Teen Drug Abuse - Prescription or Not
Differences between nonalcoholic offspring of alcoholics (family history positive, FHP) and matched offspring of nonalcoholics (family history negative, FHN) have been identified on a variety of behavioral, cognitive, and neurological measures. Compared to FHN teens, FHP adolescents and young adults demonstrate more disturbed school careers, impulsivity, rebelliousness, and nonconformity (National Survey on Drug Use and Health, 2006); poorer neuropsychological performance (Worden & Slater, 2009); and significantly lower amplitude in P300 brain waves, which are believed to measure selective attention (Cicero, et al. 2005). Further, following ingestion of alcohol, sons of alcoholics report less body sway and less subjective intoxication (Grant, et al., 2005), higher levels of flushing (McBride, 2011), and decreased P300 amplitudes when performing difficult tasks (Foster, et al., 2009).
Not all individuals with a family history of alcohol dependence become alcohol and/or drug abusers, however, and genetics alone cannot account for the transmission of alcoholism and drug abuse (Grant, et al., 2005). Among both FHP and FHN adolescents, a number of potential environmental and personal factors moderate alcohol and drug use.
Environmental Risk Factors Modeling
Environmental factors may operate independently as well as in interaction with biological factors in producing risk for the development of substance abuse (Grant, et al., 2005). The effects of modeling and social reinforcement on the initiation of adolescent alcohol and drug use seem indisputable (Worden & Slater, 2009). For example, the majority of adolescents drink alcohol for the first time with parents or relatives at home (National Survey on Drug Use and Health, 2006), and parental modeling has a significant impact on the adolescent's attitude toward alcohol (Foster, et al., 2009). Further, peer support and instruction are responsible for a substantial portion of initial adolescent marijuana use (McBride, 2011) as well as decisions to continue to use after initiation (Foster, et al., 2009).
Family Functioning
Family environment also appears to be related to adolescent substance use. Children who report a lack of closeness, support, and affection from their parents are more likely to begin to use drugs and to maintain the abuse of those drugs (Grant, et al., 2005). Other family factors associated with adolescent substance abuse include parent-adolescent conflict (Fishman & Kreis, 2007) and lack of family cohesiveness (Worden & Slater, 2009). Reiger, et al., (2008) summarized the available evidence by noting three major areas of disturbance among families of adolescent problem drinkers: parental deviance or antisocial behavior, parental disinterest and lack of involvement with their child; and lack of affectionate and supportive interaction between parents and children. Conversely, a positive, loving bond between parent and child is linked to a reduced likelihood of the child's drug use (McBride, 2011). Thus, family functioning appears to be important in initiation of substance use and progression from use to abuse.
Literature Review
Although most studies documenting a relationship between stressful life events and alcohol or drug abuse have been conducted with adults, psychosocial stress is also associated with adolescent alcohol and drug abuse (McBride, 2011s). Higher levels of stress may actually precipitate alcohol and drug abuse by adolescents (Cicero, et al. 2005). A significant correlation between the extent of life stress experienced by the family and adolescent substance abuse has been found, even after controlling for substance-related stress (National Survey on Drug Use and Health, 2006). Further, in a series of studies (McBride, 2011), Brown found that adolescents in drug abuse treatment and nonabusing teens with an alcoholic parent have more negative life experiences, and subjectively rated those events as less desirable, than nonabusing teens from nonalcoholic families.
Social Support
Over the past two decades, research has established that the availability of social relationships is related to health status, personal adjustment, and social behavior, including risk for adolescent alcohol and drug abuse. In the absence of adequate social supports, modeling, and reinforcing alternative coping efforts, some teens begin to use alcohol and other drugs to cope with stress (Foster, et al., 2009). Adolescents with a substance abusing parent may be especially likely to use drugs as a coping technique. The combined experience of parental alcohol abuse and dysfunctional social modeling may lead to inadequacies in social functioning, including impaired ability or willingness to solicit support from persons within and outside the family (McBride, 2011). Additionally, adolescents with social support networks composed of alcohol or drug abusers not only acquire behavior patterns consistent with their resource network, but also develop beliefs and values consistent with a drug-use lifestyle.
Personal Risk Factors: Temperament and Personality
The major
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