Early Onset of Substance Use:
Contributing Factors for the Rapid Progression to Addiction
Adolescent drug use in our society is often times viewed as a harmless phase that teens will, eventually, outgrow. Many believe that teens would need to continue drug use for several years into adulthood before actually becoming addicted. However, research indicates that the earlier an adolescent begins using drugs (alcohol too), the higher the chance of his/her drug use progressing to addiction.
Research conducted by Grant and Dawson showed that the age of when a person started drinking was a strong predictor for future alcoholism as defined by DSM-IV. This research focused on the age at drinking onset of 42,862 subjects and isolated factors such as age, sex, race and family history of alcohol abuse and dependence. The results of this research indicated that when a thirteen-year-old starts drinking, s/he has a 43% chance of becoming an alcoholic. If however, the thirteen-year-old has a family history of alcoholism, the probability of his/her becoming an alcoholic increases to 58%. In contrast, if the person starts drinking at age 21 and has no family history of alcoholism, the probability of alcoholism is reduced to 10% (Grant, Bridget & Dawson, Deborah, “Age at Onset of Alcohol Use and Its Association With DSM-IV Alcohol Abuse and Dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey, Journal of Substance Abuse, 1997.)
As this study indicates, rapid progression of chemical addiction in teens appears to be highly correlated with age of onset of first use and a family history of alcoholism
Why does using at an early age contribute to a rapid progression to addiction?
From birth to young adulthood, the brain is both growing and developing. During this process the brain is taking cues from the environment to determine how much serotonin, GABA and other neurotransmitters it should produce. If a person is using street drugs during this period of time, the brain will not recognize marijuana or alcohol as a drug. It will see it as an over abundance of GABA or serotonin and other neurotransmitters. Then because the brain thinks we live in a world were our necessary neurotransmitters comes from joints and beers, and ecstasy pills, it stops producing its own supply. Now the brain has a chemical imbalance and craving for the drugs occurs for the user trying to fulfill the missing brain chemistry. This imbalance effects psychology (cravings), which effects behavior (compulsion/drug seeking) and eventually the user finds drugs and uses, and then they feel normal until the imbalance reoccurs and the cycle starts over.
Other Contributing Variables
· Adolescents tend to use a combination of drugs. While adults with drug problems typically use only one drug, the drug use history for a teen/young adult drug user can consist of several different drugs. A combination of drugs being abused effects a combination of neurotransmitters and fuels brain damage. As a result, the adolescent must use increasing amounts of these drugs in order to get the same desired effect which in turn, contributes to the rapid development of addiction.
Use of Stimulant Drugs: Stimulant drugs appear to be another variable of the rapid progression of chemical dependency in adolescents. This is due to the fact that these drugs tend to cause dopamine to be released and depleted in very large amounts. As a result of this “rush” in dopamine, tolerance develops quickly and the user starts to loose the ability to experience pleasure unless they are intoxicated.

· School Environment: Easy access to drugs at school significantly contributes to the progression of drug use. Many schools have become a “drug supermarket” where adolescents can buy and sell drugs as well as join in the camaraderie of sharing their fun drug experiences and planning new times to get “high.” I am not saying that the schools are the problem, but it is the meeting place for kids to congregate Monday through Friday. I’ve treated several drug dealing teens who’ve told me that summer time is their slow season.

· For drug-using adolescents, intoxication is their social event. Although the social events of adults, such as weddings, New Year’s Eve, and Super Bowl Sunday, may promote the use of chemicals, the chemical use is only an adjunct of the social situation. However, for drug-using adolescents, drug use is the social event. In other words, the main reason for socializing is to become intoxicated.

Many adults (parents and professionals) tend to view adolescent drug use from an “adult” model of drug use. The “adult” model tells us that people need to use for many years and experience physical withdrawal symptoms to have addiction… This is not a valid view for adolescent drug users…
Young Adults Need for Addiction Treatment Outpaces Desire for Help
Federal researchers say that 21.1 percent of Americans ages 18 to 25 have alcohol or other drug problems serious enough to require addiction treatment, but few of them recognized their need for help or sought assistance from a treatment facility, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
The report, Young Adults’ Need for and Receipt of Alcohol and Illicit Drug Use Treatment: 2007, found that 93 percent of young adults classified as needing addiction treatment didn’t receive it, and that 96 percent of this population did not perceived any need for assistance. Of the 4 percent who actually acknowledged needing help to cope with an addiction, just 32.2 percent tried to access treatment.
SAMHSA researchers estimated that 17.2 percent of the young adults surveyed needed treatment for alcohol disorders in the past year, 8.4 percent needed help with illicit drug disorders, and 4.4 percent had problems with both alcohol and illicit drugs that required intervention.
The study was based on 2007 data from the National Survey on Drug Use and Health.
An interesting study, but keep in mind an adolescent or young adult with a substance use disorder is not supposed to “recognize” they have a problem. It goes against the diagnosis. It is our role to work closely with the individual, family and system to help them recognize they have a problem. That is the first step in the treatment process.

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Jon Daily, LCSW, CADC II

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