Identifying the relationship between alcohol and/or drug use & mental health among Adolescents

November 7, 2019

“Mental Health I think is how positively or negatively you perceive the world around you and yourself,” says an anonymous source. 

Mental health can affect anyone and can interfere with an individual’s emotional and physical well-being. There are many factors when evaluating mental health especially the use of alcohol and drugs. The dependent relationship between mental health and alcohol and/or drug use is referred to as a dual diagnosis (also referred to a co-occuring disorder). It is defined as, “a term for when someone experiences a mental illness and a substance use disorder simultaneously(NAMI).”

An adolescent can be defined as anyone from ages 10-19 years old and is a transitional phase of growth that involves internal and external changes. This transitional phase makes adolescents vulnerable to experiment with alcohol and/or drug use and are at a higher risk of developing an addiction. 

According to Ms. Coleridge a highschool mathematics teacher who also teaches two electives based in psychology, “Acknowledging mental health is important because we need to reduce stigma. It’s not a mental disability it’s a brain disorder.  It can often be a chemical imbalance in the brain. The brain is not functioning at an average rate.” In understanding a dual diagnosis (co-occuring disorder) as a society, we have to be aware of what it is, how adolescents are more susceptible to developing these dependencies, become aware of the symptoms and acknowledge the issue, and provide treatment options whether that be an intervention, a program or reducing the stigma around alcohol and/or drug use and mental health. Ultimately, we should always keep in mind that there is hope for anyone.

Teen Co-Occuring Disorder

A cross-sectional study investigating the cross-sectional association between any alcohol or drug use and alcohol-related and drug related problems and mental health of Norwegian adolescents concluded that, “Early debut of alcohol and drug use and drugs problems is consistently associated with more symptoms of mental health problems.” 

BMJ

Early debut of alcohol and drug use and drug problems is consistently associated with more symptoms of mental health problems, indicating that these factors are an important general indicator of mental health in adolescence.

According to Ms. Brown, a Biology and Health teacher at the NYC iSchool, “Fifty percent of people who are addicted to drugs are suffering from a mental illness and 90% of addiction happens when you’re a teenager.” 

Furthermore, according to “Substance Abuse and Mental Health Issues(HelpGuide),” 

  • “Roughly 50 percent of individuals with severe mental disorders are affected by substance abuse.”
  • “37 percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.”
  • “Of all people diagnosed as mentally ill, 29 percent abuse either alcohol or drugs.”

According to an anonymous source, “I have experimented with drugs and alcohol. I have clinical depression and general anxiety disorder and I was diagnosed with both when I was 14 years old. (Maybe 13).” 

Additionally, Gilian Bennett, a freshman at Sacred Heart University, says that she “has anxiety and MDD(Massive Depressive Disorder and has tried weed and barely has had alcohol.” 

However, it’s important to be aware of the fact that those with a co-occuring disorder(s) aren’t the only ones affected, says Kofi Owens-Lopez, a senior at City-As highschool. In an interview, he said that he has observed the effects and symptoms of alcohol and/or drug use and mental health among his family. “There are a lot of alcoholics in my family. They behave very depressed, generally seem detached from everyone around them, and occasionally have angry outbursts where they lose their temper easily,” he said. 

He said that he has observed these negative effects manifesting into, “extreme depression, imobility, and self harm.” 

Additionally, an anonymous source has also has observed someone struggling with drug and/or alcohol abuse and it’s damaging effects: “I have a friend who is currently also very heavily dependent on weed. She’s always high and I haven’t seen her sober in months. When she’s not high she’s generally really mad or in a bad mood until she gets high and then she is satisfied. I also have an aunt who is an alcoholic. She doesn’t admit it, but she’s always drunk and she’s usually much happier when she’s drunk and she lives in Europe. There’s a lot of binge drinking in Europe, which results in higher alcoholism.” 

Furthermore, through reflections, the anonymous source has been able to make realizations about herself and the negative health effects drugs had on their life: “I think with my friend that struggles with weed it makes me realize the type of person that I was when I was using drugs and it makes me realize how unhealthy it really is; not only physically but mentally as well. I found myself to be very distant from people that didn’t have weed on them or what I wanted at the time and I see that a lot in my friend. It made me not want to smoke anymore.” As a society we have to understand the reason(s) behind these correlating statistics and effects and get to the core of adolescent mental health, which inevitably will help us treat a co-occurring disorder(s).  

Reason(increased risk) for Alcohol and/or Drug Use among Adolescents

An adolescent is a transitional phase of growth and development. Co-Occurring disorders can develop in any individual regardless of age, but adolescence presents an increased risk of dependency on alcohol and/or drug use related to mental health. 

According to (Caroline Miller), “Adolescent brains are still developing, the results of “teenage-medication” can be more immediately problematic.” 

The term teenage-medication has a sarcastic connotation when related to the use of alcohol and drugs since it is in fact not an actual form of medication for teenagers dealing with mental health disorders. The use of alcohol and drugs can cause feelings of numbness, which may distract an individual from their current problems, but it does not solve them. In actuality, if the problem is not addressed, the situation can get progressively worse, and that’s what propels addiction. 

According to Leane Jaffe, a psychotherapist, she has observed adolescent patients and said, “I have observed that anyone who uses and abuses substances use it as a form of self-medication through numbing. Substance use and/or abuse may be a way to temporarily numb pain but doesn’t make the pain go away.” A psychotherapist is a professional trained to work with people to explore conflicts, mood issues, and help patients develop the skills to properly function in daily life. “Psychotherapy is a treatment response to help people feel their feelings in order to release them,” says Jaffe. “Adolescents are known for their faulty sense of invincibility, which is putting them at risk of addiction.” 

The National Survey on Drug Use and Health conducted research on alcohol use in the past asked respondents aged 12 or older(adolescent) about their alcohol use in the 30 days before the interview. However, first we should understand the difference between current use of alcohol, binge alcohol use and heavy alcohol use.

According to the “Dietary Guidelines for Americans 2015-2020,” U.S. Department of Health and Human Services and U.S. Department of Agriculture, “moderate drinking is up to 1 drink per day for women and up to two drinks per day for men”(NIH). The National Institute on Alcohol Abuse and Alcoholism,” defines binge drinking as, “a pattern of drinking that brings blood alcohol concentration(BAC) levels to 0.08 g/dL. This typically occurs after 4 drinks for women and 5 drinks for men – in about 2 hours”(NIH). 

Lastly, heavy alcohol use according to Substance Abuse and Mental Health Services Administration can be defined as, “binge drinking on 5 or  more days in the past month.” So, according to National Survey on Drug Use and Health research, “136.7 million Americans aged 12 or older reported current use of alcohol, 65.3 million reported binge alcohol use in the past month, and 16.3 million reported heavy alcohol use in the past month,” in 2016. 

SAMHSA

This national report summarizes key findings from the 2016 National Survey on Drug Use and Health (NSDUH) for indicators of substance use and mental health among people aged 12 years old or older in the civilian, noninstitutionalized population of the United States. Results are provided for the overall category of individuals aged 12 or older as well as by age subgroups.

In all the subjects interviewed there was a noticeable trend in responses to the question, have you experimented with drugs and/or alcohol? Respondents said that they had experimented with alcohol and/or drugs at some point in their lives. However, experimentation is not an abnormal teenage behavior. In fact, it is common for teenagers to experiment with alcohol and/or drugs. 

Ms Brown believes that her role as an educator is,“to empower students to make their own informed decisions. To give kids information and tools that they need.”

Identifying Mental Health and Alcohol and/or Drug use Problems

Identifying issues related to co-occurring disorder and the increased risk among adolescents, combined with  learning about ways to help adolescents cope with these issues, can bring awareness to adolescent mental health and alcohol and/or drug addiction and abuse. 

According to an anonymous source, “I think it’s been a bit of a roller coaster to be honest. My first years of being a teenager I had a lot of anxiety. I was trying to figure out who I was and trying to fit in but when I started smoking and stuff like that I found a group of friends. When I moved to the city and I started using drugs I was in a really good mental health state. I found an amazing group of people and I was always happy because I was high, which I realized was actually really unhealthy for me. Right now, I’m really stressed and have a lot going on so I’m not as happy as I’d like to be.” 

An underlying factor that contributes to adolescent mental health is stress. Stress is a feeling of an  emotionally and physically tension. Your body is reacting to a challenge or demand and that is what causes the sensation of feeling stressed. Adolescents are constantly facing challenges and demands whether it’s, school work, activities, social life, etc and therefore many adolescents can identify with the feeling of being stressed. 

According to another anonymous source,, “I think my mental health has declined since I was 13 because of the stress that was put on me, but also somehow I developed many negative habits that now have stuck with me for years.” 

However, while stress can be prominent in an adolescent’s life and can cause a decline in their mental health, the act of growing up comes with learning ways to cope with such tensions. For example, “I believe it has improved because with age comes experiences, and you learn from those experiences. Every time my mental health has been hurt, I learn something about myself or others and I learn different tools of coping,” says junior Ellie Kauffman. 

This idea of growing up and learning from experiences doesn’t just occur among adolescents but can also be present in adults as well. 

According to Patricia Kummel, a ssychologist, she said that her mental health has improved since she was 13 years old because “I know more now and so I have better coping strategies, how my history will impact what is happening in the present, and more awareness and when something is going on I can make more sense of it.”

Treatment for Alcohol and/or Drug Abuse for Adolescents

Tackling adolescent alcohol and/or drug use is a challenging thing to do; there’s not a one size fits all since there’s a spectrum of disorders and not one solution that will work for everyone. However, there are treatments that are recommended to help and support an individual with alcohol and/or drug abuse and mental health problems. The first thing to do is know which comes first, substance abuse or mental health problem? 

According to Leanne Jaffe, “The substance abuse has to be treated first, as a first priority. The first rule of business is to get someone sober. There is no psychological treatment without sobriety. For example, many treatment programs they will have professionals on staff to deal with these psychological aspects but they can’t be seen in private practice.” 

Furthermore, according to “Substance Abuse and Mental Health Issues(HelpGuide),” 

  • “Alcohol and drugs are often used to self-medicate the symptoms of mental health.”
  • “Alcohol and drug abuse can increase the underlying risk for mental disorders.”
  • “Alcohol and drug abuse can make symptoms of a mental health problems worse.”

However, Ms. Browndisagrees with dealing with the alcohol and drug use first and believes that, “you have to treat the mental illness first. The drug use is a symptom of the mental illness and if you give someone the things they need to cope with the drugs they’ll become secondary and you can give them a more stable life.”

In evaluating treatment options, it’s also  important to understand how the individual is affected by their situation. Symptoms may vary and therefore the treatment has to accomodate for these variations. 

“Mental health has affected me in many ways because sometimes it makes me feel like I am not worthy of life or worthy of other things that most people deserve. And it makes me feel very self conscious and has made many simple things like getting up in the morning hard for me,” says an anonymous source. 

According to Kauffman, “Mental health disorders have affected my sleep, appetite and weight on a surface level. But they have also affected the way I think about the world. I don’t get the privilege of ever being at peace with my mind. My mind is always ruminating and thinking deeply, which is not always pleasant. It can make me really sad, unmotivated and sluggish, which can lead to forgetting to take care of myself. Or it can make me racy and antsy.” 

Ms. Coleridge believes that her role as an educator is, “to try and be a trusted adult. I hope some subset of the school thinks that I can be trusted to go to. I think it’s important to be having these conversations to reduce stigmas.” 

Furthermore, acknowledging mental health is important to understand what comes next regarding treatment options. Kauffman acknowledges that mental health, “is extremely important because if you can’t address it you can’t fight it. Acknowledging is the first step to recovery. From there you can get therapy, medication, or other support.” 

Gillian Bennet says that adolescents are not getting the support and treatment that they need to overcome drug and/or alcohol abuse and to manage painful and difficult feelings she believes that, “teenagers are being taught the wrong way about these sorts of things.” 

Additionally, Kofi Owens Lopez believes that, “the most expensive programs that deal with alcohol and/or drug abuse are too expensive for those that need it.” Furthermore, “It should be much more accessible(no more parental permission) and it should be affordable. Also, there should be more support in schools. Everything should not be such a big dark secret,” says Patricia Kummel.  

In understanding a dual diagnosis(co-occuring disorder), we have to be aware of what it is, how adolescents are more susceptible to developing these dependencies, become aware of the symptoms and acknowledge the issue and provide treatment options whether that be an intervention, a program or reducing the stigma around alcohol and/or drug use and mental health and always keep in mind that there is hope for anyone. Programs and treatment options for adolescents include, “Next Generation Village,” which provides personalized care, “Elks River’s Dual Diagnosis Treatment Program,” which provides group therapy and a positive peer culture. Additionally, there’s always the option of detoxification, medication and psychotherapy or counselling. 

According to an anonymous source, “anyone struggling with emotional damage should know that it is a long process to get better and it may never feel like you’ll get better, but there is a part of you that wants to get better. It’s hard to want to get better though because all you may know is the feeling of sadness, but once you feel happiness, you’ll be able to acknowledge just how far you’ve come.”

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