2

To feel

goodTo have novel

feelings

sensations

experiences

AND

to share them

To feel

betterTo lessen:

anxiety

worries

fears

depression

hopelessness

under 21 - 31% binge 1 x month

Drinking 80%

Smoking 70%

Marijuana 47%

Other Drugs 29%

Huffing 2 million age 12- 17 tried

American Medical Association (Aug 2005)

Found that 25% of parents provided alcohol to kids between 12 – 20.

Found that 25% allowed their kids to drink in the last 6 months.

DRUGSDRUGS

BRAIN MECHANISMS

BRAIN MECHANISMS

BEHAVIORBEHAVIOR

ENVIRONMENTENVIRONMENT

HISTORICALHISTORICAL

ENVIRONMENTALENVIRONMENTAL

- previous history- expectation- learning

- previous history- expectation- learning

- social interactions- stress- conditioned stimuli

- social interactions- stress- conditioned stimuli

- genetics- circadian rhythms- disease states- gender

- genetics- circadian rhythms- disease states- gender

PHYSIOLOGICAL

6

Brain Chemistry – Teen brains 2-3X more active.

Intense experiences - emotionally

Perception of Risk – adults scary –kids reward

Thinking and feeling disconnected– more so in males.

Alcoholism: Clinical & Experimental Research July 2004 O’Connor & Kasari

Children whose mothers drank while pregnant - displayed symptoms of depression even when the mother quit drinking. Much more relevant for daughters than sons. Girls with higher levels of prenatal alcohol and mothers who reported depression showed the greatest number of depressive symptoms.

Journal of the American Academy of Child & Adolescent Psychiatry

Teens reporting increased family arguments at 15 had increased risk of major depression.

Teens reporting family violence by 18 were more likely to have a mental illness, A & D abuse dependence, lower self esteem, and lower life satisfaction by age 30. Also compromised health.

Major Findings were:◦ 80% of all juveniles between 10-17 have a

substance abuse issue.

◦ 75% also have a mental disorder.

◦ Of those using - 92% tested positive for marijuana.

◦ Only 3.6% of those who needed treatment –received it.

Enhance Motivation – Why change?

Enhance Insight – What to change?

Enhance Skills – How to change?

12

Behavior – Danger Avoidance

Physiology/Health

Affective/Emotion

Social/Family

Cognitive – Educational and Vocatrional

Spiritual

SHASHI K. BHATIA, M.D., and SUBHASH C. BHATIA, M.D Journal of the American Academy of family Physicians Jan., 2007

At any given time, up to 15 percent of children and adolescents have some symptoms of depression. Five percent of those nine to 17 years of age meet the criteria for major depressive disorder, and 3 percent of adolescents have dysthymic disorder. The incidence of depressive disorders markedly increases after puberty

By 14 years of age, depressive disorders are more than twice as common in girls as in boys, possibly because of differences in coping styles or hormonal changes during puberty.

Depression impacts growth and development, school performance, and peer or family relationships, and it can be fatal.

Major depressive disorder is a leading cause of youth suicidal behavior and suicide.

Anxiety disorders are among the most common mental, emotional, and behavioral problems to occur during childhood and adolescence. About 13 of every 100 children and adolescents ages 9 to 17 experience some kind of anxiety disorder; girls are affected more than boys. About half of children and adolescents with anxiety disorders have a second anxiety disorder or other mental or behavioral disorder, such as depression.

Thus, it is true that most adolescents normally engage in some delinquent behavior, however, far fewer engage in a pattern of delinquent behavior. The DSM-IVstates that the range of incidence of conduct disorder in males is 6% to 16% with urban areas showing a higher level. The range for females is 2% to 9%. Symptoms of conduct disorder are often seen in children as young as 6 years old, however, by age 16, those who have conduct disorder will have displayed its characteristic pattern of unconcern for other’s rights and property and deceit/manipulation.

Journal of Clinical Psychiatry (June, 2005)

An epidemiological study of 43,000 adults found a significant association between abuse or addiction and addictive (APD) personality disorder, conduct disorder, and adult (APD) behavior.

This association was higher for women than men.Dependence on tranquilizers, sedatives, marijuana, inhalants, or hallucinogens were more likely APD.

Abuse of cocaine, alcohol, amphetamines, sedatives, or hallucinogens more likely to have adult (APD) behavior.

We need to treat APD syndromes to reduce abuse.

WE HAVE NOT FOCUSED ON THE CORE ISSUES.

WE HAVE FOCUSED ON WHAT WORKS FOR US - “Wars on Drugs”

WE INVESTED IN DRUG TREATMENT ONLY

WE DID NOT TAKE INTO ACCOUNT THE PERSONALITY AND EMOTIONAL DEVELOPMENT

1. Peer drug use

2. School suspensions

3. Law infringements

4. Truancy

5. Conflict with parents

6. Regular smoking

7. Lower school aspirations

8. More school failures

9. Health factors

10. Family History

1. Aggressive Social Behavior

2. Delinquency

3. High Risk Sexual Behavior

4. Tobacco, Alcohol and Substance Use

5. Academic Failure

6. Depression

7. Truancy

8. Lack of Family Supervision

Cognitive behavioral approaches are more structured and directive.

Cognitive behavioral approaches consistently appear to be the most effective treatment therapy for substance abusers.

Programs that include the cognitive component are more than twice as effective as programs that do not