Wednesday November 26, 2014

Substance use in adolescence

Locking Hearts Together

I recently had the chance to chat with and listen to a seminar delivered by Dean Nicholson around substance use and sexual abuse. Nicholson is the administrator of East Kootenay Addiction Services in Cranbrook, B.C. He recently conducted award-winning research surrounding substance use and sexual abuse in youth.

Before diving too deep into his results, it is important to outline that drug and alcohol use occur on a spectrum. To start, there are non-users. Next are experimental users; this is one to three uses of a particular substance. Moving along there are social/recreational users. This means usage occurs less than once a week and the reason for using is for socializing with peers. These levels are completely normal for adolescents to use. It should be noted that in these categories use typically occurs on weekends.

Regular use, one or two uses a week, is where questions should start being asked. Are they using with the same peers, or is the group changing? Are they adjusting surroundings to accommodate drug use? Use at this stage is the beginning of social management, using because one is bored or stressed.

Problem use is three or more times a week. The use is primarily occurring with acquaintances, strangers or alone. The use is more for negative reasons. Youth in this group even begin to report negative consequences for using.

Addiction use is rare amongst adolescents. It should be noted that, at this stage, one cannot move back on the spectrum. The choice is to keep using and be addicted, or to be a non-user. Here, if found in youth, we see physical symptoms of withdrawal, and cognitive effects.

Now, most youth fall under the social/recreational category. Most adolescents outgrow their substance use by 25 as more demands are placed on their schedule.

Nicholson asked the question in his research, ‘does sexual abuse predict drug use?’ What he found was that of youth who reported no sexual abuse only 63 per cent reported drinking alcohol, and had an average age of first use at 12.8. Youth who responded that abuse occurred before the age of 10 years had an average first use age of 12.2 and about 85 per cent were consuming alcohol. When the abuse occurred after 10, 92 per cent were drinking and were on average consuming by 12.6 years.

There is a consistent trend that if the youth was abused before the age of 10 their average age of first use was the youngest among those not abused and those abused after 10. However, those who were abused after 10 had the greatest percentage of use among the groups. For example, of youth who reported no abuse, only 27 per cent were using marijuana and they were exposed around age 13.7. For those abused before 10, 61 per cent were using and were exposed around age 13.0; and of those abused after 10, 63 per cent were using and began around age 13.4. This pattern was true for ecstasy, cocaine and mushrooms.

So in short, yes, sexual abuse does predict drug use. I am sure many front line workers are well aware of this. To view the complete study, visit and click on resources.



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