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

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.

 

 

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Snowfall warning issued for Vanderhoof, Fraser Lake and surrounding communities.
Snowfall warning issued for B.C.’s Interior

Between 10 - 15 cms of snow expected in the Prince George, Stuart - Nechako region

Fort St. James Secondary School announced a confirmed incident of COVID-19 exposure at the school. (Black Press file photo)
COVID-19 exposure confirmed at Fort St. James Secondary School

Northern Health will be following up directly with anyone who is identified as a close contact

RDBN board meeting. (Priyanka Ketkar photo/Lakes District News)
Thiessen and Parker re-elected to RDBN board

The board voted unanimously on Nov. 19

Mary Cox and Jack Plant dance in their pyjamas and slippers at the morning pyjama dance during the Rhythm Reelers’ 25 Annual Rally in the Valley Square Dance Festival in Chilliwack on June 4, 2011. Sunday, Nov. 29, 2020 is Square Dancing Day. (Jenna Hauck/ Chilliwack Progress file)
Unofficial holidays: Here’s what people are celebrating for the week of Nov. 29 to Dec. 5

Square Dancing Day, Disability Day and International Ninja Day are all coming up this week

Black Press Media and BraveFace have come together to support children facing life-threatening conditions. Net proceeds from these washable, reusable, three-layer masks go to Make-A-Wish Foundation BC & Yukon.
Put on a BraveFace: Help make children’s wishes come true

Black Press Media, BraveFace host mask fundraiser for Make-A-Wish Foundation

Kevin Bieksa during his days playing with the Vancouver Canucks. (Photo: commons.wikimedia.org)
Bieksa to guest on free Canucks Alumni ‘Hot Stove’ on Zoom app

Former NHL player has become a game analyst on Sportsnet

114 Canadians were appointed Nov. 27 to the Order of Canada. (Governor General of Canada photo)
Indigenous actor, author, elder, leaders appointed to Order of Canada

Outstanding achievement, community dedication and service recognized

More than 60 cm of snow has fallen at Ulkatcho First Nation near Anahim Lake in the Chilcotin since a snowfall warning went into effect Thursday, Nov. 26. (Graham West photo)
VIDEO: More than 60 cm of snowfall in Chilcotin since Thursday, Nov. 26

Graham West of Ulkatcho First Nation captures the scene on video

Screenshot of Pastor James Butler giving a sermon at Free Grace Baptist Church in Chilliwack on Nov. 22, 2020. The church has decided to continue in-person services despite a public health order banning worship services that was issued on Nov. 19, 2020. (YouTube)
2 Lower Mainland churches continue in-person services despite public health orders

Pastors say faith groups are unfairly targeted and that charter rights protect their decisions

A big job: Former forests minister Doug Donaldson stands before a 500-year-old Douglas fir in Saanich to announce preservation of some of B.C.’s oldest trees, July 2019. (B.C. government)
B.C. returning to ‘stand-alone’ forests, rural development ministry

Horgan says Gordon Campbell’s super-ministry doesn’t work

Peter Wilson, left, and Micah Rankin, right, formed the Special Prosecutor team that was tasked with reviewing and litigating charges stemming from the Bountiful investigation. Trevor Crawley photo.
End of Bountiful prosecution wraps up decades of legal battles

Constitutional questions had to be settled before a polygamy prosecution could move forward

Alexandre Bissonnette, who pleaded guilty to a mass shooting at a Quebec City mosque, arrives at the courthouse in Quebec City on February 21, 2017. THE CANADIAN PRESS/Mathieu Belanger - POOL
Court strikes down consecutive life sentences; mosque shooter has prison term cut

The decision was appealed by both the defence and the Crown

Most Read