Substance Abuse Seen in Adolescents

 Abstract

        Substance abuse among adolescents has increased significantly over the last several years. For the purpose of this paper, adolescents can be defined at teenagers, or individuals of the ages 10-19. Substance abuse may be described as a mental condition in which individual over-uses specific drug(s) (either legal or illegal), to a degree that causes issues or restrictions on a person's life. Substance abuse has the potential of causing many life-threatening situations for the abuser.

        Throughout this work, the role of a nurse, specifically, will be explored in regard to identifying and taking care of adolescents suffering from addiction. Several articles and data will be provided to support the impact nurses have on adolescents struggling with substance abuse and their prevalence in the patient population. Steps nurses can take in order to provide responsible and sufficient care for their patients will be demonstrated.

Due to the current opioid epidemic, as well as personal concerns for the safety of my future patients, this topic is relevant. Health care providers are often abusers primary source of education and care, which is why this is a topic that merits discussion and understanding.

Medical Practitioner's Responsibility Regarding Substance Abuse

It is common for adolescents to start experimenting with drugs, such as alcohol. Teens may be unaware of the risks and ramifications of consuming alcohol at a young age and in excess. A Topical Approach to Life-Span Development explains how drug abuse effects the brain. Addictive substances often have a similar chemical makeup, such as the presence of the neurotransmitter dopamine. Dopamine is described as the neurotransmitter that gives the body pleasure, which explains why such drugs can become addicting as they elicit a pleasurable response (Santrock, 2016). Generally, when adolescents drink they feel more confident in social situations and, therefore, believe it is a tool to gain acceptance (Davies 2012). This explains why so many high schoolers and college students enjoy drinking and often over consume alcohol. In addition to raising levels of dopamine, adolescents can also over consume alcohol causing the opposite effect. Overconsumption results in a decrease in the natural dopamine produced by the body and sent to the brain. This then leads to a decrease in overall pleasure. Furthermore, due to addictive properties in many drugs, substance abuse can often lead to overconsumption, which can cause a lack or imbalance in hormone levels and the overall sense of comfort, or pleasure, in the human body.

        Due to the expenditure of dopamine and pleasure, substance abuse can take a strong toll on the work ethics of students. Scandinavian Journal of Caring Services writes to explain how school nurses recognized substance abuse in students, identified them, and how they effectively treat the abusers (Pirskanen 2006). The results show that more than one fourth of the participants were binge drinkers. Nearly 20% of the participants passed out due to substance use and 19% of the participants were smokers. Of all the participants, 53% were experimental users, 22% were recurring users, 9% were risky users, and 16% were hazardous users (Pirskanen, 2006, p. 444). After the results were collected, the nurses proposed individual interventions with their students. The school nurse and student relationship is important in acknowledging and assessing the abuser's actions. These results support the mission to inhibit the misuse of alcohol in adolescents. With that being said, however, there needs to be more educational opportunities for adolescents to further learn about the effects of alcohol and drug misuse. This includes both the physical and mental aspects of abuse. No matter the reason for substance abuse, whether it is the adolescents former background or peer support, there needs to be a source for prevention, intervention, and treatment.

        Alcohol misuse in adolescents can have many physical, psychological, and social effects. Physical effects can be serious and can cause severe symptoms such as liver damage, trauma, declining dental and oral health, destruction of brain cells, heart failure, etc. Along with physical effects there are psychological effects as well. Among these are disorders such as, anxiety, depression, self-harm, etc. An environmental influence can be seen through societal disorders as well. With these medical concerns being considered, it is understandable as to why alcohol misuse has become an important topic in the health care setting. Davies N.J (2012) explains the common reasons for misusing alcohol. The trending motivators include escapism, forgetting one's problems, gaining confidence, and giving adolescents something to do in their free time (p. 45). Davies (2012) also mentions that if a nurse or other educator tackles this issue early on, then they are more likely to eliminate alcoholism in the adolescent. The earlier the adolescent experiments with alcohol, the more likely they are to develop problems later on in life. A Topical Approach to Life-span Development also mentions that the chances of becoming addicted to alcohol increase when an individual is exposed to it before the age of 14 (Santrock, 2016). This brings a call to action for nurses and other medical providers to begin discussing the warning signs of addictions and dangers around substance abuse to both parents and children of an appropriate age.

        The accredited article, BMC Family Practice, performed a study on methods of medical treatment for teen users in the health care setting. This research project was conducted to examine primary care and how they treat their adolescent abusers/users. The results showed that there was a high number of adolescents that were not screened for abuse and, therefore, did not receive necessary intervention. Lisa Meredith (2018) explains the possible reasons for the lack of such screenings and interventions. She explains that the health care providers do not have adequate training, organizational skills, strong enough relationships with their patients, etc., that the realm of substance abuse requires. This can be changed with the help of more educational opportunities for nurses and other medical specialists to become more adept and competent on this topic. Meredith's (2018) study found the following: those that were at the higher risk for misuse were more likely to get screened and receive intervention. Additionally, older adolescents were likely to receive screening, but not receive intervention and counseling. Adolescents from minority groups were less likely to be screened than white adolescents (p.7). The segregation between those who were able to be screened and/or receive intervention or counseling warrants this process unfair and inadequate. Adolescents should be treated equally and receive the same measures when presented to health care facilities. 

        The pivotal step in eliminating substance abuse in adolescents is treatment. As a health care provider, one must ask themselves what is necessary for the patient to reduce urges and symptoms, as well as work towards conquering their addiction. Davies (2011) writes about alcohol misuse in adolescents and calls it the learning zone. It appears her learning zone goal is to teach nurses about the implications of alcohol misuse and the proper steps to be taken in helping these individuals.

        The first step of the learning zone is for nurses to perform an assessment on the patient. The assessment allows the nurse to know whether or not the abuser has any desire or motivation to help change his or her behaviors. This assessment can be done through motivational interviewing. Motivation interviewing can allow an opportunity for an abuser to accept that they have a problem and illness. Davies (2011) discusses the importance of the Theory of Planned Behavior (p.46). This theory is designed to encourage changes in negative behavior and learn the intentions of the abuser. This model was developed to help understand alcohol misuse and help develop interventions and counseling for the patient. Specialists are then able to assist the adolescents and give advice and education on this issue. Nurses are able to provide care and advice during consultations with a patient. In order for a nurse to properly assist a patient, he or she needs to not only consider the alcohol misuse, but also the adolescent's living arrangements and other factors that may cause triggers. Nurses can work with other people in their community on this issue to better understand their patient. Examples of other resources one may take advantage of including counselors, teachers, family members/friends, support groups, career services, etc.

        Nursing students and future nurses can use this research to better their profession. A crucial component to nursing is the ability and desire to help others. The topic of alcoholism relates to nurses in two distinct ways; the first being the relationship between the nurse themselves and an addict. The relationship between the two can benefit nurses in treating his or her patients and provide them with beneficial feedback and advice. The second reason is that statistics have shown that more can be done in health care facilities and schools to educate these adolescents on the risks and effects of alcoholism.

There simply are not enough educational opportunities to learn about substance abuse in school settings and health care facilities. This is a community based issue. Nurses and other medical professionals can be the change for these individuals. When a nurse receives a new patient, it is their job to evaluate the patient and be aware of warning signs and risk factors for abuse. It is also the nurses job to inform their patients about the risks and implications of substance abuse. In addition, it is the nurses job to approach these adolescents in an appropriate and effective manner. The abuser in some cases, may not want to hear they have to stop drinking. If this is the case, the nurse should try a harm-reduction approach. This type of message gives adolescents alternatives to drinking, and/or encourages them to choose low percentage alcoholic beverages. With the help of programs and education, nurses can become professionals on how to care and treat adolescent abusers.

After researching alcohol misuse and abuse seen in adolescents I have become more knowledgeable on this topic. I will now be able to use this information as a nurse when dealing with any patients that may abuse alcohol or another substance in general. Although I am not yet a trained professional, I can take responsibility in educating myself and preparing myself in regard to this topic. When I encounter a future patient, I must remember to evaluate them and use the assessments demonstrated in this research. I will educate them on prevention, risks, symptoms, treatments, and the causes and effects of alcohol. If I suspect any abuse, I will take the next steps in providing them with the proper care. I will provide them with a support team that will include other nurses, doctors, counselors, etc. that can help me gain more knowledge on the subject, as well as my patient and their circumstance. This support team can then be there as a resource for my patient to come clean or decrease his or her consumption going forward. As a nurse, I will pledge to educate my patients as soon as possible about substance abuse. I will also take responsibility and understanding that this begins with the educators ourselves to inform, set a good example, and exist as an accessible resource to such patients.

 

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