Youth and Addiction:
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A Guide to Help Attorneys Make the Best
Choices for Addicted Youth in Trouble With
the Law
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Michael Crosby LCSW Ph.D.
Causes of Adolescent Substance Abuse
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External Factors
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Insufficient parental supervision and monitoring
Lack of communication and interaction between parent and teen
Poorly defined rules and expectations against substance use
Inconsistent and excessively severe discipline
Family conflict
Favorable parental attitudes toward adolescent substance use
Parental alcoholism, drug use, or abuse
Addiction during pregnancy
Peer pressure
Media Outlets
Misinformation
Causes of Adolescent Substance Abuse
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Internal Factors
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high sensation seeking
impulsiveness
psychological distress
difficulty maintaining emotional stability
perceptions of extensive use by peers
perceived low harmfulness to use
Self-medication
Low self-confidence
Boredom
Rebellion
Attention Seeking
Instant Gratification
Treatment Options
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Medications
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withdrawal and treatment
Behavioral Treatments
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Outpatient: Cognitive-Behavioral Therapy,
Multidimensional Family Therapy, Motivational
Interviewing, Group Counseling
Inpatient: Residential Facilities
Aftercare: Continued support after leaving
Treatment Options
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Treatment Programs
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Individual and group counseling
Substance abuse education
Family education
Recreation therapy
Mindfulness groups
Relapse Prevention
Dual-Diagnosis/Co-Occurring Treatment
Treatment
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Education must be a component for treatment
to be successful
Education must be a part of treatment for the
whole system (parents as well as the
identified client)
Education must include developing skills for
parents to learn to set limits and enforce
consequences for inappropriate behavior
Statistics of Teen Use
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More teens die from prescription drugs than
heroin/cocaine combined
More than 60% of teens said that drugs were sold,
used, or kept at their school
1 in 9 high school seniors has synthetic marijuana
1.3% of seniors have used bath salts
Young people who drink alcohol are 50 times more
likely to use cocaine than teens who never
drink
About 64% of teens who have abused pain relievers
say they got them from friends or relatives
Statistics of Teen Use
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Adderall use (mostly prescribed to treat ADHD) has
increased among high school seniors from 5% in 2009 to
8%
Only 35% of 12th graders believe that using Adderall
occasionally is risky
By 8th grade, 30% percent of adolescents have consumed
alcohol, 16% percent have smoked cigarettes, and 15%
have used marijuana
Teens whose parents talk to them regularly about the dangers
of drugs are 42% less likely to use drugs than those whose
parents don't. However, only a quarter of teens report
having these conversations.
7% of high school seniors smoke daily, up from 5% five
years ago
Statistics of Teen Use
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Marijuana- 17% of 10th graders and 23% of 12th
graders have used in the past month
Synthetic Marijuana- 9% of 10th graders and 11%
of 12th graders have used in the past year
Prescription Drugs- 15% of 12th graders have used
non-medically in the past year, yet only 35% feel
they are taking a risk
Alcohol- 15% of 10th graders and 28% of 12th
graders have gotten drunk in the past month
Cigarettes- 17% of 12th graders have used in the past
month
Consequences Leading to Treatment
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Neglecting Responsibilities
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Legal Ramifications
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Arrests, tickets, jail time
Problems in Relationships
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School, work, or home
Family, friends, significant other, job
Engaging in high-risk behaviors
Health problems
Adult and Adolescent Assessment
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Assessments for drug or alcohol addiction
evaluate the condition of each patient in
order to determine whether or not a
diagnosis of chemical dependency or
chemical abuse exists
Adolescents do not show the same
psychological, behavioral, and
physiological characteristics central to
adult assessment
Adult and Adolescent Assessment
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Adolescents and adults differ in the pattern of
alcohol and drug use as well as the
development of substance abuse
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Teens are less likely to abuse just alcohol, but are
more likely to abuse marijuana and other drugs with
alcohol
Adults in treatment are most likely there for just
alcohol dependence
Teens meet diagnostic criteria for substance abuse
faster than adults
Internal vs. External Motivation
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Internal Motivation
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Motivation driven by an interest in the task itself;
exists within the individual
External Motivation
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The performance of an activity to attain an outcome;
comes from outside of the individual
Family Involvement
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Practical Definition
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The active engagement and participation of family
members in the practice, program, and policy areas of
teen substance abuse treatment, recovery services, and
support
Importance
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Families learn about current services, policies and
procedures, emerging trends/challenges and research
on the system from professionals
Professionals learn about unique experiences,
perspectives, strengths and weaknesses from families
Family Involvement
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Three key areas of focus: Practice, program,
and policy
Practice
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Adolescent substance abuse treatment service
providers welcome, engage, support, and respect
families where they are
Family members gain awareness and understanding of
addiction as a brain disease, develop realistic
treatment and recovery expectations, and identify
available family support services
Family Involvement
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Program
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Families empowered to provide valuable input for
agency/program on quality improvement planning
Provide input into developing valuable community based family
support services
Policy
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Policy-makers listen to family member experiences, welcoming
and respecting family expertise and seeking family input as part
of the policy making process
Family members experience opportunities to influence policy and
develop relationships with policy-makers and other family
advocates
Difficulties With Family Involvement
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Problem is too severe
Family is the root of the problem
Family lacks resources
Failure of the foster care system
Failure of the Department of Juvenile Justice
Co-occurring Illnesses
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As many as 6 in 10 people with a substance
use disorder also suffer from a mental
health condition
Fewer than 10% of adults with co-occurring
disorders receive treatment for both
conditions; more than half of them
receive no treatment at all
Reevaluating Progress
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Have the interventions worked?
How would the teen be without them?
Possible improvements to treatment
Potential for relapse
Re-administering tests
?????????
Dealing With Relapse
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Between 66 and 80% of adolescents and adults begin using
again within the first six months after a treatment episode
Triggers: peer influence, life changes, socially isolated
situations, stress, over-confidence, complacency,
mental or physical pain, remembering the positives of
past using, boredom, self-pity
Support Team Relapse Prevention- keep drugs and
alcohol out of the house, praise and encourage, talk
openly about feelings of relapse and threats to sobriety,
relieve stress, encourage self-care practices
What to do after ??????????????
Drug Testing Strategies
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Type (hair vs. urine)
Frequency
What you test for
What is positive
Confirmation (GCMS)
Consequences
Aftercare Services in the Community
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Requires creation of a set of systems across
formal and informal social control
networks as well as the use of community
services to prevent relapse
Includes peer support group programs,
individual and family therapy sessions, and
relapse prevention strategies utilizing
friends, family, and leisure activities