Tuesday, February 12, 2013

Teenage Substance Abuse

Adolescents who abuse substances begin their relationship with drugs without the intention of becoming addicted. Drugs are used for a variety of reasons; many believe adolescents use substances in order to feel accepted and help diminish social anxiety or feel a sense of excitement and power. Usually, when teenagers turn to drugs and alcohol, they do so to help manage their emotions – either trying to numb or block out certain feelings of insecurity, inadequacy, anger, fear, resentment, lack of self worth, etc., negative past experiences or sensations – and/or to feel in control. Substance misuse is indicative of impairment in an adolescents’ sense of who they are. Drugs serve the temporary function of soothing unwanted emotions and providing a false sense that the adolescents are in control of their feelings.

The issue of youth substance abuse may be masked not only because drug experimentation is common among young people but also because adolescents are able to more easily recover from physical effects. Parents and significant others may only recognize a young person’s struggle with chemical dependency when more obvious symptoms, such as changes in physical appearance, struggles with academics, loss of interest in previous activities, and irresponsible behavior no longer remain hidden. Once discovered, adolescents may withdraw or get instinctively angry because there is a threat to their external source of comfort and security and they lack an internal locus of control. If teens are force to give up substances, they become vulnerable to their emotions and the past experiences that contributed to the use of drugs or alcohol in the first place.

Difficulties in adolescents with substance abuse have specifically been found in the following areas:

Self-esteem: Addicted teens struggle with feeling good about themselves and the use of substances helps mask their deflated self image. They feel inadequate, insecure, and vulnerable and use substances to compensate for this sense of emptiness.   

Regulating feelings: Chemically dependent adolescents have difficulty tolerating feelings, emotions, or stressful situations. Using drugs or alcohol helps teenagers not have to feel anything and it blocks distressing emotions. It also has the potential to mask painful memories or experiences that the youth has never processed (e.g., traumatic event – including parental divorce/separation – loss, feeling neglected or disconnected from family, feeling unworthy or unwanted, etc.). Conversely, some forms of substance use (e.g., stimulants) can also spark feelings when one experiences an emotional void. 

Maintenance of relationships with others: Adolescents may struggle to feel accepted by non-users who do not provide the same sense of relief, comfort, or stability as a substance. Using drug or alcohol allows for withdrawing from others and prevents relationships from forming. Depending on their past relational experiences with family and caregivers as well as friends and peers, relationships may be viewed as difficult or unsupportive, so to engage in them becomes painful and not worth it. Substances can help keep those relationships at bay.

Caring for oneself: When relationships with a substance become superior to all else, such preoccupation help reinforce adolescent insecurities. The need for substances to control emotions and past experiences supersedes any other responsibilities, such as physical care (e.g., hygiene, eating well, etc.), personal tasks (e.g., homework, chores, etc.), maintaining relationships with family or friends, and protecting oneself by making healthy life choices. 

With these thing in mind, it is evident that recovery from substance abuse must involve strengthening one’s sense of self in order to develop the capacity for healthy emotional regulation. This process for an adolescent will take time. A young person will need to work through many defensive feelings to address what a drug means, what it means to use/not use and who they are when not on substances. Family members, who may be pushing for the addicted person to recover, must keep this in mind and avoid accelerating the process. To be the most effective caregivers, parents must also understand the basics of substance abuse and the unique characteristics of adolescent dependency. There must be recognition that a chemical has served some role for the adolescent and within the family context. Individual psychotherapy can help provide a space for adolescents to safely explore their past, examine the underlying reasons for their substance use, and work through past experiences and feelings so they no longer overwhelm the adolescent emotionally. Support from others in similar situations, whether through Al-Anon or family support groups, may also be necessary. Finally, family therapy can be considered, not only to help support the struggling adolescent but also to help the family start to reorganize, recover, and work to enhance positive, healthy connections and relationships.

Posted by Asya Brodsky, LSW


Meeks, J.E. & Bernet, W. (2001). Chemical Dependency in Adolescents. In Meeks, J.E. & Bernet, W., (5th Ed.), The Fragile Alliance: An orientation to Psychotherapy of the Adolescent (pp. 412-431). Malabar, FL: Krieger Publishing Company.

Khantzian, E.J.  (1995). Self-Regulation Vulnerabilities In Substance Abusers: Treatment Implications.  The Psychology and Treatment of Addictive Behavior, p. 17-41.