Substance Use and Abuse

Adolescents are far more likely to experiment with alcohol and drugs than younger or older individuals. But many who experiment or only use occasionally do not experience long-term effects—as long as they escape short-term negative outcomes such as accidents and sexual risk-taking. As you might expect, early onset of use (e.g., using alcohol before age 14 or illegal drugs before age 15) is associated with increasing use over time and greater risk for alcohol and drug disorders (Chassin et al., 2004). But what risk factors can adults watch for before substance use begins?

Characteristics of the individual are related to substance use. Those who develop substance problems are more likely to be sensation seeking, aggressive, impulsive, and have poor behavioral control—and many of these qualities are evident between 3 and 5 years of age. Problems with cognitive skills related to self-regulation such as planning, organizing, and selective attention are also related to increased risk of substance abuse. A history of antisocial behavior, including aggressiveness and conduct problems, is also a risk factor (Chassin et a1., 2004).

Teens' beliefs, values, and experiences also play a role in whether they use alcohol and drugs. Those who believe that alcohol and drugs are a threat to their health or their future goals are less likely to use them, while those that think of drug use as less risky and more fun are at increased risk. Teens who describe themselves as more religious are less likely to try alcohol or drugs. And those who experience high levels of stress are at an increased risk. Having experienced physical or sexual abuse in childhood or witnessed family or neighborhood violence increases the risk. For these teens, substance use may be an attempt to cope with circumstances that are overwhelming to them (McIntosh, MacDonald, & McKeganey, 2005; Merrill, Salazar, & Gardner, 2001; Wallace, Brown, & Bachman, 2003).

Family factors are important in predicting substance problems. Those with a family history of substance abuse are at higher risk, probably for several reasons. Families may share a genetic susceptibility for drug use and dependence, and parents who abuse alcohol or drugs provide a model of substance use for their children. Prenatal exposure to alcohol or drugs may increase the sensitivity of receptors for the substances in the child's brain or may contribute to conduct and self-control problems in the child. Alcohol and drugs are also likely to be more available in homes with a family history of substance use.

Parenting practices are also important. Harsh, inconsistent, or permissive discipline is associated with higher levels of substance use. Not surprisingly, poor parental monitoring increases the risk as well because these parents have less knowledge of what their teens are doing and who they're with. More authoritative parenting (high in warmth and responsiveness, but with appropriate expectations and discipline) is associated with lower levels of substance use. A close relationship with parents reduces the likelihood of drug use, probably because these parents monitor their adolescents more closely and perhaps have more influence on their teens' friendships. Parents also communicate their beliefs and values about substance use by their own behavior and through discussions with their children; they can also reinforce positive connections with peers, school, clubs, churches, and other organizations that affect the risk of substance use.

Of all the factors that have been studied, having friends who use alcohol and other drugs is the strongest predictor of teen substance use. Friends who use provide a model of substance use, opportunity to engage in substance use, access to the substances, and reinforcement for using. Of course, it is difficult to know exactly how to interpret this relationship. Do teens who are more likely to use substances select friends who are also likely to do so? Or are teens who would otherwise be unlikely to use drugs being influenced to use by their friends? As you might expect, it can be difficult for research to sort out these possibilities, but it seems that both selection and socialization influences are important. Regardless, it's a good idea for parents to monitor who their teens are spending time with and get to know their teen's friends.

As you can see, adolescents with more difficult temperaments, cognitive difficulties, and poor self-control of behavior and emotions are at higher risk for substance problems. These individual vulnerabilities may interact with more coercive or lax parenting practices, leading to problems with schooling and lack of acceptance into a positive peer group. These children and teens may then become increasingly involved with deviant peer groups that model, reinforce, and provide opportunities to engage in substance use—much the same way that these elements work together to produce conduct problems, aggression, and delinquent behavior.