Best Practices: Drug abuse and Adolescent on Orlando Medical News

Best Practices: Drug abuse and Adolescent

By: SYEDA N. SULTANA, M.D.

'I am not a pot head, I enjoy smoking marijuana, I don't see any harm to it, it relaxes me, I am not quitting it'.

'I just drink may be week ends with my friends , some times I get drunk , it's cool, I don't have alcohol problem' .

'I started with weed, of course started drinking beer long time ago, now I need stronger things to get high'.

' I am sorry , I need help, I was not truthful to you, I am shooting heroine now, I can't function, I do not want this life style, I am screwed I am failing grades, I am ashamed of myself'.

' I used to steal my grandparents Xanax, now I buy from you know from where'

'After my leg fracture, I was prescribed pain med, I started liking it'

'I had MI because I used a lot of cocaine, I was with friends, I did not realized it, my dad found me unconscious in my bed room'.

'I woke up in the morning and found my friend is dead, we all were shooting heroine last night together, he was my best friend, I can't get the scene out of my head, I can't sleep , I don't want to live any more , I want to be with my friend'

'Sometimes we make tea from mushroom, inhale stuffs like gasoline, air condition freon, glue, paint, nail polish remover, sniff on markers, sometimes drink mouthwash if we don't get alcohol, of course from our medicine cabinet I remove some of my parents medicine …'

'If I stop drinking, I will have no friends, you have no idea about high school and college kids, and there will be no fun in my life'

These are very common statements we probably hear in our office when parents bring their children because they either academically failing or behavior / anger issue , personality change or parents found some drugs in their room, or police arrested for selling drugs or possession of drugs.

Some addiction Myth:

Marijuana is not addicting, it is safe and recreational drug, it use for cancer patients and many county it is legal to use. There is nothing such thing called marijuana withdrawal syndrome

After detoxification the person can live drug free life

30 days inpatient will cure the problem

Over using OTC medication is not addiction

Why they use drugs?

Most of the teenagers and adolescent start with peer as experiment some continue to use occasionally but some starts using more then they intended to use and eventually drugs control their life. More and more teenagers getting into prescription medications and many thinks those are safer then other street drugs. All drugs of abuse has effect on feelings, thoughts and behavior. Because of their reinforce quality these children even they know it is not their best interest, they can not ignore either emotional (psychological ) or physical need for that( dependency). There is a point when drug use is no longer pleasurable but they continue to use to return to normal being or to cease the pain of withdrawal.

Social background of these children:

These adolescents may come from any homes but many comes from unstable family, family history of mental illness and substance abuse, parental marital conflict and families from more economical and social problems. Some of them starts as self medicating and use drugs as 'escape from reality'. Of course many children are likely to model their parent's chemical use.

It is very important to understand adolescent and teenagers who are using drugs. Developmentally they still do not have their identity, they are confused about who they are, their coping skill is not mature and when they starts using drugs to control their emotions, it significantly insults their brain's functions especially executive functions of the brain. At the end we see more impulsive adolescent and some end up being antisocial and end up with criminal activity just to support the habit. One of the heroin dependent adolescent said that he thought he could use in weekends and he can continue school and will have not affect on his academics. Many adolescent feel omnipotent has unreasonable justification on part their action and behavior.

How can we help them?

It is very important to understand that chemical and illicit drug use happening in our society, it is our children who are in need for help. We all can take part in the journey to build a drug free society. Parents need to spend more time with teenage and adolescent; know their friends, family and associate. All parents must know where their children are?, After the school hours and with whom they are with. Any change with behavior or attitude need to be asked and need specific intervention, including individual , family therapy , anger management or if needed psychopharmacological intervention if there is some indication to it. Parents need to talk with their pediatrician regarding any issue ' just gut feeling , something wrong' without feeling ashamed of themselves as bad parents. Most of the teenager and young adolescent do not lie to their doctor's if questions ask appropriately and if they feel safe. Many wants help. For the physician it is important to give the massage to children that they can talk any concern they have in their mind and spending few seconds separately without their parents. Instead asking 'do you use drugs or alcohol, may ask when did you use any drugs not prescribe to you?'

Once someone is diagnosed with substance use, they should be treated and their family needs to be part of the intervention. In school children need to educated abut drugs, how to be assertive in decision making and not giving in peer pressure. Media need to play more active role to educate the society as a whole.

Some red flags for adolescent Alcohol or Drug use:

They may come to doctor's office with unexplained physical injuries, gunshot/ knife injury , MVA or repeated injuries, persistent cough, track marks/ injection sites, inflamed /eroded nasal septum

Sudden personality change, risk taking behavior, verbally or physically abusive to parents or school teacher, poor respect to authority figure.

Poor respect to house rules, coming home very late night drunk, or staying overnight with friends without prior notice to the parents, missing classes or missing working days, legal problems, stealing , lying or making poor excuses for coming late at home.

Social isolation, change of group of friends and activities, unexplained weight loss, pregnancy, sexual transmitted disease,

Fall in academic or extracurricular performance.

Syeda N Sultana, M.D. Child, Adolescent and Adult Psychiatrist, is Board Certified Psychiatrist by American Board of Psychiatry and Neurology. She completed her fellowship, at the University Florida Shands Hospital, Gainesville, FL, in Child and Adolescent Psychiatry. She did her Residency in Adult Psychiatry from St. Louis University Medical Hospital, St. Louis, MO. She is President and CEO of Bay Hill Psychiatric Associates, a full service mental health provider. Located at 6068 S Apopka Vineland Road, Suite # 3, Orlando, FL 32819 She can be reach at Phone: 407-903-9696 or visit her at www. BayHillPsych.com She is licensed to detoxification Substance Abuse and Opioid addiction in her Bay Hill Office as an out patients visit.