Psychoactive substances and
new technologies abuse in
children and adolescents
Lenka Chudomelova
Department of Child and Youth Health
3rd Faculty of Medicine
Definition
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Psychoactive drugs are chemical substances
that affect the brain functioning, causing
changes in behavior, mood and consciousness.
Commonly abused drugs
Cannabinoids: hashish, marijuana
 Depressants: barbiturates, BZD
 Dissociative anesthetics: ketamine, phencyclidine
 Hallucinogens: LSD, mescaline, psilocybin
 Opioids: codeine, fentanyl, heroin, morphine, opium
 Stimulants: amphetamine, methamphetamine,
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cocaine, nicotine
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Other compounds: anabolic steroids
Why do people take drugs?
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To feel good
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drugs produce intense feelings of pleasure
euphoria is followed by other effects, which
differ with the type of drug used
stimulants (cocaine): the “high” is followed by
feelings of power, self-confidence, and
increased energy
opiates (heroin): feelings of relaxation and
satisfaction
Why do people take drugs?
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To feel better
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To do better
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social anxiety
stress-related disorders
depression
improve their athletic or cognitive performance
Curiosity and „because others are doing it“
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strong influence of peer pressure
Early signs of risk in the family
lack of mutual attachment and nurturing by
parents or caregivers
 ineffective parenting
 a chaotic home environment
 lack of a significant relationship with a caring
adult
 a caregiver who abuses substances, suffers
from mental illness, or engages in criminal
behavior
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Risk factors outside the family
inappropriate classroom behavior, such as
aggression and impulsivity
 academic failure
 poor social coping skills
 association with peers with problem behaviors,
including drug abuse
 misperceptions of the extent and acceptability of
drug-abusing behaviors in school, peer, and
community environments
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Drug abuse/substance abuse
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compulsive, excessive, and self-damaging
use of habit forming drugs or substances,
leading to:
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addiction or dependence
serious health damage (kidneys, liver, heart)
psychological harm (such as dysfunctional
behavior patterns, hallucinations, memory
loss)
death
Drug addiction/drug dependence
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compulsive craving for a drug which offers
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short-term intense relief/pleasure
rapid induction of emotional state individuals
normally are not able to experience
Development of addiction
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1st stage = FIRST CONTACT
 mostly in a group as a unique episode
 experience of belonging to a particular
group or culture
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2nd stage = EXPERIMENTATION
 a positive experience from the first contact
often motivates uncertain and anxious
children to continue
Development of addiction
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3rd stage = USAGE, restful phase
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trigger point (conflict, trauma)
because of the positive effect the child often regularly
returns
drug becomes part of their social life - perceived as
“the best period of his/her life ever”
evolves into compulsive patterns of substance-seeking
and substance-taking behavior that take place at the
expense of most other activities
somatic complaints begin to appear, breaking promises,
increasing need for money, occasional absence
following weekend trips, late arrivals home,
deterioration of relations in the family and at school,
loss of friends
Development of addiction
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3rd stage = USAGE, problematic/advanced
usage
develops after a few months rather years of usage
cumulating problems
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loss of control over drug use, desire to confide
loss of hobbies, lack of interest in school, work, family
conflicts and theft
serious health problems
young person perceives problems and tries to prove he's
got a control
5 – 10 days sober establish him falsely in his view
within next years the head currently runs two programs –
program of a drug and program of abstinence
Development of addiction
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4th stage = ADDICTION
unconditional loss of control over life
 drug brings nothing positive
 loss of dignity
 destruction of the closest relations
 delusion and inability to perceive reality
 loss of lust for life
difference between problematic usage and
addiction?
 doses of the drug
 ability to admit the addiction
Development of addiction
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5th stage = QUITTING
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never ending stage
life will never be as friendly as with the drug
experiencing pain
high motivation
great social support
ESPAD 2011 - Alcohol
ESPAD = The Europian School Survey Project on
Alcohol and Other Drugs
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1,6 %
60,0 %
strict nondrinkers
regular consumers
! Risk alcohol consumption rising !
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Example: drunkennes during last month admitted
37% of 16 year old:
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1/5 three times during the past month
5% ten times
ESPAD 2011 - Illegal drugs
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experience with:
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cannabis .......................... 42%
ecstasy ............................ 8,3%
hallucinogens .................. 5,6%
first experience in younger age
girls prefer to experiment with amphetamines
and sedatives
Consumption of tobacco, alcohol and
drugs in CR
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one of the leading positions in Europe
reasons
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high tolerance to consumption
physical and financial accessibility even for children and
youth
influence of media („celebrities“)
commercial interests
role models in the family
lack of control mechanisms and sanctions
Gambling
slot machines
 terminals
 electro roulette
 common cause
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lack of money (allowance)
lack of hobbies
peer influence
Virtual reality
internet addiction
 computer games
 completely identical problems as in drug
addiction
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Prevention principles
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prevention programes should enhance protective
factors and reduce risk factors (Hawkins et al.
2002)
prevention programes should address all forms of
drug abuse (legal, illegal drugs, inappropriate use
of legally obtained substances (Johnston et al.
2002)
prevention programes should address the type of
drug abuse problem in the local community
(Hawkins et al. 2002)
prevention programes should be tailored to
address risks specific to population characteristics
like age, gender, ethnicity (Oetting et al. 1997)
Risk factors x protective factors
Protective
factors
Risk facto rs
Domain
Early Ag g ress ive
Behavior
Individ u al
Lack of P a rent a l
Supervi s ion
Fa m ily
Parent a l
Monitoring
Peer
Acad e mi c
Competence
Substance Abuse
Drug Av a ilab ilit y
Poverty
School
Communi t y
Impuls e Contr o l
Antidrug Us e
Polic ies
Strong
Ne ighborhood
Attachment
Examples of preventive interventions
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Prior to birth
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preventing/delaying pregnancy in young and vulnerable
mothers
antenatal health service
antenatal educational courses/home visitation
Examples of preventive interventions
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Early childhood
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school preparation programes
school-based drug education
parent education
family therapy
Examples of preventive interventions
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Adolescents
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school-based drug education
peer intervention, peer eduaction
youth sport and recreation programs
mentorship
employment and training
Examples of preventive interventions
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Community based prevention
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education campaignes
homelessness strategies
crime prevention
regulation and law enforcement
judicial procedures
harm-reduction strategies (I.e. low threshold centers)
How to say “NO”
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assertiveness
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an important communication skill
learn to reject things that are not right for him based on his
conviction,
ability to say no can save the child from the very first contact
with the drug
self-confidence/self-esteem
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child should perceive that he is a unique human being
child with an adequate self-esteem would not use drugs to
confirm his confidence in relation to peers
Literature
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http://www.who.int/substance_abuse/publications/global_a
lcohol_report/en/
http://www.espad.org/
http://www.unodc.org/unodc/en/data-and-analysis/WDR2012.html
http://www.who.int/substance_abuse/links/othersites/en/
NIDA: Preventing drug use among children and
adolescents. (A research-based guide for parents,
educators and community leaders. Second edition.)