This is an important time for mentors and peers to step in and offer nonjudgmental assistance. The teenager needs to know she is not alone. Many girls face her situation, and there are support groups made up of experienced professionals and peers alike who can help ease her worries and assist her in making an informed decision that best suits her individual circumstances. Not every girl can or should make the same choice. Some will have families willing to support her regardless of the outcome; others are isolated and have no one to turn to at home. Some have partners who want to take responsibility for the child, while others may not know who the father is, or may not want him involved. Different teenagers will also hold varying religious and moral beliefs about what is best for themselves and the unborn child, and these must be approached with sensitivity.

Counselors must be prepared to present an unbiased view of every possibility. While the girl may face ridicule and harsh gossip if she continues the pregnancy, many people will also offer genuine support. Under every circumstance, it is important to encourage the teenager to continue her education in some form. Even if she decides to carry and keep the child, without an education she will find herself unable to support her family in the future. Help her understand her rights regarding education, and offer all options including home schooling, night classes, or a leave of absence — always with the focus on continuing school and finding a path to success. Help her realize that having a child may interfere with her career plans, but that many mothers build successful personal and professional lives. There are an infinite number of paths forward, and a determined teenager can find a way to succeed.

Do not avoid discussing the medical realities, however. Teenagers are more likely to miscarry or experience complications such as premature labor and low birth weight. Teenage mothers are more likely to require bed rest during the late stages of pregnancy and a cesarean section during delivery, and the child is at greater risk for a range of complications.

Of course, while supporting a pregnant teen is vital, the key to addressing the problems associated with teenage pregnancy is prevention. Provide accurate, unashamed information about sex and pregnancy to children and teenagers, and encourage community members to do the same. Involve parents and teachers in the process. Make sure young people know their options for preventing pregnancy, from abstinence to contraception, and allow teenagers the freedom and platform to discuss these topics in a supportive environment. Teenage pregnancy must be viewed not as a taboo to be kept silent, but as a real and active social issue requiring a proactive approach. The counselor must be able to maintain a nonjudgmental stance toward pregnant teenagers and their children without losing sight of the genuine dangers they face.

Teenage Suicide

Suicide is a frightening subject for most people — the idea that a loved one could actually end his or her own life, that someone could be in so much pain that death becomes the most appealing option. Often, those left behind by a suicide feel guilty and angry, feeling betrayed and abandoned, not understanding why the person would cause such pain to others. Over the past twenty-five years, the overall rate of suicide has decreased. However, for people between the ages of fifteen and twenty-four, the rate has actually tripled. Suicide is one of the three leading causes of death among teenagers, and many suicides go unreported as such, meaning rates may be even higher than currently believed. Everyone involved in the lives of teenagers must be aware of the risk factors most commonly associated with suicide, and it often falls to the school counselor to inform not only teenagers but also teachers and families about the facts relating to teen suicide.

One of the leading causes of suicide in any person is depression. Often unrecognized, depression is especially misunderstood and misdiagnosed in teenagers. Clinical depression is frequently overlooked as nothing more than normal teenage angst and the pressures of high school and the transition into adulthood. Furthermore, the feelings of teenagers are often dismissed by adults as fleeting and meaningless, or teens are accused of simply trying to attract attention by acting angry or sullen. Signs to watch for in a depressed teenager include changes in appetite — both loss of appetite and compulsive overeating — and changes in sleep patterns, such as fatigue or sleeplessness. A depressed teenager may suddenly become less active or lose interest in things that were previously very important to them, such as sports or other hobbies. Depression often causes social withdrawal, and the person may express, subtly or openly, thoughts of death or self-punishment. These symptoms must be taken seriously.

A second risk factor for teenage suicide is substance abuse. Teens often turn to drugs or alcohol in an attempt to ease the pain of depression, but these substances typically make the problem worse. They enhance depression and lower inhibitions, meaning that suicidal thoughts that were previously suppressed may become acted upon simply because of the altered state of mind. Addiction is also painful, and even when drug use began as a social experience rather than a response to pain, it can lead to feelings of torment and loss of control that may turn into suicidal ideation.

A third risk factor is behavioral problems. Teenagers who are having legal trouble or engaging in criminal activity are more prone to suicide. Teenagers who frequently fight at school or at home are also at heightened risk. Not all suicidal teenagers sit quietly writing depressive poetry — the teenager who engages in destructive behavior is also at risk of being self-destructive, and because this profile does not match the popular stereotype of a suicidal person, the warning signs are often missed until it is too late.

Additionally, parents must be aware that access to lethal means makes a teenager more likely to act on suicidal thoughts. Prescription tranquilizers or razor blades left in an accessible place can be the deciding factor. The most dangerous risk is the presence of a firearm: having a gun in the home makes suicide five times more likely compared to homes without one. Teenagers who have already made a prior suicide attempt require especially close monitoring, as they are far more likely to try again. It is unsafe and inaccurate to assume that a teenager attempted suicide merely for attention. Teenagers who have experienced a traumatic event, recently or during childhood, are also more prone to attempting suicide.

Before a suicidal teenager can receive treatment, someone must recognize the warning signs and respond appropriately. Counselors can help parents watch for indicators of depression and suicidal thinking, as well as providing guidance on how to talk to the teenager. Counselors must take every teenager's feelings seriously and never dismiss any mention of suicide or self-harm. Educating young people about suicide so that they can watch out for peers in need — and so they can develop their own skills for coping with stress and loss — is equally important. Professional assistance through therapy, support groups, and sometimes medication is available to help.