Drug use is common among teenagers. By late adolescence, a recent study published in the Archives of General Psychiatry showed that as many as 78 percent of teens have abused alcohol and over 40 percent have used other drugs. Although these statistics are daunting, millions of teens are not using drugs. Which group does your teen belong to? How can you know?
Addiction has no single cause, but rather often results from a number of biological, social and psychological risk factors. Here are the top 10 risk factors for teen drug addiction:
#1 Family History of Addiction
Addiction has a strong genetic component. If a parent, grandparent, sibling or other blood relative has struggled with some form of addiction (drugs, alcohol, gambling, food, sex), your child is at greater risk as well. For example, children of alcoholics are two to four times more likely than other children to become alcoholics themselves. In addition to the many genes involved in addiction, there are a number of environmental influences that play a role including parenting style and family dynamics.
A new generation of children being born already addicted to opiates and other powerful drugs will likely face a greater risk of addiction later in life.
#2 Impulsive Personality
Early problems with impulsivity (the inability to control actions) and sensation-seeking (the need for high levels of stimulation) are associated with a higher risk for later drug and alcohol problems. People who tend to overlook the potential negative effects of a specific action are also at increased risk.
Recent research published in the journal Nature Neuroscience shows that some teenagers may be wired for risk-taking behavior like drug use. Areas of the brain responsible for controlling impulsivity were less active in teens who misused drugs, even if they only used less than four times in their life.
High levels of stress put teens at greater risk for drug use. According to a survey by The National Center on Addiction and Substance Abuse (CASA) at Columbia University, high stress teens are twice as likely as their peers to smoke, drink and use illegal drugs. The opposite problem -- frequent boredom -- also put teens at risk for drug use.
Abuse of stimulants such as Adderall and Ritalin, commonly prescribed for attention deficit hyperactivity disorder, has become an issue among students competing to get into top colleges. Recent stories show teens are actually snorting ADHD drugs rather than taking them orally to get a faster effect.
#4 Having a Mental Health Condition
Research increasingly shows that teens use drugs to find a solution to negative feelings or moods. Those who have depression, anxiety, personality disorders or other mental health conditions are at greater risk for self-medicating with drugs. Some of the disorders most commonly associated with addictions include attention deficit hyperactivity disorder, depression and anxiety disorders.
#5 Lack of Parental Supervision or Involvement
Teens who do not have a close relationship with their parents, or who receive little parental monitoring or supervision, have an increased risk of addiction. Other related risk factors include low or unrealistically high parental expectations, inconsistent or severe punishment, and high levels of family conflict.
#6 Having Friends Who Use Drugs
Peer pressure is a strong factor in the initiation of teen drug use. In an effort to fit in, look cool or just to satisfy their curiosity, teens are more likely to use drugs if their friends are using or have favorable attitudes toward drug use. Teens who have friends that use marijuana or other drugs are at nearly three times the risk of becoming regular marijuana users themselves, according to a study by scientists from Cardiff University and the National Institute on Drug Abuse. The earlier a teen starts drinking or using drugs (often by age 10-12), the greater the risk of later addiction.
#7 Childhood Trauma
Early childhood abuse, neglect and other forms of trauma are highly predictive of later addiction. Research shows that early life experiences program the brain for what to expect later in life. Kaiser Permanent's Adverse Childhood Experiences (ACE) study found a clear relationship between severe childhood stress and all types of addictions. Adverse childhood experiences can include emotional, physical and sexual abuse, neglect, having a mentally ill or addicted parent, losing a parent to death or divorce, living with domestic violence and having one or both parents in prison. The more adverse experiences a child has the higher the chance of drug or alcohol problems.
#8 Perceptions About Drugs
A teen who believes that drugs and alcohol aren't very harmful or that their parents approve of their drug use is far more likely to become addicted to drugs. Prescription drug abuse has been rising among teens, and they often believe these drugs are inherently safe because doctors prescribe them. Most teens get prescription drugs from the medicine cabinet in their home or the homes of friends.
Teens also tend to look to celebrities to decide what is cool or trendy. Research increasingly shows that media influences and celebrity role models play a role by glamorizing drug use.
#9 School Problems
Teenagers who struggle in school are more likely to become involved with drugs or alcohol, particularly if their academic difficulties begin as early as elementary school. Warning signs include having a learning disability, poor grades, skipping school, low motivation and poor bonding with classmates and teachers.
#10 Lack of Community Support
Living in a low-income community or one where drugs are easily accessible and alternative activities, such as parks, community centers and sports programs are unavailable has been associated with higher levels of drug use.
Your teen's probability of becoming addicted to drugs or alcohol depends on how many of these risks they're exposed to and their stage of development. The good news is that each risk factor can be combated with protective factors, such as a strong parent-child relationship, opportunities for social involvement, academic support and clear standards for behavior. Even in the adolescent years, parents are extremely influential. By taking steps to shift the balance in favor of protection rather than risk, you can help your teen avoid a lifetime struggle with addiction.
David Sack, M.D., is board certified in psychiatry, addiction psychiatry and addiction medicine. He is CEO of Elements Behavioral Health, a network of addiction and mental health treatment programs that includes the Promises Treatment Centers, The Ranch outside Nashville, The Sexual Recovery Institute, and The Recovery Place.