Youth and Addiction: A Guide to Help Attorneys Make the Best

Choices for Addicted Youth in Trouble With the Law

Michael Crosby LCSW Ph.D.

Causes of Adolescent Substance Abuse External Factors

Insufficient parental supervision and monitoring Lack of communication and interaction between parent and teen Poorly defined rules and expectations against substance use  Inconsistent and excessively severe discipline Family conflict Favorable parental attitudes toward adolescent substance use Parental alcoholism, drug use, or abuse Addiction during pregnancy Peer pressure Media Outlets Misinformation

Causes of Adolescent Substance Abuse Internal Factors

high sensation seeking impulsiveness  psychological distress difficulty maintaining emotional stability perceptions of extensive use by peers perceived low harmfulness to use Self-medication Low self-confidence Boredom Rebellion Attention Seeking Instant Gratification

Treatment Options Medications

withdrawal and treatment Behavioral Treatments

Outpatient: Cognitive-Behavioral Therapy, Multidimensional Family Therapy, Motivational Interviewing, Group Counseling

Inpatient: Residential Facilities Aftercare: Continued support after leaving

Treatment Options Treatment Programs

Individual and group counseling Substance abuse education Family education Recreation therapy Mindfulness groups Relapse Prevention Dual-Diagnosis/Co-Occurring Treatment

Treatment Education must be a component for treatment

to be successful Education must be a part of treatment for the

whole system (parents as well as the identified client)

Education must include developing skills for parents to learn to set limits and enforce consequences for inappropriate behavior

Statistics of Teen Use More teens die from prescription drugs than

heroin/cocaine combined More than 60% of teens said that drugs were sold,

used, or kept at their school 1 in 9 high school seniors has synthetic marijuana 1.3% of seniors have used bath salts Young people who drink alcohol are 50 times more

likely to use cocaine than teens who never drink

About 64% of teens who have abused pain relievers say they got them from friends or relatives

Statistics of Teen Use Adderall use (mostly prescribed to treat ADHD) has

increased among high school seniors from 5% in 2009 to 8% Only 35% of 12th graders believe that using Adderall

occasionally is risky By 8th grade, 30% percent of adolescents have consumed

alcohol, 16% percent have smoked cigarettes, and 15% have used marijuana

Teens whose parents talk to them regularly about the dangers of drugs are 42% less likely to use drugs than those whose parents don't. However, only a quarter of teens report having these conversations.

7% of high school seniors smoke daily, up from 5% five years ago

Statistics of Teen Use Marijuana- 17% of 10th graders and 23% of 12th

graders have used in the past month Synthetic Marijuana- 9% of 10th graders and 11%

of 12th graders have used in the past year Prescription Drugs- 15% of 12th graders have used

non-medically in the past year, yet only 35% feel they are taking a risk

Alcohol- 15% of 10th graders and 28% of 12th

graders have gotten drunk in the past month Cigarettes- 17% of 12th graders have used in the past

month

Consequences Leading to Treatment Neglecting Responsibilities

School, work, or home

Legal Ramifications Arrests, tickets, jail time

Problems in Relationships Family, friends, significant other, job

Engaging in high-risk behaviors Health problems

Adult and Adolescent Assessment Assessments for drug or alcohol addiction

evaluate the condition of each patient in order to determine whether or not a diagnosis of chemical dependency or chemical abuse exists

Adolescents do not show the same psychological, behavioral, and physiological characteristics central to adult assessment

Adult and Adolescent Assessment Adolescents and adults differ in the pattern of

alcohol and drug use as well as the development of substance abuse

Teens are less likely to abuse just alcohol, but are more likely to abuse marijuana and other drugs with alcohol

Adults in treatment are most likely there for just alcohol dependence

Teens meet diagnostic criteria for substance abuse faster than adults

Internal vs. External Motivation Internal Motivation

Motivation driven by an interest in the task itself; exists within the individual

External Motivation The performance of an activity to attain an outcome;

comes from outside of the individual

Family Involvement Practical Definition

The active engagement and participation of family members in the practice, program, and policy areas of teen substance abuse treatment, recovery services, and support

Importance Families learn about current services, policies and

procedures, emerging trends/challenges and research on the system from professionals

Professionals learn about unique experiences, perspectives, strengths and weaknesses from families

Family Involvement Three key areas of focus: Practice, program,

and policy Practice

Adolescent substance abuse treatment service providers welcome, engage, support, and respect families where they are

Family members gain awareness and understanding of addiction as a brain disease, develop realistic treatment and recovery expectations, and identify available family support services

Family Involvement Program

Families empowered to provide valuable input for agency/program on quality improvement planning

Provide input into developing valuable community based family support services

Policy Policy-makers listen to family member experiences, welcoming

and respecting family expertise and seeking family input as part of the policy making process

Family members experience opportunities to influence policy and develop relationships with policy-makers and other family advocates

Difficulties With Family Involvement Problem is too severe Family is the root of the problem Family lacks resources Failure of the foster care system Failure of the Department of Juvenile Justice

Co-occurring Illnesses As many as 6 in 10 people with a substance

use disorder also suffer from a mental health condition

Fewer than 10% of adults with co-occurring disorders receive treatment for both conditions; more than half of them receive no treatment at all

Reevaluating Progress Have the interventions worked? How would the teen be without them? Possible improvements to treatment Potential for relapse Re-administering tests ?????????

Dealing With Relapse Between 66 and 80% of adolescents and adults begin using

again within the first six months after a treatment episode Triggers: peer influence, life changes, socially isolated

situations, stress, over-confidence, complacency, mental or physical pain, remembering the positives of past using, boredom, self-pity

Support Team Relapse Prevention- keep drugs and alcohol out of the house, praise and encourage, talk openly about feelings of relapse and threats to sobriety, relieve stress, encourage self-care practices

What to do after ??????????????

Drug Testing Strategies Type (hair vs. urine) Frequency What you test for What is positive Confirmation (GCMS) Consequences

Aftercare Services in the Community Requires creation of a set of systems across

formal and informal social control networks as well as the use of community services to prevent relapse

Includes peer support group programs, individual and family therapy sessions, and relapse prevention strategies utilizing friends, family, and leisure activities