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Being a teenager and raising a teenager are individually, and collectively, enormous challenges. For many teens, illicit substance use and abuse become part of the landscape of their teenage years. Although most adolescents who use drugs do not progress to become drug abusers, or drug addicts in adulthood, drug use in adolescence is a very risky proposition. Even small degrees of substance abuse (for example, alcohol, marijuana, and inhalants) can have negative consequences. Typically, school and relationships, notably family relationships, are among the life areas that are most influenced by drug use and abuse.

One of the most telling signs of a teen's increasing involvement with drugs is when drug use becomes part of the teen's daily life. Preoccupation with drugs can crowd out previously important activities, and the manner in which the teen views him or her self may change in unrealistic and inaccurate directions. Friendship groups may change, sometimes dramatically, and relationships with family members can become more distant or conflictual. Further bad signs include more frequent use or use of greater amounts of a certain drug, or use of more dangerous drugs, such as cocaine, amphetamines, or heroin. Persistent patterns of drug use in adolescence are a sign that problems in that teen's environment exist and need to be addressed immediately.

What causes adolescent substance abuse?
There is no single cause of adolescent drug problems. Drug abuse develops over time; it does not start as full-blown abuse or addiction. There are different pathways or routes to the development of a teen's drug problems. Some of the factors that may place teens at risk for developing drug problems include:

• insufficient parental supervision and monitoring
• lack of communication and interaction between parents and kids
• poorly defined and poorly communicated rules and expectations against drug use
• inconsistent and excessively severe discipline
• family conflict
• favorable parental attitudes toward adolescent alcohol and drug use, and parental alcoholism or drug use

It is important to also pay attention to individual risk factors. These include:

• high sensation seeking
• impulsiveness
• psychological distress
• difficulty maintaining emotional stability
• perceptions of extensive use by peers
• perceived low harmfulness to use

How do you know when to seek help?
The earlier one seeks help for their teen's behavioral or drug problems, the better. How is a parent to know if their teen is experimenting with or moving more deeply into the drug culture? Above all, a parent must be a good and careful observer, particularly of the little details that make up a teen's life. Overall signs of dramatic change in appearance, friends, or physical health may be signs of trouble. If a parent believes his or her child may be drinking or using drugs, here are some things to watch for:

• Physical evidence of drugs and drug paraphernalia
• Behavior problems and poor grades in school
• Emotional distancing, isolation, depression, or fatigue
• Change in friendships or extreme influence by peers
• Hostility, irritability, or change in level of cooperation around the house
• Lying or increased evasiveness about after school or weekend whereabouts
• Decrease in interest in personal appearance
• Physical changes such as bloodshot eyes, runny nose, frequent sore throats, rapid weight loss
• Changes in mood, eating, or sleeping patterns
• Dizziness and memory problems

Howard Liddle, Ed.D.