Monday, October 12, 2015

Substance Abuse Disorder in Young Adults

Complexities in Practice and Understanding Theory

The above topic is a training I attended last Friday at Brynn Mawr College Graduate School of Social Work & Research. In order to keep my license to practice in the state of Pennsylvania, I must complete 45 hours of training every two years. In order to keep my job at Fairmount, I must complete 25 hours of training because that is what's required for DDAP. It is safe to say, I will be in a classroom as long as I want to keep my license and since it took a hell of a lot of work to get that license in the first place (besides sitting for state boards) I intend to make sure I keep it.

I work with a lot of patients between the ages of 18 to 30 years old and given that the average heroin addict is a white male between the ages of 18 to 30 years old from the suburbs, I chosen a class to address this population. I would rate this training as no more than adequate. Though, I did learn some new information most of the information I was already aware of. I wanted to learn more about prevention as well as more therapeutic interventions. There was very little information about prevention and the interventions spoken about such as Motivational Interviewing and Cognitive Behavioral Therapy are techniques I already use. I guess I wanted something more.

What I did learn;

Chester, Delaware and Lancaster Counties have the highest addiction rates especially as it pertains to opiates. It is not Philadelphia.

Most kids start taking pills right out of their parent's medicine cabinets right in the home. The message I received appeared "common sense", lock up the medications.

Environmental concerns around the pharmaceutical age and the minimization of the use of marijuana fuels the addiction process.

When raising your children "Explain not blame". We live in a time of "Prescription Explosion, Minimization of Marijuana, An Opiate Epidemic, College Age Drinking". One crushed 30 mg Percocet equals 5 bags of heroin. Kids ages 18 to 25 years old are the biggest abusers of prescription opioid pain relievers (right out of their parent's medicine cabinets), ADHD stimulants and anti-anxiety drugs such as Ativan, Xanax, ect. More than 3,000 young adults die yearly from prescription drug overdoses. Notice this number does not include heroin addicts. Today, drug overdose is the leading cause of death in young adults.

75% of opioid addiction patients switch over to heroin. More than 300 million opioid pain medication prescriptions are written every year which equals one bottle of pills per adult in America. I will add that this is one of my "pet peeves". I will never understand why doctors/dentists feel it is necessary to write opioid prescriptions for every little pain/procedure. One in twenty high school students has abused Vicodin, and one in thirty high school students  has abused Oxycontin. Guess what? Over 50% of them started at age 12 years old.

Then there is the myth surrounding today's marijuana and its addictive substance known as THC. In the 1970's and 1980's marijuana contained lower than 4 to 5 % of the addictive substance THC compared to today's marijuana which contains an average of 80 to 90 % of the addictive substance of THC. Because of the popularity of medical marijuana and the perception that marijuana is not dangerous has lead to a culture of acceptance. The problem is the concentration of THC in today's marijuana is a catalyst to mental health problems in our youth. Our brain does not even fully develop until age 25 years old so using a substance high in THC on an undeveloped brain creates problems with the brain. especially when it comes to impulse control, decision making and problem solving.

There was also a lot of discussion around process addictions and substituting one addiction for another. Many folks with substance addictions also have process addictions or those who become sober from the substances turn to process addictions such as gambling, codependency, internet, food, sex, pornography, gaming, body image and obsessive dieting and exercise, shopping, clothes, clutter, work, cutting, kleptomania, depressive cycles and being attracted to chaos.


38% of us cannot go more than 10 minutes without checking our cell phones, or email.

There is a whole new generation growing up in the technology age which fragments language and leads to fragmented relationships. Of course if we do not know how to form healthy relationships than we automatically decrease our much needed social interaction and supports. The most important thing adults can do is model behavior. Put the cell phones away at the dinner table and limited internet use.


82% of substance abuse and/or process addicts also have a mental health diagnosis. It does not matter which came first but it does matter that both are treated at the same time.

Counselors need to understand both addiction and mental health and learn to bridge the gap.

As a society we must remove the stigma of those with addictions and mental health diagnosis in order for proper treatment to occur. There are so many people who suffer in silence for fear of being an outcast in society. It is a disgrace how society treats those who suffer whether it be the individual or family.

"Remember if you do not heal from both you may not heal from either".

What can we do to help? EDUCATE EDUCATE EDUCATE

The important thing we can do to help our children as they enter into young adulthood is to build resiliency.  Kids who are resilient do better than kids who are not resilient. It can be developed over time because it is learned. Pay attention to your kids. Listen intend of preach. Nurture. Make your home a safe place. Model the behavior you want from your kids. Do not be inconsistent. Watch your unrealistic expectation of your children. Children who do not feel so good inside feel isolated and will look for external things to feel better. And remember that even the healthiest family framework can produce a child who wonders externally however if they were given a solid foundation, and they do not die prematurely as a result of the external instant gratification with help and support, they can come back and live healthy productive life.

(Michael Blanche MSS LCSW)

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