What is substance use disorder?

Substance use disorder means that a person uses substances even though it causes harm to themself or others. It can range from mild to severe. The more signs of this disorder a teen has, the more severe it may be. It can develop from the use of almost any type of substance. This includes alcohol, cannabis or other drugs, prescription medicines, and over-the-counter medicines.

Most of the time, substance use disorder in teens starts with casual use. You or your teen may not think there will be a problem if a substance is used once or twice. But substance use can lead to substance use disorder. And it sometimes happens quickly.

Substance use changes the brain's structure and how it works. Teens who keep using substances may form a strong need, or craving, for them. And it may get harder to control the use. Teens may neglect school, work, or their relationships. Or your teen may want to stop using substances but can't. Your teen may become physically dependent on the substance. Stopping use may cause physical symptoms (withdrawal).

Why do teens use alcohol or drugs?

Teens may use alcohol or drugs for many reasons. They may do it because they:

• Want to fit in with (or may be pressured by) certain friends or groups.
• Like the way it makes them feel.
• Believe it makes them more grown up.
• Want to escape from their problems. For example, some teens may use drugs to try to:
  • Avoid the symptoms of mental health conditions, such as attention deficit hyperactivity disorder (ADHD) or depression.
  • Ease feelings of insecurity.
  • Forget about past trauma or abuse.

Why is it important to recognize and address alcohol or drug use?

Using alcohol or drugs affects the brain and causes changes in your teen's alertness, perception, movement, judgment, and attention. These changes may make your teen more likely to:

• Risk their health and life. Alcohol and drug use is a leading cause of death and injury from car crashes, suicide, violence, and drowning.
• Have unprotected sex. This can lead to unwanted pregnancy and sexually transmitted infections.
• Be involved in a crime. Drug use and underage drinking are illegal and can lead to arrest and jail time.
• Have trouble at school or drop out of school.
• Have health problems because of alcohol or drug use.

How do you know if your teen is using drugs or alcohol?

You may worry that your teen is using drugs or alcohol if they become withdrawn or negative. But these behaviours are common for teens. They may also be signs of a mental health condition, such as depression.

It's important not to accuse your teen unfairly. Tell your teen that you are concerned. Try to find out why their behaviour has changed.

Experts recommend that parents look for a pattern or a number of changes, not just one or two. Signs that a teen may be using drugs or alcohol include:

• Having red and glassy eyes and often using eyedrops and breath mints.
• Paying less attention to dressing and grooming.
• Loss of appetite or unexplained weight loss.
• Doing worse in school or skipping school.
• Acting secretive or sneaky.
• Withdrawing from family and friends.
• Having new friends that they don't want you to meet.

What can you do to prevent drug use?

• Be a role model. Your attitude toward drugs is one of the greatest influences on whether your teen will use drugs. Don't use illegal drugs or misuse legal drugs.
• Learn about drugs. Find out what drugs teens are using and what the signs of using them are. Learn the signs of an overdose and how the drugs can harm your teen's growth and development.
• Share your beliefs. Teens need to know what you think about important issues, including drugs. Talk with your teen about what drug use does physically and emotionally. If you have a family history of drug use, talk with your teen about their increased risk for drug use problems.
• Stay connected. Set times when the family is expected to be together, such as at mealtimes. Plan family outings or other family-fun activities. Let your teen know that you value them and that they contribute to the family. Get to know your teen's friends, and know where your teen is at all times. Be awake and talk to your teen when your teen comes home at night.
• Be fair and consistent. Find a mix between supervising your teen and giving your teen privacy and independence. Set rules and let your teen know what will happen if the rules are broken. Always follow through and discipline your teen if your teen breaks the rules. But don't make the consequence too severe for the rule.
• Encourage activities. Find things your teen likes to do, and keep your teen busy with those things. Sports and playing in bands are two examples.

How can you help your teen say no to drugs and alcohol?

You can teach your teen these ways to respond if someone offers them drugs or alcohol.

• Look the person in the eye and say "No, thanks." Sometimes that's all you need to do. Say it as many times as you need to. Also tell the person not to ask you again: "I'm cool with my decision, so don't bother me again."
• Say why you don't want to use drugs or alcohol. Here are some examples: "I don't like how I act when I drink or use drugs," "I like to know what I'm doing," "If my parents find out, they'll take my car away," or "I have to practice with my band tomorrow."
• Walk out. It's okay to leave a party or group where others are drinking or using drugs.
• Offer another idea. For example, say "I'd rather play video games" or "Let's listen to some music." By doing this, you might also prevent your friend from drinking or using drugs.
• Ask for respect. Make it clear that you don't want to drink or use drugs and that continuing to ask you is showing no respect for your opinions: "I don't give you a hard time. So why are you giving me a hard time?"
• Think ahead. If you think you might go someplace where people are drinking or using drugs, don't go. But if you do go, think in advance about what you will do if someone offers you drugs or alcohol.

How is substance use disorder treated?

Treatment for substance use disorder usually includes group therapy, one or more types of counselling, and education. Sometimes medicines are used to help a teen quit. Teens who are physically dependent on substances may need medical treatment. And they may need to stay in a hospital or treatment centre.

Treatment focuses on more than substance use. It also helps your teen cope with the anger, frustration, sadness, and disappointment that often happen when a person tries to stop using substances.

Treatment also looks at other parts of your teen's life, like relationships with friends and family, school and work, medical problems, and living situation. It helps you and your teen find and manage problems. Treatment helps your teen take control of life so that your teen doesn't have to depend on substances.

Substance use disorder affects the whole family. Family counselling often is part of treatment.