NAMI NORTH CAROLINA

 Some signs that a teen with mental illness may also have a substance use disorder:

      ·        New group of friends
·        Dishonesty about whereabouts.
·        Unexplained absences or staying in the bathroom a long time.
·        Begins smoking.
·        Odor of glue, aerosol, alcohol or smoke.
·        Increased antisocial attitudes and behaviors.
·        Red or watery eyes; pinpoint or dilated pupils; needle marks.  Wears  sunglasses at inappropriate times.  Always wears long-sleeved shirt.
·        Paraphernalia found
·        Increased need for money.
·        Missing money or valuables.

Brain biology:

• Substances increase the availability of the neurotransmitter dopamine, creating a pleasurable feeling.
• Substances act on the limbic system, intensifying or dulling feelings.
• Substances may provide temporary relief from the pain of mental illness, or seem to facilitate “normal” functioning.
• Some individuals have more genetic predisposition than others.
• Mental illness generally occurs first; sometimes the substance use is self-medication, but the mental illness is not necessarily the cause of the substance use.  The two problems are closely intertwined.
• Substance use worsens the course of mental illnesses and increases the likelihood of violence.

Treatment:

• Both mental illness(es) and substance use disorder(s) have effective treatments.
• Treatment for mental illnesses involve counseling and, when necessary, medication.  Substance use treatment involves specialized counseling and sometimes medication.
• Integrated treatment produces the best results.  Integrated treatment addresses treatment for mental and substance disorders with a single team or provider trained in both specialties.   Abstinence is not required before the disorders are treated.   Patients cannot be refused access or ejected from these programs.  Integrated treatment is not yet widely available, but more professionals are being trained. 
• Youth with mental illnesses do not respond well to the confrontation and stress involved in typical substance abuse programs.

Prevention Note:

• Treatment of ADHD (Attention Deficit/Hyperactivity Disorder) in childhood appears to reduce the risk of subsequent alcohol and drug abuse  (Wilens, et al, “Does Stimulant Therapy of Attention-Deficit/Hyperactivity Disorder Beget Later Substance Abuse?  A Meta-analytic Review of the Literature,” Pediatrics, Vol. 111 No. 1., January 2003, pp. 179-185.)

Classroom applications:

• Do not sermonize or moralize about the substance use.
• Do not confront.  
• Have a positive vision of this youth’s recovery.
• Focus on strengths and competencies.
• Recognize even small amounts of progress.
• Collaborate with parents and treatment professionals.

Advice for parents/care givers

• Recovery is possible, but will take a while.  Be patient.
• Relapses are normal and to be expected.  Treatment can continue.
• Closely monitor youth’s activities and friends.
• Reduce access to places, people, and situations associated with substance use.
• Recognize even tiny amounts of progress.
• Stay positive and hopeful.
• Educate yourself about substance use as a treatable disease.
• Advocate for integrated treatment if it is not yet available in your area.

Resources for Youth:

http://teens.drugabuse.gov/ - The NIDA for Teens Web site is brought to you by the scientists at the National Institute on Drug Abuse (NIDA).

Resources for teachers and parents:

·        “The Dual Diagnosis Recovery Sourcebook” by Dennis C. Ortman.

·        “Blamed and Ashamed: The Treatment Experiences of Youth With Co-occurring Substance Abuse and Mental Health Disorders and Their Families,” Publication Order Number:  KEN02.  Call 1-800-789-2647, or write: National Mental Health Information Center, P.O. Box 42557, Washington, DC 20015, or online at www.mentalhealth.org.

·        “Co-Occurring Disorders Among Adolescent Treatment Populations,” Hoffmann et al. al., Dual Diagnosis Recovery Network, call 888-869-9230 or online at www.dualdiagnosis.org.

Copyright, 1998 through 2004, NAMI North Carolina, Inc. All rights reserved.