On the last track, we discussed the four phases of addiction as a "feeling disease". These are, the user discovers substance-induced mood swings, the user seeks a mood swing, harmful dependence, and using to feel ‘normal’.
On this track, we will discuss the seven ways in which chemical dependence in teenagers differs from chemical dependence in adults. I like to provide this information to parents, especially if they also have a history of substance use and or abuse. In my experience, there are seven main differences between chemical dependence in teenagers and chemical dependence in adults. As I describe these seven, decide if any of this information would be beneficial to a client you are currently treating.
Seven Ways Chemical Dependence Differs in Teenagers vs. Adults
#1 - Polydrug Use is Higher Among Teenagers
The first is that polydrug use is higher among teenagers. As you know, adult addicts tend to stay faithful to one or two mind-altering chemicals. Teenagers are likely to use whatever is available. Alcohol, marijuana, and cocaine are the most readily used and abused by teenagers today, but there are also many others widely accessible.
An added threat lies in the fact that since everything but alcohol is illegal. These illegal drugs are not regulated. Many teenagers neglect to ask exactly what they are buying and using. As you are aware, it is not uncommon today to find cocaine or heroin laced with the rat poison strychnine.
Is a parent or teen you are treating aware of this?
#2 - Adult Chemical Dependence Lies in Motivation for Using
The second difference I find between teenage and adult chemical dependence lies in the motivation for using. As you know, adults generally drink for external reasons- an occasion, stressful life event, or "pressures at home".
Teenagers tend to use substances to feel better, stronger, more confident, and for other internal reasons, more often than adults. Also, teenagers will often admit to the goal of getting drunk or high at a party. As you are aware, adults usually do not admit to this goal, instead saying they are going out to ‘socialize’.
#3 - Levels of Use Are Harder to Determine in Teenagers
A third difference I’ve noticed is that levels of use are harder to determine in teenagers. As you know, it is difficult to determine the line between the abusive use of a substance and early addiction in adolescents.
For example, Jennifer, 17, carefully conceals her marijuana use from her parents. In an adult, concealing alcohol or other drug taking from friends and family is a sign of chemical dependence. Although it may also be a sign of chemical dependence for Jennifer, it is just as likely that she doesn’t want to be caught and punished by her parents.
As you are aware, marriage difficulties and job issues, which are reliable evidence of chemical dependence in adults, are unlikely to come into play in a teenager’s experience. Some behaviors in teens that mirror adult chemical dependence issues may also be attributable to the teen’s special education issues, such as moodiness, hyperactivity, and poor concentration.
#4 - Addiction Happens More Quickly For Teenagers
In addition to a high incidence of polydrug use, motivation for using, and difficulty in determining levels of use, the fourth difference I see is that addiction happens more quickly for teenagers. According to Shaefer, it may take several years for an adult to reach the chronic stages of alcoholism. A teenager abusing the same amount of alcohol can progress through the same stages in less than 15 months. Other drugs create dependence much faster.
Is your teen client aware that crack cocaine produces a high within seconds, and teenagers become addicted to it quickly. Crack is also cheap, and widely available. In some parts of the country, it is now the number 2 drug of choice, second to alcohol.
#5 - Emotional Arrestment of Chemical Dependence Happens Earlier in Teenagers
The fifth difference I have found is that the emotional arrestment of chemical dependence takes place earlier in teenagers than in adults. As you are aware, chemical dependence causes an arrestment of emotional development, leaving the user incapable of working through grief, negative feelings, or relationships.
Many teenagers who stop using are still pre-teens emotionally. Unlike many adult addicts, these teenagers have no emotional development to fall back on. Many adult addicts I work with remember "how good things were" before they started using; most teenagers do not have these memories. I find that when working with teenage addicts, I do less in terms of rehabilitation, and more habilitation- they need to be taught how to live.
#6 - Delusional System in Teenagers is More Complex
The sixth difference I find is that the delusional system in teenagers is more complex than in a chemically dependent adult. As you are aware, chemical dependents of all ages are out of touch with reality due to denial, rationalization, projection, minimizing, and memory distortion. I find that it is even more difficult for teenagers to accept their chemical dependence because of their age.
Matthew, 16, addicted to alcohol, stated "I can’t be an alcoholic! Everyone knows alcoholics are guys over 50 who live in trailer parks!"
#7 - Teenagers Have Built-in Enablers
In addition to the fact that polydrug use is higher among teens, the reasons teenagers use drugs are more internal, levels of use are harder to determine in teenagers, addiction happens more quickly in teenagers, emotional arrestment takes place earlier in teenagers, and the delusional system in teenagers is more complicated, the seventh difference I observe in my practice is that teenagers have built-in enablers, especially parents.
Jeremy, 18, had cost his father David over $30,000 in fines due to car accidents, DWIs, and broken machinery at David’s business. Every time Jeremy got arrested, David would bail him out. When I asked David how long he planned on continuing this, he stated "Jeremy’s my son, you know."
I find that the average chemically dependent adult has 10-12 enablers- family, spouse, a boss, in laws. But the average teenage chemical dependent has 50-60 enablers- parents, friends, friend’s parents, teachers, law enforcement officers, medical professionals- who all make it easier for the teenager to keep using! As you are obviously aware, it is much more difficult for parents to stop enabling their children, than it is for spouses or friends to stop enabling other adults.
"Duties and Responsibilities" Technique
I asked David to work through the Duties and Responsibilities exercise with me. I explained to David that this exercise is likely to take some time to complete.
First, I asked David to list on a sheet of paper all of the things he considered to be his responsibility in his home life, relationships, and work. One responsibility David listed was paying fines that his son Jeremy’s substance addiction caused.
Next, I asked David to make a detailed list of what responsibilities belonged to the other people in his life. When a responsibility was shared, I asked David to write down what percentage of the responsibility was his. David was surprised to learn how much inappropriate responsibility he had heaped on himself, and how little responsibility he had allowed others to assume.
Would it be beneficial to play this track for the parents of a teen who is using, or for the using teen themselves?
On this track, we have discussed the seven ways in which chemical dependence in teenagers differs from chemical dependence in adults. These reasons are polydrug use is higher among teens, the reasons teenagers use drugs are more internal, levels of use are harder to determine in teenagers, addiction happens more quickly in teenagers, emotional arrestment takes place earlier in teenagers, the delusional system in teenagers is more complicated, and teenagers have more "built in" enablers than adults.
On the next track, we will discuss four levels of teenage addiction. These are use, misuse, abuse, and addiction. We will also discuss the characteristics, chemicals of choice, and consequences of use at each level.
Peer-Reviewed Journal Article References:
Field, M., Heather, N., Murphy, J. G., Stafford, T., Tucker, J. A., & Witkiewitz, K. (2020). Recovery from addiction: Behavioral economics and value-based decision making. Psychology of Addictive Behaviors, 34(1), 182–193.
Lee, D. C., Stanger, C., & Budney, A. J. (2015). A comparison of delay discounting in adolescents and adults in treatment for cannabis use disorders. Experimental and Clinical Psychopharmacology, 23(2), 130–137.
Ramo, D. E., & Brown, S. A. (2008). Classes of substance abuse relapse situations: A comparison of adolescents and adults. Psychology of Addictive Behaviors, 22(3), 372–379.
What are the seven differences between chemically dependent adults and teenagers?
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