Stages Of Adolescent Substance Use

I. Experimental Use

Junior-high-age students, especially boys, are great experimenters with various types of mood-altering substances. Some may never go beyond the experimental stage. They may decide that substance use is not for them, but a majority of them will continue to experiment and become regular users. They will use beer and pot in this stage, and will learn to seek and enjoy the mood swings that these substances will provide. A child who exhibits abuse at this stage may be establishing a lifelong pattern. Or the substance use may level off and stay at the "social recreational" level, causing no interpersonal conflict or externally harmful consequences. It is difficult to assess dependency at this stage. The normal turmoil of adolescence is baffling to both teenagers and their parents, and caution is advised in any evaluation procedure. Many students have been inappropriately labeled as dependent when in fact they are not. They may be using drugs, but that fact alone does not make them dependent.

Simply using more does not, by itself, indicate dependency. But a pattern of regular use, coupled with some adverse behavioral changes, can show a definite move towards possible dependency. The point here is not how much is being used, or how often, but why it is being used and what behavioral changes occur as a result of the use. If teenagers have to lie to their parents about their savings accounts, about why they have dropped out of school sports or other activities, or about who their companions are, and have to maintain these fictions in order to continue using drugs, they will begin to experience real guilt. Unfortunately, this guilt produces feelings of intense self-hate, which results in increased drug use. A cycle of use-guilt-remorse-increased use begins.

Preoccupation with drugs is one of the major indicators of a substance abuse problem. More and more of the student's time, energy and money are spent on thinking about being high and insuring that a steady supply of drugs is available. Questioning a user at this stage will reveal that very few of his or her daily activities do not include drug use. The user accepts this as normal. Problems with parents or police may serve to cause the abuser to decide that it would be smart to cut down or to quit using all together. And they may succeed for a few weeks. Generally though, these periods of abstinence will not last. They do serve, however, to strengthen the abuser's sincere delusion that, because he or she "quit," there is no problem. It can be pointed out to the abuser that, even though he or she feels that there is still a choice as to whether or not to use, the "choice" is always the same: to keep using.

By the time the user has reached a state of dependency, negative personal feelings have been building steadily until they require daily, even hourly, medication with drugs. Abusers in this state are unable to distinguish between normal and intoxicated behavior. To them, being high is normal, and no rationale or moral argument can break through their chemically maintained delusion. This delusion persists even in the face of overwhelming evidence that his or her abuse is out of control and is physically, mentally and emotionally strangling him or her. The abuser will continue to insist that there is no problem, that is not out of control, and that he or she can quit at any time.