What is Substance Abuse?
Use of drugs or alcohol or other addictive substance becomes abuse when someone uses a drug or alcohol outside of how it was intended or prescribed. For example: taking non-prescription drugs beyond the purpose and/or amount indicated; taking someone else’s prescription drugs; taking your own prescription drugs beyond the amount and/or frequency indicated; increasing the concentration of an addictive substance; smoking marijuana to relax. Drinking is alcohol abuse when its effects negatively impact your college-age son’s or daughter’s academic progress, social life, or health.
According to CASA Columbia (2011), adolescent substance use including smoking, drinking, misusing prescription drugs and using illegal drugs is the number one health problem in North America. Moreover, it has reached epidemic proportion. Substance abuse is clear and present danger to millions of American adolescents. It has high, long-range human and financial consequences to our country.
An estimated 55,000 college-age adolescents receive alcohol treatment annually in USA. An estimated 110,000 college age students are arrested annually for alcohol-related violations including driving under the influence and public drunkenness.
This does not begin to identify those who are undiagnosed but have a drinking problem. Alcohol is the fourth leading cause of death in the US.
The National Institute on Drug Abuse reports that regular marijuana use among college students is the highest it has been since 1980. In a survey conducted by The Addiction Center, 80% of college students reported abusing alcohol. 30% admitted to having symptoms of alcohol abuse. Between 1993 and 2005 the number of college students who admitted to use of popular tranquilizers like Xanax and increased by 450%.
Source: National Institute on Drug Abuse
This guide is intended to help parents prepare their college age kids for the new experiences and new temptations that will face them when they go off to college. It is also meant to help parents recognize signs of substance abuse and help them seek help.
What Drugs do Adolescents Take Most Frequently?
As the above chart shows the most commonly used substances of high school seniors and college-age adolescents include: alcohol and tobacco. These are followed closely by the rapidly gaining substance: marijuana. Next most popular substances vary by age. Young adolescents use inhalants like household cleaners, glues, or pen fumes. Older adolescents use synthetic marijuana known as“K2” or “Spice” and prescription medications—most frequently opioid pain relievers like Vicodin and stimulants like Adderall. In college-age adolescents, prescription and over-the-counter medications account for most of the commonly abused drugs.
Signs of Substance Abuse in College Students
One of the most helpful things parents can do is be aware of the signs that your college-age son or daughter might be involved in substance abuse. The Addiction Center suggests watching for the following indicators that a college student is abusing drugs or alcohol:
- Lower interest in classes and/or extracurricular activities
- Notable change in academic performance, grades,
- Changes in sleeping patterns—having difficulty sleeping; sleeping during the day but not able to sleep at night; sleeping ten or more hours a night…
- Noticeable weight gain or loss
- Becoming involved with new friends who have a reputation of abuse
- Dropping old friends because they are “a drag” or “nerdy” or “don’t know how to party”…
- Acting secretive about personal and/or social life
- Marked changes in behavior or personality
- Mood swings, depression, or irritability
- Unexplained money problems
Remember: Signs and symptoms of drug or alcohol abuse vary with the individual, the substance that is being abused, stressors, physical and emotional changes, lifestyle changes that are part of college life. However, the above indicators should serve as red flags that something isn’t right and that further discussion and exploration are indicated.
Who are the Most Likely College Candidates for Substance Abuse?
Certain college campus groups are considered to be at higher risk for substance abuse. These include but are not limited to:
- Members of fraternities or sororities
- College athletes
- Students with a history of socio-emotional or mental health concerns
- Those who live in on-campus housing and dorms/li>
- Students who are under extreme internal and/or external stress to succeed
- Males of college age
How do Adolescents become Addicted?
Addiction happens with repeated use of any addictive substance. Over time, these substances actually change the way the brain works. Natural inhibition systems that normally stem impulse control break down and the adolescent becomes addicted to the substance. Adolescents are more vulnerable to addiction than many other groups because they are impressionable, affected by peer pressure, in a new environment and often stressed by the demands—and freedoms—of this new lifestyle. Lack of parent supervision and monitoring and association with others who use addictive substances do not help.
Prevention is the Key!
By thought, word, and deed, the message the adults in an adolescent’s life regarding use of addictive substances is powerful. It is much more effective to prevent an addiction from occurring than it is to treat one.
The following are some effective strategies for parents, teachers, coaches and other significant adults in a college-age adolescent’s life:
- Teach kids by modeling and discussion ways to resist social pressures to use addictive substances including drugs, alcohol and nicotine.
- Help kids build self-esteem through social activities and extra-curricular programs.
- Teach kids by modeling and direct instruction good decision-making and problem-solving skills.
- Maintain a healthy, open communication with college-age adolescents.
- Teach and model effective ways to relieve stress including exercise, sports, hobbies, yoga, meditation, guided visualization and therapy drama.
- Teach adolescents how to live independently without abusing their new-found freedom. Kids who have made smaller decisions as they are growing up become better able to make larger decisions when they are off to college. Help them learn independent thinking skills.
Strategies for Dealing with Suspected Substance Use
The following strategies are offered by the National Center on Addiction and Substance Abuse.
Identify the substance your college-age son or daughter is using. Drugs can seriously and forever affect the adolescent developing brain. Substance use can negative affect family and peer relationships, and academic performance. Addictive substances begun as a teen or college-age adolescent, often continue as adults addictions which affect relationships and work performance. It is critical to your child’s present and future well-being to identify and intervene in drug use early.
Get help for your child even if substance use has not reached the addiction stage. Substance use problems exist on a spectrum from mild, occasional “experimental” use to problematic use to addiction. Substance use is not like a pimple or a cataract that must ripen to be removed. This use can be treated successfully at any stage. Prevention is ideal but nipping early use is next best. Waiting and hoping the problem will “solve itself” or your child will “outgrow” the problem is playing with fire. Optimist but seldom the correct course of action.
Monitor your son’s or daughter’s activities. Trust is a wonderful thing but with college-age kids who have new-found freedom, it is safest to know what is going on and who your son or daughter is associating with. Check the signs of substance use and be sensitive to how your college-age offspring is behaving. Communication is vital. This is something that should have been occurring while your child was growing up but if it didn’t start then, now is the time to initiate it.
Never underestimate what appears to be “testing the waters” or “experimenting” with substance use. Isolated instances of drug taking can quickly become substance abuse.
Schedule annual medical visits. Use these as an opportunity to ask your child about drug use. Standardized screening tools help pediatricians, dentists, emergency room doctors, psychiatrists, and other clinicians determine an adolescent’s use of such substances as: tobacco, alcohol, and illicit and nonmedical prescription drug s. Identified use helps the health care provider assess substance use severity and provide a brief intervention or refer the adolescent to a substance abuse treatment program. Regular medical checkups as part of your son’s or daughter’s healthcare can put your mind to rest as a parents or flag new use and nip it in the bud..
Adolescents with substance use problems rarely see their use as a “problem”. Getting your adolescent into addiction rehab may be a battle but it is one worth fighting. Keeping him in the program is another necessary battle. Stay the course. You may even need to seek legal action to force your child to stay in rehab. Regardless of the attitude that the addict has to want to quit, research shows that treatment can work even if when it is mandated and your child is forced to undergo rehab. This is the time for tough love.
Which Treatment Program?
Not surprisingly, there is no “one size fits all” program that is ideal for every person who struggles with substance abuse. The most effective treatment program is the one that produces the most lasting results and this varies from individual to individual and even from one time to another in each individual. To say that the most residential or the most expensive program would be the most appropriate for the needs of your college age adolescent would be inaccurate. Every treatment should begin with a thorough assessment of your son’s or daughter’s physical, emotional, and mental needs. This should include your child’s strengths as well as his/her weaknesses. The most effective treatment should encompass the individual’s medical, psychological, emotional and social needs. It should also examine your child’s relationships with family, friends, his/her school community, and colleagues. Investigation should include his/her progress in school: academic, behavioral, and social issues.
Using this information, a treatment plan should be devised that addresses all aspects of your son’s or daughter’s environment—not just his/her substance addiction. Unless the whole situation is addressed, the factors that led to the addiction will not be removed and addiction is, thus, highly likely to recur. The most effective addiction treatment plan supports your college-age adolescent’s personal needs including physical, emotional, psychological and social needs. The program should have resources to deal with personal, environmental and legal issues.
In many cases, treatment plans that include behavioral therapies work well with adolescent substance use issues. Therapists specially trained to work with adolescent addicts will work with your son or daughter to improve self-image, increase motivation, stronger self-control and inner incentives to avoid substance use.
Therapists will work with your son or daughter to help him/her discover triggers to substance use and learn ways to avoid these cravings or triggers to drug use. Together they will build the skills that help your child resist substance use. The goal of any treatment plan is abstinence and an understanding of how and why the substance abuse arose.
It takes a village to raise a child. This is true of addiction treatment. Families and the community are important aspects of treatment. The support of family members is crucial to your son’s or daughter’s rehabilitation. Evidence-based interventions for adolescent substance abuse aim at strengthening family relationships, improving communication and building family support abstinence from substance abuse. Community members including: school counselors, coaches, peers, and mentors encourage getting treatment and supporting during and after treatment.
Effectively treatment of substance use by college-age adolescents must identify and treat related emotional and/or mental health conditions. Adolescent substance abusers often suffer from other conditions such as: depression, anxiety disorders, attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and obsessive compulsive disorders. Effective substance abuse treatment includes treatment for social/emotional/mental problems.
Let the treatment facility know all the facts. They cannot work in a vacuum. Issues such as child abuse or attempted suicide, running away, bullying… should be identified and addressed. Adolescents who have substance abuse issues often have a history of trauma, physical, emotional, and/or sexual abuse .
Treatment does not occur in a vacuum. It is vital that as a parent you keep an eye on substance use during treatment. Relapse, or a return to substance use, is common. Triggers may be environmental, situational, internal like mental stress or social. Identify a return to drug use early. Relapse connotes a need for more treatment or an adjustment in the treatment plan.
In order to be effective treatment must be in place for an adequate amount of time. Follow up after treatment is vital. How long? This depends of the severity of the substance abuse, the type and extent of the treatment and the adolescent’s progress. Trust the therapists. They know. They have a wealth of experience. Don’t assume you know better than they do and don’t let your college aged adolescent wheedle, beg, make demands and otherwise manipulate you! Studies show better outcomes in a treatment program of three or more months .Relapses often occur. Many adolescents also benefit from continuing care following treatment that includes: monitoring of substance use, follow-up visits in the home as well as linking the family to other services.
Cover all the bases. Adolescent drugs users are at high risk for sexually transmitted diseases like: HIV and hepatitis B and C. They often engage in high risk behaviors like multiple sex partners, casual sex, unprotected sex and sharing contaminated drug injection equipment, unsafe tattooing and body piercing. Testing for sexually transmitted diseases and counseling to help them modify or change their high-risk behaviors are often wise actions.
If your son or daughter had a physical illness, you would go to all extremes to seek a cure. Substance abuse is no different.
Where to Get Help
When you first learn that your college-age son or daughter is a substance user, there is an immediate feeling of disbelief, panic, and helplessness. Your first thought after: This cannot be happening is Where do I go for help?
Treatment needs to be readily available. Getting help quickly and nearby is vital. Those needing treatment can get lost if treatment is not immediately available and readily accessible. Just like with any serious illness, the earlier treatment can be begun, the greater the likelihood of a successful outcome.
There is a high likelihood you will know very little about substance abuse problems and treatment options. Basically, you need help. Where do you turn? Here are some suggestions: Good places to start include your family doctor and the college’s health services. Both these facilities will have information on local treatment programs and facilities.
What Can I Expect?
The first step is detoxification. During this period the substance has a chance to get out of your son’s or daughter’s system. This is not a fun time. Those who are addicted most often experience severe withdrawal that may include nausea, hallucinations, headaches, sweating, chills and tremors. It is important that medical personal be on hand in case of dangerous reactions liked convulsions or heart problems. Detox can lessen symptoms as well.
Having cleaned the substance from the system, the next step is counseling. This period of at least three months is aimed at the psychological and behavioral issues. These are the root causes that led to substance abuse or addiction. Counselors help college students learn how to cope with substance cravings and the triggers that started substance use.
Counselling may occur in an in-patient or out-patient setting. The program selected has a lot to do with your child’s addiction, its severity and your child’s unique needs. Financial concerns may also play a part as the cost of various treatment programs and institutions varied widely.
Whichever program you select, look for these components:
Components of an Effective Substance Abuse Program
Effective Substance Abuse treatment programs deal with more than just the physical effects of the substance. They cover several areas including educational and mental health. They include not just your college-age adolescent but the family.
Behavioral therapy is most often at the heart of the treatment program. It begins as soon as detox has occurred and may last a few hours to several months. Therapists vary in their focus. Behavioral therapy may involve your child’s desire and/or motivation to address his/her substance use. Behavioral therapists provide incentives for abstinence. They help your child build skills to resist drug use. They work with your son or daughter to find replacement activities for his/her drug-use that are both constructive and rewarding. Therapists help your child learn problem-solving skills, and improved interpersonal relationships. Behavioral therapy may take the form of individual counselling, peer support groups, family counselling, and/or large group therapy.
Medications may be prescribed during detox to ease the severity of the symptoms. They may also be prescribed to help your child reduce his/her addiction. They might include: methadone, buprenorphine, and naltrexone if your son or daughter is addicted to heroin or other opioids. If it is an alcohol addiction acamprosate, disulfiram, or naltrexone might be used to treat alcohol dependence. A nicotine replacement product (patches, gum, lozenges, or nasal spray) or an oral medication like bupropion or varenicline may be a part of nicotine addiction therapy. These medications are not a solution but rather one effective component of a comprehensive behavioral treatment program.
Effective substance use treatment programs are constantly reassessed and modified as your child’s needs change. No one treatment fits everyone. Every addiction varies in type, degree, and your son’s or daughter’s motivation to kick the habit.
Besides medical and behavioral aspects of treatment your child may also need counseling or psychotherapy, family therapy, parenting instruction, vocational rehabilitation, and/or social and legal services. In most cases an approach that focuses on continuing care provides the best results.
Final Thoughts: Parent to Parent
Parents who have experienced what you are going through can often offer the most insightful advice. Strongly consider joining a family support group for families of kids who have a substance abuse problem.
Parents who have experienced what you are going through, suggest the following:
Strongly oppose your son’s or daughter’s use of substance in any way or form. Even a one-time ‘trial’ or ‘experiment’ can be critical.
Enlist support from family members and other significant other adults in your child’s life. This might include aunts and uncles, grandparents, neighbors, coaches, guidance counsellors, teachers—anyone who has any influence in your child’s life and who can communicate support.
Attend support group sessions for parents. These will help you problem solve and help you realize others share your concerns and are going through what you are experiencing. You need to know you are not alone!