How Do We Know Who Will Develop A Substance Use Disorder?

Statistics suggest that only 1 in 10/12 people who use substances develop a substance use disorder. The question is: who makes up that 10 to 12%?

Someday, we will have lasers and be able to probe into a person’s brain to determine if he/she will, given the right life variables, develop a drug problem. Until then, we are left with a collection of “indicators”, listed below, that can help us measure a person’s risk.

  • Age of onset: The younger a child is when they start, the greater chance they will develop a problem.
  • Mental health problems: Anxiety, depression, ADD, Learning Differences etc. increase risk.
  • Medical problems: Example: chronic pain disorders of any kind.
  • Trauma: Poverty, abuse, neglect, bonding and attachment problems.
  • Family dysfunction: Persistent interpersonal conflict including yelling, swearing, physical or emotional abuse, avoidance, parent’s substance use and/or mental health problems.
  • Family history: While there is no “alcohol gene”, the percentage of teens developing a substance use problem is 60% if one parent has a substance use disorder and up to 80% if both parents have one.
  • Environment/opportunity: Because teens are wired to be curious and to explore what’s novel in their world, having access and opportunity to use drugs increases risk.

In my practice I use the following checklist, in addition to the indicator listed above, when assessing a teen/family.

  • Decline in school performance
  • Conflict with parents/ family members
  • Behavioral problems, lying, stealing (home and school)
  • Involvement with police and/or juvenile justice system
  • Drugs/alcohol found (home, room, car etc.)
  • Decreased interest in activities previously enjoyed
  • New group of friends
  • Unwillingness to discuss with parents their concern about drugs/alcohol use.

If 2 or more indicators are present, I know the teen is at risk, and intervention of some kind will be probably needed. However, I have also seen situations where no indicators were present, and yet the abuse was in full flight. These assessment tools, while being far from perfect, are our best means of determining the probability of a teen developing a substance use disorder.

For the adolescent outpatient substance abuse treatment for teens in Sonoma County,  THE NEXT STEP PROGRAM in Santa Rosa is a great place to begin evaluating whether a substance use problem exists or can develop into substance abuse. Call Mark Falls, PhD, a family and addiction therapist in Santa Rosa at 707-525-9300 for an assessment.

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