SUBSTANCE ABUSE AMONG CHILDREN

Introduction

Substance abuse and dependence is now one of the most frequently occurring adjustment disorders in adolescents, young adults, and the general population. In fact, substance use disorders are the most prevalent form of psychiatric disorder in the United States (Rivers & Shore, 1997). Although all age groups are affected by this pervasive difficulty, adolescents and young adults are particularly heavily affected. A substantial proportion of the adolescent population uses drugs or alcohol to the extent that their health, interpersonal relationships, or school performance is adversely affected (Johnston, O'Malley, & Bachman, 2003). Primarily, the main purpose of this paper is to provide an analysis regarding one of the problems among children and adolescents, which is the substance abuse. The discussion will focus on the written document of McWhirter (2004), and will attempt to provide insightful details regarding substance abuse among children and adolescents. In Chapter 7, of McWhirter's written paper, the author have described the severity of substance use among children and adolescents, the problems related with it and the plausible solutions that can be used to solve such problems.



At Risk Youth

One of the problems faced by industrialized nations today, specifically United States is the growing number of individuals who are using or abusing substances including, illegal drugs, alcohol, and tobacco. Although, it has been noted that the overall consumption of drugs in the US has declined by 50% in the past 20 years, the past 10 years have revealed some increase in drug abuse among adolescents (Johnston, O'Malley & Bachman, 2003: US Department of Health and Human Services, 2002). In the case of alcohol use and drug abuse, Stephen (1998) states that polls of youth indicate that nine out of 10 teenagers drink alcohol to some extent by the time they finish high school, and a majority have used illegal drugs. According to the National Youth Violence Prevention Resource Center (2002), teenage consumption of alcohol is a serious problem in the United States. Recent survey revealed that 52% of eighth graders (and 80% of high-school seniors) have used alcohol at some time (Michigan University Institute for Social Research, 2000). The research also found that 25% of eighth graders (and 62% of high-school seniors) have been drunk. Furthermore, while it is illegal for minors to be given access with alcoholic drinks, it seems that such restriction has no, if only little, effect. The MUISR (2000) also found that 71% of eighth graders and 95% of high-school seniors say that they have easy access to alcohol.

In the two weeks survey study made by The National Institute on Drug Abuse (NIDA) in cooperation with its Monitoring the Future Study (MFS), it shows that 50% of senior high schools habitually drink alcohol, 26% of which is involved in bringe drinking and, over 20% of the tenth grades are into bringe drinking (Johnston, O'Malley & Bachman, 2003).

In terms of tobacco use, it has been noted that its use is more prevalent and that most children are trying to experiment with tobacco as 9 years of age. According to McWhirter (2004), the use of tobacco and alcohol are critical since both are regarded as "gateway" substances, which often lead to the use of illicit drugs such as coca based substances and marijuana. In the study made by Grunbaum, et al (2002), it has been found out that close to 20% of secondary students had been offered, sold, or provided illegal drugs like marijuana on school premises at some period during 12 months. The data given only shows that, different substances have been used by children or adolescents. This means that all children are at high-risk of abusing these substances because they have been aware of such and use it at the earlier age.



Determinants of Substance Abuse and Common Characteristics of Users

Majority of today's youth faces conflicts that they can barely handle in a very young age. Modernization has brought many social changes in the society. Children are being taken for granted, usually by parents who both work and have no time for their children. Another factor is the issue of broken family, peer pressure, and many other issues that would make a youth feel inferior of himself/herself. Youth like these seeks a way to express themselves and unfortunately, this search for self –expression has often lead to deviant practices such as joining gangs, engaging in pre-marital sex and engaging in substance abuse. Stephen (1997) wrote that growing numbers of children are being neglected, abused, and ignored. Without change, the dark specter of generational warfare could become all too real. Stephen (1997) further continues that child-care advocates reports that up to 15% of 16-to 19-year-olds are at risk of never reaching their potential and simply becoming lost in society.

In other recent studies, the research shows that family and peer influence, individual characteristics including behavior and personality can also be considered as factors that influence children and adolescent to engage in substance abuse (Johnston, O'Malley & Bachman, 2003). There are several ways to determine if a youth is at-risk of substance abuse. Christle, et al (2002) cited that researchers have identified a number of demographic and behavioral characteristics of youth that contribute to their risk of involvement with substance abuse. These include ethnic minority status; aggressive, antisocial behavior; difficulties in school and school failure (including educational disabilities). These risk factors are common denominators in the backgrounds of youth who require a variety of human services like child welfare services.



Consequences of Substance Abuse

Substance use and abuse is in the forefront of societal problems. It is a pervasive problem, affecting directly or indirectly the overwhelming majority of persons. The deleterious impact of alcohol and drugs is devastating. The involvement of some children and adolescents in substance abuse often lead to different consequences. Such consequences include physiological, psychosocial and legal aspects. It is noted that the physiological effect of drug abuse depends on the drugs that has been used. Substance abuse undermines physical health. For example, chronic alcohol abuse is associated with diseases of the liver, central nervous system, and heart. Often, as in the case of the brain disorder Korsakoff's syndrome, the damage resulting from alcohol abuse is irreversible. Additional health problems stemming from the use of other substances are well documented (Colby, 2004)). Well-known examples are lung cancer caused by smoking, and pervasive central nervous system damage resulting from the inhaling of solvents, cardiovascular disease and neurological damage (NCCDPHP, 2000). In addition, many substances are toxic in excessive doses, resulting in numerous acute and chronic effects on physical health, potentially leading to permanent disability or death. Finally, substance abuse increases the risk for acquiring other health-related problems, such as HIV, sexually transmitted diseases, or trauma secondary to accidents while under the influence of psychoactive substances (NCCDPHP, 2000).

Mental health disorders often occur with substance abuse. Co-morbidity
is relatively common, with up to one third of individuals with psychiatric disorders reporting a lifetime history of substance abuse disorders as well. In some instances, psychiatric disorder precedes or even contributes to the development of substance abuse, whereas in others, emotional and behavioral disturbances arise within the context of alcohol and drug use problems. A large body of research has delineated the disproportionate representation of psychological dysfunction in substance abusers. Included are problems in personality, mood, self esteem, coping, behavior, and social functioning. Once again, some of these psychological difficulties may be evident prior to the onset of substance abuse, although psychological functioning often worsens over time in individuals with substance use disorders (McWhirter, 2004).

In addition, children and adolescents who are involved in substance abuse may also be affected in terms of their educational status. Abuse of specific substances may also contribute to relatively unique psychological presentations, such as the a-motivational state that has been linked to chronic marijuana use. Other psychological effects of substance abuse are directly linked to the biological impact of psychoactive substances (such as anxiety and irritability stemming from withdrawal) and the behaviors that result from dependence on drugs and alcohol (such as craving and preoccupation with obtaining desired substances).



General Prevention and Intervention Strategies

Dependence on the support of others begins at conception, but even as people become increasingly self-sufficient, they continue to require assistance from others in one form or another throughout life. Young people struggling to become social beings and unique individuals at the same time are in particular need of the various forms of social support. When that support is missing, the resulting isolation from others increases the potential for progression from normal youthful dissonance toward more dangerous consequences that can include death or lifelong social and emotional disturbances and sometimes tend to get involve in different things that may even try to make worst of their situation such as substance abuse (Colby, 2004). In response to the increasing numbers of at-risk youth, numerous programs have been developed to cope with problem.

Here are some basic examples of approaches. Stephen (1997) states that positive reinforcement is one of the approaches that works well on at-risk youth. He states that children crave attention more than anything else, especially positive attention. "A baby who is cuddled, talked to, and stimulated in the first six weeks of life is much more likely to be intelligent and well adjusted than a baby ignored and simply fed and cleaned up in silence. Later, the child who is rewarded with praise for accomplishments is much more likely than others to become optimistic and achievement oriented" (Stephen, 1997). He also states that one extinguishes unacceptable behavior by ignoring it and eliminating the child's ability to gain attention.

On the other hand, pats on the back, awards, and ceremonies to celebrate accomplishments are particularly effective in fostering pro-social behavior and giving at-risk youth a stake in society, helping them overcome lack of hope and lack of faith in the future. He then suggested that using positive reinforcement must become a way of life for parents, teachers, and others. Teaching positive reinforcement to potential parents has been successful in reducing the at-risk population. Parent education can offer information and skills to assist the parent-to-be with incentives to learn and use good child-rearing practices. A similar program, Healthy Families America, was launched in 1992 by the National Committee to Prevent Child Abuse to help establish home visitation programs, service networks, and funding opportunities so all new parents can receive the necessary education and support regarding proper child rearing so as to prevent the involvement of children in risky matters such as substance abuse (Stephen, 1997).

Stephen (1997) also states that mentoring is one the effective ways to prevent or stop children or adolescents to engage in abusing substances. He cites the, leaders in Kansas City that are on a quest to recruit, train, and assign 30,000 mentors - one for every at-risk child in the city. Zimmerman, et al (2002) states that, researchers have suggested that natural mentors may play a vital role in adolescent development. Young people often attribute their safe passage through the tumultuous years of adolescence to the influence of significant non-parental adults such as teachers, extended family members, or neighbors. Zimmerman, et al (2002) has found empirical support for the proposition that having a natural mentor may play a vital role in the lives of adolescents.

It has also found out that having a natural mentor was also associated with lower levels of problem behavior, and youth with natural mentors had more positive attitudes toward school across the range of friends' negative school behaviors. However, natural mentors had somewhat larger direct effects on school attitudes than they did on problem behaviors. Nevertheless, having a natural mentor may play a vital role in the lives of adolescents. "Respondents with natural mentors reported lower levels of problem behavior, including marijuana use and nonviolent delinquency, than did those without mentors. This was true even after we adjusted for demographic variables and known risk factors such as problem behavior norms and friends' problem behaviors. Having a mentor partially offset the effect of these negative peer influences, providing evidence of a compensatory effect" (Zimmerman, et al, 2002). In addition, they suggested that programs that create settings that provide opportunities for youth to interact with non-parental adults may help adolescents foster the development of natural mentoring relationships.

McWhirter (2004) states that, programs are now appearing in schools and community centers to provide attitudes and skills necessary to resolve conflict among children and adolescents non-violently. Models have been developed by the American Bar Association and the Justice Department, as well as by educators. He further states that "one of the best models involves training school staff - teachers, administrators, custodians, bus drivers, and cafeteria workers - in creative nonviolent conflict-resolution methods." He concluded that older students are also taught these techniques, and they in turn teach younger students, turning peer pressure into a positive rather than negative force. Community school programs are also effective because most youth spend their time at school. Stephen (1997) gave some examples of successful Community school programs. One of the programs is in Missouri, where 6,000 volunteers keep 675 schools open for extra hours. Another examples are the Boys' and Girls' Clubs that offer mentoring in New Jersey schools and the Safe Haven programs in New York that provide safe environments and positive after-school tutoring and enrichment programs.

Another program that is effective in the prevention of children and adolescents in substance abuse is the Life-skills training. Life-skills training have been defined as the formalized teaching of requisite skills for surviving, living with others, and succeeding in a complex society. It is reported that life-skills training was "proposed as the treatment of choice" when applied to prevention with adolescents. In addition, life skills which assist in the development of an adolescent's self-efficacy "include the ability to solve problems, to communicate honestly and directly, to gain and maintain social support, and to control emotions and personal feelings." Life-skills programs vary in the types and quality of services they provide. McWhirter (2004) stated that "essential components of any life-skills curriculum are based on the development of fundamental, generalized interpersonal skills." Successful life-skills programs appeared to have similar core elements. Effective programs addressed developmental needs, health promotion/problem prevention, and high-risk groups. This program involves adventures as a self-esteem enhancer. The overall goal of adventure-based activities and programming appears to be the enhancement of participants' self-esteem or self-concept. Accordingly, adventure programming activities and experiences include excitement, risk taking, cooperation and competition, trust, communication, physical, mental, and emotional challenges, physical activity, problem-solving and creativity, group and individual skill development, and fun. With all these prevention programs, children and youth initiative is obviously an important factor for at-risk recovery.



Summary

It shows that substances such as alcohol, drugs and tobacco abuse are really prevalent in children and adolescents in the United States. The use and misuse of these substances usually occurs because of different reasons within the society in which these children and adolescents belong. These include family, peer pressure and other stressful factors that affect the way children cope with the society and make them more exposed or prone to use and misuse different substances. It is easy to determine if children and youth are engaged in these activities. The features or characteristics that may be seen are aggressiveness, antisocial behavior, difficulties in school and school failure.

The discussion also tackles the possible consequences that children and adolescents may face if they will engage themselves in abusing the substance mentioned above. The children and youth may be affected in terms of physiological, psychosocial and legal consequences. Physiological includes the physical and other health related problems that these children may encounter. Psychosocial includes the problems in terms of social interaction with other individuals in the society, since youth involve in abusing substances may have a tendency to have an anti-social behavior. And lastly, legal consequences, if these children and adolescents will not stop using these substances, there will be a tendency that these individuals will become delinquent and may be involved in criminal cases.

In order to prevent substance abuse among children and adolescents, the government and other part of the society has been able to initiate different prevention programs, which aims to totally prevent the engagement of these young individuals to such activities. Prevention programs are being administered within the family, school, community and other organizations who are trying to make a better living society for the youth.

All in all, it can be said that all people in the society are being challenged by different environmental factors that tests are ability to choose the most favourable activities for us. And since, children and adolescents are just beginning to taste what the world can give them, they are considered to be more prone on risky and dangerous activities such as substance abuse. In this manner, the older ones must be able to provide all the needs of children and make them aware of all the possible consequences that they may faced if they would engage in these activities. Awareness is closely related to prevention because if these children will understand the possible risks of engaging in using and misusing substances, they will be more willing to ignore these substances and be involved in worthwhile activities.