What is substance use disorder?

Substance use disorder means that a person uses substances even though it causes harm to themselves or others. It can range from mild to severe. The more signs of this disorder a teen has, the more severe it may be. People who have it find it hard to control their use.

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).

Substance use disorder can develop from the use of almost any type of substance. This includes alcohol, drugs, prescription medicines, and over-the-counter medicines. If your teen develops this disorder, the substance controls their life. Your teen may keep using it even though it harms relationships, leads to legal trouble, or causes physical problems.

Why do teens use drugs?

Teens may use drugs for many reasons. They may want to:

• Fit in with friends or certain groups.
• Feel good.
• Seem more grown up.
• Rebel against adults.
• Escape problems. For example, teens may use drugs to try to:
  • Avoid the symptoms of mental health problems, such as attention deficit hyperactivity disorder (ADHD) or depression.
  • Ease feelings of insecurity.
  • Forget about emotional, physical, or sexual abuse.

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

Drug use affects the brain and causes change in your teen's alertness, perception, movement, judgment, and attention. These changes may make your teen more likely to:

• Risk their health and life. Drug use is a leading cause of death and injury from automobile crashes, suicide, violence, and drowning.
• Have unprotected sex and/or be sexually assaulted. This can lead to pregnancy and sexually transmitted infections, including HIV.
• Be involved in a crime. (And remember that the substance use itself also may be illegal.)
• Have trouble at school or drop out of school.
• Have health problems because of drug use.

How do you know if your teen is using drugs?

You may worry that your teen is using drugs if your teen becomes withdrawn or negative. But remember that these behaviours are common for teens. Do not accuse your teen unfairly. Try to discover why your teen's behaviour has changed by telling your teen that you are concerned.

Look for a pattern or a number of changes. Your teen may have a drug problem if your teen:

• Pays less attention to how they dress or look.
• Is eating less and losing weight.
• Has red and glassy eyes and often uses eyedrops.
• Is doing worse at school or skipping school.
• Seems to be hiding things from you and acts sneaky.
• Withdraws from your family and old friends. Your teen may have new friends that your teen doesn'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

You can teach your teen these ways to say no if your teen is offered drugs.

• Look the person in the eye and say, "No thanks." Sometimes that is all you need to do. Say it as many times as you need to. Also ask 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. Here are some examples: "I don't like how I act when I'm on 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 using drugs.
• Offer another idea. "I'd rather play video games" or "Let's listen to some music." By doing this, you might also prevent your friend from using drugs.
• Ask for respect. Make it clear that you don't want to 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 using drugs, don't go. But if you do go, think in advance about what you will do if someone offers you drugs.

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.