Children substance abuse

American Academy of Child and Adolescent Psychiatry Practice parameters for the assessment and treatment of children and adolescents with substance abuse disorders. J Am Acad Child Adolesc Psychiatry 37 122—126, 1998 American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000... 

Centers for Disease Control and Prevention Gamma hydroxy butyrate use—New York and Texas, 1995-96. JAMA 277 1511, 1997 Centers for Disease Control and Prevention Adverse events associated with ingestion of gamma-butyrolactone—Minnesota, New Mexico, and Texas, 1998-1999. MMRW Morb Mortal Wkly Rep 48 137-140, 1999 Chatlos JC Recent trends and a developmental approach to substance abuse in adolescents. Child Adolesc Psychiatr Clin N Am 5 1-27, 1996... 

Alcohol Health Res World 22 122-123, 1998 Solhkhah R, Finkel J, Hird S Possible risperidone-induced visual hallucinations. J Am Acad Child Adolesc Psychiatry 39 1074-1073, 2000 Solhkhah R, Wilens TE, Prince JB, et al Bupropion sustained release for substance abuse, ADHD, and mood disorders in adolescents (NR31), in New Research Absrracts, Annual Meeting of the American Psychiatric Associarion. Washington, DC, American Psychiatric Associarion, 2001... 

Stewart RD, Fisher TN, Hosko MJ, et al Experimental human exposure to methylene chloride. Arch Environ Health 25 342-348, 1972 Substance Abuse and Mental Health Services Administration Preliminary Estimates from the 1995 National Household Survey on Drug Abuse. Rockville, MD, U.S. Department of Health and Human Services, 1996 Tenenbein M, PillayN Sensory evoked potentials in inhalant (volatile solvent) abuse. J Paediatr Child Health 29 206-208, 1993... 

Merikangas KR, Dierker LC, Szatmari P (1998a) Psychopathology among offspring of parents with substance abuse and/or anxiety disorders a high-risk study. J Child Psychol Psychiatry 39 711-720... 

Chaffin, M., Kelleher, K. and Hollenberg, J. (1996) Onset of physical abuse and neglect psychiatric substance abuse and social risk factors from social community data. Child Abuse and Neglect 20, 191-203. 

Kerwin, M. (2005) Collaboration between child welfare and substance abuse fields combined treatment programs for taoxhets. Journal of Pediatric Psychology 50, 7, 581-597. 

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Nair, P., Schuler, M.E., Black, M.M., Kettinger, L. and Harrington, D. (2003) Cumulative environmental risk in substance abusing women early intervention, parenting stress, child abuse potential and child development. Child Abuse and Neglect 27, 997-1017. 

O Flynn, M. (1999) The Adoption and Safe Families Act of 1997 changing child welfare policy without addressing parental substance abuse. Journal of Contemporary Health Law and Policy 16, 243-271. 

Semidei, Radel, L. and Nolan, C. (2001) Substance abuse and child welfare clear linkages and promising responses. Child Welfare League of America 80, 2, 109-128. 

Numerous studies found that childhood sexual, physical, and emotional abuse also predisposes victims of such abuse to the development of depression in adulthood (e.g., McCauley et ah, 1997). The risk for depression increases with early onset and severity of the abuse as well as with the experience of multiple types of abuse. In addition, child abuse is related to an array of anxiety disorders, including generalized anxiety disorder and PTSD (e.g., Kendler et ah, 2000). Other disorders related to childhood abuse include substance abuse, eating disorders, dissociation, and so-... 

Bukstein, O., Lilly, G., and Kaminer, Y. (1992) Patterns of affective comorbidity in a clinical population of dually diagnosed adolescent substance abusers. J Am Acad Child Adolesc Psychiatry 31 1041-1045. 

Hovens, J., Cantwell, D., and Kiriakos, R. (1994) Psychiatric comorbidity in hospitalized adolescent substance abusers. / Am Acad Child Adolesc Psychiatry 33 476—483. 

Kaminer, Y. (1995) Issues in the pharmacological treatment of adolescent substance abuse. / Child Adolesc Psychopharm 5 93-106. 

Stowell, J. and Estroff, T. (1992) Psychiatric disorders in substance abusing adolescent inpatients a pilot study. J Am Acad Child Adolesc Psychiatry 31 1036-1040. 

Weinberg, N., Rahdert, E., Colliver, J., and Glantz, M. (1998) Adolescent substance abuse a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 37 252-259. 

Cochrane Review). The Cochrane Library. Chichester John Wiley Sons Solberg U, Burkhart G Nilson M (2002). An overview of opiate substitution treatment in the European Union and Norway. International Journal of Drug Policy, 13, 477-84 Soyka M (2000). Substance misuse, psychiatric disorder and violent and disturbed behaviour. British Journal of Psychiatry, 176, 345-50 Spataro J, Mullen PE, Burgess PM, Wells DL Moss SA (2004). Impact of child sexual abuse on mental health. Prospective study in males and females. British Journal of Psychiatry, 184, 416-21... 

FIGURE 10—6. Depressive and anxious symptoms are not only a hallmark of major depressive disorder but are frequently associated with other psychiatric disorders, including bipolar disorder, schizophrenia, and schizoaffective disorder with organic causes of depression, such as substance abuse with childhood mood disorders (child) with psychotic forms of depression and with mood and psychotic disorders resistant to treatment with drugs (treatment-resistant), among others. 

There are two telltale changes that are almost always associated with a child s substance abuse ... 

When substance abuse causes the child to suspend caring, act harmfully to self or others, and abuse freedoms that... 

The only reason taking a restrictive stand with a substance-abusing child can work is because parents consistently enforce the new regimen, and the child reluctantly conforms to what they have decreed. They can t force the child to obey because they can t control the child s choices. They can only influence those choices by the family structure they impose and the consequences they apply to decisions that are made. The child s compliance is an act of consent. To some extent, he or she agrees to go along with what they want. If, after several months of taking a restrictive stand, the child shows no signs of consent, then the problem may not be abuse. It may be addiction. 

From having been the initiators for what needs to happen in the family, they become primarily reactors to what is happening, effectively ceding family influence to the substance-abusing or addicted child. (This is why part of parental recovery from codependency is reclaiming initiative to run the family.)... 

Codependency describes what happens to the conduct of communication, the definition of roles, and the interactions between family members when the dominant power in the family becomes the substance abuser or addict. When it is the child who has fallen victim to substances, parents increasingly depend their decisions, for how to feel, what to think, and what to do, on the child s self-destructive behavior. In consequence, parents experience at least three harmful effects. 

During the inevitable ups and downs of adolescent growth (see Keys 19 to 23), times of significant, persistent sadness in their child should be taken seriously by parents because these may either be a precursor or consequence of substance abuse. What can a parent watch out for A few common signs of feeling seriously depressed include ... 

A child is at increased risk of suicide if.. . the child has substance abuse problems. . . Alcohol increases the risk of suicidal behavior by worsening feelings of depression and by diminishing self-control. About half of those who attempt suicide are intoxicated at the time of the attempt.. . Drug overdose is the method most frequently used in suicide attempts." (See Suggested Reading, Merck, pp. 413414.)... 

Does a young person ever abuse drugs or alcohol in order to escape or medicate suffering from low self-esteem, or does self-esteem ever become lowered as a result of abusing drugs or alcohol The answer to both parts of this question is "Yes." Substance abuse and addiction can be both the cause and consequence of low self-esteem. Therefore Key to the prevention of, and recovery from, substance abuse and addiction is helping the child build and maintain a strong, positive sense of self-esteem. 

When it comes to their child breaking free of substance abuse or addiction, there is a very important reality that parents must accept they have no actual control over their child s decision to use, or not to use, alcohol or drugs. Desperate to save the young person from possible self-destruction, this statement is an unwelcome one because it sounds like saying there is nothing they can do. Untrue. It is actually the key to understanding the help that they are empowered to give. 

When a hard problem like substance abuse or addiction is allowed to blur boundaries of individual responsibility in family relationships, then effective action is almost impossible to take. Two sources of great confusion in this situation are usually blame and guilt. The substance-abusing child often blames parents rather than take responsibility the guilty parents often blame themselves rather than hold the child accountable. 

The effects of a child s substance abuse and addiction don t seem to make good sense in at least three puzzling... 

At this point, counseling can help restore constructive parenting around the substance-abusing child. Why is this so important Because it s very hard for an unhealthy-acting boy or girl to get well in a family system that either models or reinforces its own unhealthy behavior. When parents are helped to replace their confused, inconsistent, and enabling conduct with firm and constructive stands, the afflicted child is given a healthy set of rules and expectations that he or she can choose to live by. 

The refusal to abide authority has usually allowed the substance-abusing child to back parents off from healthy structural stands they would normally take, five sources of their social authority losing influence in the process. 

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