Part IV: Drugs, Alcohol and Mental Health Problems – Which Came First?

Alcohol and marijuana (or cannabis) are the substances most used by B.C. teenagers, writes Dr. David Smith.

Dr. David Smith

When mental health issues arise among teenagers, parents often wonder: Did alcohol or drugs cause this? Or did a pre-existing mental health issue cause the substance use?

Substance use and mental health problems often go hand-in-hand. In fact, surveys show that 33 per cent of youth with a diagnosed mental health condition also have a substance use issue. The rates are even higher among those with a diagnosed substance use condition (such as dependence on alcohol or addiction to drugs), with anywhere from 60 to 80 per cent found to have an underlying mental health condition.

When mental illness and substance use show up together it is called a “concurrent disorder” and it is particularly challenging to treat because both issues must be explored and treated at the same time.

Sometimes the two are very closely entwined; sometimes they just exist together.

Why do the two issues so often occur together? One reason is that the risk factors underlying both the mental health condition and the substance use issue are similar and may include a genetic predisposition, family history or any of a series of common life stressors such as a past experience of loss, trauma, abuse or poor attachment; a difficult or unstable family or living situation; limited supportive adults in their life; chronic stress; learning disabilities or poor school performance issues; poverty and neglect.

Sometimes, the substance use itself can actually trigger mental health concerns like depression, paranoia or hallucinations that may clear up once the substance use is stopped.

Another reason is self-medication. Sometimes a teenager begins to use substances because he or she finds it provides temporary relief from uncomfortable or disconcerting symptoms. They may feel using the substance helps relieve anxiety, tension or depression. For a time it reduces psychological or physical suffering or makes them feel better. When self-medication is occurring, there is a greater risk of long-term dependence because the youth truly feels the substance is helping them cope.

Alcohol and marijuana (or cannabis) are the substances most used by B.C. teenagers.

Read: Part III: Youth Dealing with Depression (Dec. 19, 2014)

We now know that adolescent brains, particularly the critical frontal lobes, are not completely developed until about age 25. Youth brains are not just immature versions of adult brains, they also appear to be more vulnerable to substance use in ways that adult brains are not. It seems that the younger the start, the higher the risk. The older youth are when they started using alcohol or marijuana, the less likely they are to be current users or to engage in risky behaviours such as mixing different types of alcohol, drinking at high risk levels, using drugs such as amphetamines or crystal meth, or to have injected drugs.

Fortunately, results from the 2013 Adolescent Health Survey found that more B.C. students are waiting to try alcohol and/or cannabis until after they are at least 15 years of age or older.

But the 2013 survey also found that 75 per cent of 16-to-18 years had tried alcohol and 46 per cent had tried marijuana. While most youth do not develop long-term addictions or mental health issues, substance use alone comes with significant risks to their health and wellness.

Binge drinking, alcohol poisoning, driving while intoxicated, unprotected sex, and injuries are all risks that arise from substance use, independent of any mental health concerns.

Protective factors against using either drugs or alcohol include good supervision from caring adults, strong connections to school, a positive peer group, involvement in extracurricular activities, and positive self-esteem and attitudes.

In recent years, concerns have been raised about the role heavy marijuana use can have in the onset of psychosis (hallucinations and delusions) and even schizophrenia. In the 2002 Dunedin study (UK) researchers found that cannabis use in adolescence significantly increased the odds of developing schizophrenia in adulthood, especially in psychologically vulnerable individuals who had used the drug by age 15. (More research on this link will be forthcoming, but we do know that stopping cannabis use is the first essential step to getting the psychosis and schizophrenia under control.)

If you suspect that drugs or alcohol may be a problem with your child and may be contributing to a mental health problem, see your family doctor. The doctor may decide to refer you to the Child and Youth Mental Health Services in your community or to the Provincial Youth Concurrent Disorders Program at BC Children’s Hospital. Other resources include: the BC Alcohol & Drug Information & Referral Service at 1-800-663-1441.

For more information about concurrent disorders see: mindcheck.ca, camh.ca; kelthymentalhealth.ca

And talk to your children from early ages about the importance of avoiding the use of any substances to protect their brain health. Dr. Carol-Ann Saari, medical director of the BC Youth Concurrent Disorder Clinic at BC Children’s Hospital, notes: “The longer youth can let their brains develop without exposure to drugs, the healthier their brains will be.”

**********

Dr. David Smith is an adolescent and adult psychiatrist and the medical director of the Okanagan Psychiatric services for Interior Health. This series of columns on common child and youth mental health issues is a project of the Child and Youth Mental Health and Substances Use Collaborative. The Collaborative involves multiple individuals, organizations and ministries all working together to increase the number of children, youth, and their families receiving timely access to mental health services and support in the Interior Health and Vancouver Island regions. The Collaborative is jointly funded by Doctors of BC and the government of B.C.

 

 

Just Posted

Province not doing enough for forestry sector, say Liberals

Although Minister of Forests says government working to diversify industry, rural economies

Local company Northern Homecraft wins big at Northern B.C. awards

Vanderhoof company won in two categories for homes built in Fort St. James area

Stolen truck involved in fatal collision on Highway 16

Wednesday’s two-vehicle crash killed one man, 23, and injured two others

UPDATE: West Fraser to permanently reduce production in Quesnel, Fraser Lake

The move will affect 75 employees in Quesnel, 60 in Fraser Lake

Feedback sought on environmental impacts of New Gold’s proposed Blackwater Mine

Public is invited to comment in final round of consultation

REPLAY: B.C’s best video this week

In case you missed it, here’s a look at the replay-worth highlights from this week across the province

Death toll rises to 76 in California fire with winds ahead

Nearly 1,300 people remain unaccounted for more than a week after the fire began

Trump says report on Khashoggi death expected in a few days

Jamal Khashoggi was a columnist for The Washington Post who was slain Oct. 2 inside the Saudi Consulate in Istanbul

CUPW requests mediator as deadline for Canada Post offer expires without deal

Prime Minister Justin Trudeau weighed in Saturday night with a last-minute plea to the two sides

Trudeau says he won’t negotiate in public on future of LGBTQ rights in USMCA

Legislators urged Trump not to sign the agreement unless the language was removed.

Price makes 36 saves as Habs edge Canucks 3-2

Late goal lifts Montreal past Vancouver

BC Minister of Agriculture loses stepson to accidental overdose

Lana Popham announces death of her 23-year-old stepson, Dan Sealey

Canadian military’s template for perfect recruits outdated: Vance

Gen. Jonathan Vance, the chief of defence staff says that the military has to change because the very nature of warfare is changing, particularly when it comes to cyber-warfare

‘Toxic’ chosen as the Word of the Year by Oxford Dictionaries

Other top contenders for 2018 include ‘gaslighting’ and ‘techlash’

Most Read