Substance Abuse Treatment for Adolescents
__________________________________________________________________

Free Module: Do you know what they are talking about?

Objectives

Upon completion of this module you will be able to:

• Identify some of the terms used by adolescent clients to describe substance use
• Identify patterns in adolescent substance use and abuse
• Utilize resources for further information regarding these trends

"What’s a Clambake?" This is a quiz developed by Michael Nerney, keynote speaker at the Mid-Atlantic Regional Conference on Substance Abuse Prevention and Treatment for Adolescents. The questions and answers are based on his interviews with high school and college students. Match up the slang term with the correct description __________________________________________________________________________ __ 1. Clambake A.  LSD and ecstasy __ 2. Glass B.  Alphaethyltriptomine(visual hallucinogen) __ 3. Liquid X  C.  Ecstasy __ 4. Roboshots  D.  Several people get in a car, close all windows and vents and smoke pot __ 5. ET E.  Dextromethorphan (cough suppressant) __ 6. Candy Flip F.  Gammahydroxybuterate (GHB) __ 7.  Special K G.  Cigarettes or joints soaked in formaldahyde __ 8. Passion H.  Ketamine __ 9. Wets I.  Methamphetamine __ 10. Rolls  J.    Malt beverages with 6% alcohol

Answers: The answer key can be found on the Course Document page.

Additional Terms

PSYCHOACTIVE CHEMICALS

(content and html © 2000 Erowid.org. http://www.erowid.org Permission granted for use in this course)

___________________________________________________________________________

Patterns of Use

Adolescents’ patterns of substance use are different from adults, as is their perception of themselves and their world. Their developmental tasks are also different, and typical interventions for prevention and treatment, modeled entirely on adult development, are not appropriate. Developmental issues are discussed in detail in Module 1 of this course.

The focus of adolescents is on the short-term, and so they do not perceive long-term consequences of drug use as a deterrent. Their biggest perceived risk is feeling excluded/different from their peers. In addition, drugs and alcohol work in the short-term. Adolescents have not yet mastered deferred gratification, and so taking a drug or a drink that increases feelings of well-being and mastery/coping immediately will frequently provide a more powerful experience than any written or verbal information given by adults.

Adolescents are more likely than adults to try new drugs (or drugs they don’t know the name of) on the recommendation of a peer or based on what they see in the media/internet. They do not drink for the taste, nor do they have a preference for one drug or beverage, as adults often do. They will use whatever their peer group is using. They may hear about a negative consequence in relation to a drug but their orientation is focused on the risk/adventure and the positive stories they have heard from peers. They also hold the belief that the negative event will not “happen to me”.

For example, young girls value cigarettes as a way to stay thin and prevent weight gain. Nicotine suppresses appetite, and also soothes and helps with self-assurance. These are immediate benefits for the adolescent girl that are of greater value for her than any future consequences, such as emphysema, cancer or high blood pressure.

Another difference between adolescents’ and adults’ substance use patterns is that adolescents spend excessive amounts of time and energy in drug–seeking behaviors, developing and following rituals, purchasing drug-related clothing, and attaching to an identity related to their alcohol/drug use. Even in the stage of social use, the adolescent will engage in drinking/drugging games and rituals. In contrast to adult social use, an adolescent will rarely stop at one-two drinks. The goal is to experience the risk of getting high or drunk. Binge drinking is common in social situations for adolescents and is often viewed as “normal” by the peer group. In adults, binge drinking is typically associated with the middle stage of addiction.

Personal Experiences

Here are examples of experiences with alcohol/drugs that people have posted on the internet (age and identity unknown) that illustrate some of these patterns.

Experience #1: Ecstasy

     “On the Eve of the Millenium, I ventured out with many of my friends to party the new year in. We had already passed the countdown and it was getting late, about 1 or 2 am. My friends Joe, Mike and Nester all showed up at the party I was at and asked if I wanted to go with them to rave. I agreed because I am a big lover of the rave scene. So we all piled into Mike's car and went to his house. Joe said he got Mike 4 hits of x and we were all going to share. We all took a hit. I remember Joe came up to me, put the pill in my hand and handed me the Gatorade. I drank it down and he said ' Don't think about it, and it will hit you quicker' So we proceeded to Mike's bedroom and we all sat around talking. Mike put on some Bjork, and we all just enjoyed the music.

   Soon enough I felt a tingling all over my body. I noticed my skin felt like a different surface, like rubber. I put my head in my hands and felt the strands of hair flow between my fingers. I went to lie down on the bed and put my jacket over my face. The lining was so soft and seemed to flow like water over my face. They asked me 'Are you okay?' I answered back, 'Mmmhmm.' They asked me to go sit by them on the floor. As I sat down, I felt the white carpet rub against my hands. I had never felt such softness in a carpet. I noticed this and yearned to feel the carpet on my arms and body. So I lay down on the floor and proceeded to roll around like a cat… rubbing my body all over the carpet. Nester got me up and put my hands on his head. It was incredible. He had a shaved head and the peach fuzz was so incredibly soft, I never felt anything like it.” [Editors note: This experience proceeds into sexual behaviors.]

Ecstasy

Experience #2: The Quest

     “I was told almost a week in advance that I might have the opportunity to try Ecstasy with the young lady who acted as a guide for my first LSD trip. We were to meet at a given tube station not far from the nightclub where the experimentation would take place.

I was not easy about trying a new psychedelic in a crowded place, realizing this could have been difficult to handle with LSD. But there lay the opportunity and I just hoped to have enough mental control (practice of Yoga helping) if things got tight. I had read about MDMA in Peter Stafford's Psychedelics Encyclopedia, but was aware E's are not very often pure MDMA. In addition, the book had stayed at home and my memory of its contents had faded somewhat. So I scanned the net for an Ecstasy FAQ and read that, also reading whatever current reports of the experience were posted on alt.drugs. Quite strangely, that was also the week my father decided to give me a hysterical account of some absurd and manipulatively badly written article in a Swiss newspaper depicting the dreadful and possessive evils of the Love Pill. He knows I have profound interest in altered consciousness and its chemical gateways, but not what I'm up to in my spare time... Anyway, I psyched myself up all week for the event, and when the Saturday evening came, I left a little note on my desk explaining that if I was unlucky that night, the Quest had been worth it.”

Experience #3: Dad’s alcohol

     “Well me and my friend were walking home from school and he was telling me about his dad's significant amount of alcohol. He said that when we got there he would challenge me to how many shots we could take. We got there and he said I could choose whatever kind I wanted. I chose a bottle of 80 proof bicardi. He took out some shot glasses and poured the first 2 shots. We tilted our heads back and chugged. That stuff was strong! It burned a little and was bitter tasting. We decided it was time for round 2. I poured the shots this time. As before, we tilted our heads back and chugged. It was still a little bitter but the burn wasn't as bad. As for the next 2 shots, all that happened was the same, only the bitterness and burn weren't as bad. At this time we felt all dizzy. He poured another round. I leaned back and gulped mine. He had a bit of trouble with his, but he took it like a man. The next 2 shots were pretty intense. We both took them, But we just couldn't handle anymore. We filled the bottle with water to make it look like none was missing. I remember seeing everything as a blur, And when I stood up to go sit on the couch, my legs were heavy as hell and I fell down. I crawled to the couch. I had this terrible headache. I sat on the couch and leaned back for a while. I stared at the ceiling and couldn't tell where the fan was. I suddenly felt this surge in my throat. I ran to the bathroom and threw up all in the toilet (I think). Then I crawled over to the couch and just lay there. I was tired so I just fell to sleep. When I woke up, my friends’ dad wasn't home yet so I woke him up and we cleaned up everything. We still felt dizzy so we decided to go to my house (across the street) to smoke some weed. That’s what I remember.”

Summary:

These experiences reflect some of the adolescent patterns discussed. They will be used later in the course for discussing assessment and treatment approaches. If you are interested in reading about additional experiences, visit the Erowid website.

Links and Resources

ATTC Adolescence resources

Girl power

Club Drugs

Erowid

Focus Adolescent Services

Academic Press: Journal of Adolescence

Whats Your Anti-Drug?

Go to "Module 1" in Course Documents

______________________
updated: 4/14/2003 mw