There’s ample evidence that many youth use drugs to self-medicate for depression, anxiety, and fear, not to mention a host of mental-health disorders. The drugs they take may become the focal point for both kids and their parents, but they may be masking deeper problems. How can a parent know? Parents consult expert after expert, but even the experts don’t necessarily know either. Diagnosis isn’t an exact science, and it’s complicated, particularly for adolescents and young adults, for whom mood changes, including depression, are common. Many symptoms of these disorders appear to be identical to some of the symptoms of drug abuse. Also, by the time experts finally figure out that there’s a problem, drug addiction may have exacerbated the underlying mental health ailment and fused with it. It becomes impossible to know where one leaves off and the other begins. This is frequently referred to by professionals as “double trouble.”
“Considering the level of maturity of young adolescents, the availability of drugs, and the age at which drugs are first used, it is not surprising that a substantial number of them develop serious drug problems,” writes Robert Schwebel, PhD, in Saying No is Not Enough. “Once this happens, the effects are devastating. Drugs shield children from dealing with reality and mastering developmental tasks crucial to their future. The skills they lacked that left them vulnerable to drug abuse in the first place are the very ones that are stunted by drugs. They will have difficulty establishing a clear sense of identity, mastering intellectual skills, and learning self-control. The adolescent period is when individuals are supposed to make the transition from childhood to adulthood. Teenagers with drug problems will not be prepared for adult roles. They will chronologically mature while remaining emotional adolescents.”
My exposure to theories of development while studying psychology at the University of Scranton in the early 1980s, as well as in current psychology courses at Colorado Christian University, tells me that children’s brains are at their most malleable – that is, the greatest change takes place – before they are two years old and then again when they are teenagers. The worst time for a person to be tampering with their brain is when they are a teenager. Drugs radically alter the way teenagers’ brains develop. Experience and behavior help to set up a cycle that may deepen emotional problems. The biological infrastructure that develops as a result may become more acute and more intractable. It enforces and reinforces the psychological problems, which become more firmly established. Treating people whose drug use began when the were teenagers, as did mine, is further complicated because deconstructing or rerouting established pathways have biological as well as emotional and behavioral roots.
To understand the risks associated with psychoactive substances in adolescents, it helps to understand that teenagers are not just less-experienced adults; they are undergoing an important yet challenging developmental stage in which they are prone to errors of judgment, and sensitive to neurological assault by drugs and psychoactive substances. More than any other age group, adolescents are at risk for substance addiction, and, more than any other age group, they risk permanent intellectual and emotional damage due to the effects of drugs.
Obviously, the human brain is sculpted by experience, which is processed primarily by the pre-frontal cortex. This area of the brain executes such skills as setting priorities, formulating strategies, allocating attention, and controlling impulses. The outer mantle of the cortex is involved with processing abstract information and understanding rules, laws and codes of social interaction. Teenagers are notorious for their obsession with social interaction, as well as for making up social rules and breaking them. They are merely testing limits. As teenagers grow into young adults, they often exhibit a fascination with abstract thinking on topics like history, culture, and media, which demonstrates their growing ability to understand the larger world. While the teenage brain is in some ways ill-equipped to make decisions and choices without the help of trusted adults, it is perfectly designed for the types of intellectual and social challenges teenagers most need to master.
Still, development of fully mature complex thinking takes a long time. MRI studies show that the development of the pre-frontal cortex and outer mantle of the brain continues into the early 20s, and may not be completed until the mid 20s. There are many ways that psychoactive substances can alter or damage the development of the adolescent brain. Psychoactive substances often target and alter the function of neurotransmitters, which are chemical messengers that allow nerves to communicate with each other. Interference with neurotransmitters can directly damage fragile developing neural connections. More importantly, drug and alcohol use alters perception, and may interfere with developing perceptual skills. Habits and choices associated with the use of drugs and alcohol slowly become ingrained into the wiring of the brain. Repeated action becomes habit, and the habits of thought, perception, and reasoning developed in childhood and adolescence can stay with a person throughout his or her lifetime. My addiction began at the vulnerable young age of 18. I continued to abuse drugs and alcohol throughout nearly forty years of my life.
As many mental health professionals are quick to point out, if you do something for long enough it becomes automatic. Nowhere does this wisdom more hold true than in teens and young adults. Though teens may change clothes, ideas, friends and hobbies with maddening frequency, they are busily developing ideas about themselves, their world, and their place in it that will follow them for the rest of their lives. Adults may spend years trying to create or break even the simplest habit, yet most adults find that their most profound ideas about themselves and the world were developed in high school or college. This is because, by age 25 or so, the brain is fully developed, and building new neural connections is a much slower process.
Early detection and treatment is essential to heading off the development of substance addiction in adolescents. Given their brain development, teenagers cannot be expected to understand the full range of consequences in their choices regarding drugs and alcohol. The disease must be prevented, and where it cannot be prevented it must be arrested while there is still time for a full recovery.
O God, that men should put an enemy in their mouths to steal away their brains! That we should, with joy, pleasance, revel, and applause, transform ourselves into beasts. – Wm. Shakespeare.