Higher drug abuse among gay youth likely tied to rejection

For a lesbian, gay, or bisexual youth, “coming out” is an extremely stressful, though important event that can result in improved self-esteem, social-support, and psychological adjustment.

However, a recent study found that the reactions to such a disclosure have a lot to do with the risk of those youths abusing alcohol and drugs.

Social rejection and drug abuse among gay youth

The results revealed that the more rejecting reactions a youth receives, the more likely they are to engage in drug abuse including alcohol, cigarette, and marijuana use. This was true even after researchers controlled for a number of other important variables like emotional distress and demographics (race, ethnicity, education, socioeconomic status, etc.).

This makes a lot of sense. After finally deciding to go through with such a monumental disclosure, harsh rejections likely cause some serious damage to a youth’s self-esteem, making escape by drugs an attractive option. Although coming out can eventually lead to increased self-esteem even for this youth, the road there is not an easy one.

The good news was that accepting reactions seemed to protect youths from the harmful effects of being rejected – Social support helps!

The researchers suggested that drug abuse prevention attempts with LGBT youths address the impact of rejecting reactions to sexual-orientation disclosure directly in order to hopefully reduce their negative impact.

Here’s a video about the difficulties of coming out in high-school:

Reference:

Rosario, Schrimshaw, & Hunter (2009). Disclosure of sexual orientation and subsequent substance use and abuse among lesbian, gay, and bisexual youths: Critical role of disclosure reactions. Psychology of Addictive Behaviors, 23, 175-184.

Parenting advice – What’s important when it comes to teens, alcohol, and drugs

Parents often ask us what they can do to prevent their children or teens from becoming alcoholics, drug addicts, criminals, and the likes. I’ve been all of these and more, and so I’d like to share my insight with you now that I’ve made it over to the other side:

You can’t prevent anything – but you can educate, inform, prepare, and support.

My family breaths success; it also breeds its. My father was a star athlete who turned into a star doctor and a star family man. He also never drank alcohol and couldn’t care less about drugs. My mother was a beauty queen who always helped me get the best grades in school, even if it meant that she ended up doing my art projects for me and keeping me up all night so I’d finish my work. I’m not sure if it was my perception or my parents’ actual wish, but I always felt like unless I saved the world, I would end up a nobody. Drinking enough alcohol to black-out and consuming every drug on earth was never supposed to be on my menu.

A recent article I read in a monthly psychology magazine (see my post on it here) talked about this sense of perfectionism in our culture and its effect on teen depression, anxiety, and alcohol and drug abuse. Did you know that these are highest among more affluent teens?

Advice #1 – Shooting for good performance is important, but focusing on it as a sole measure of success can lead to trouble.

I got gifts for grades, and the best gifts came only with the best grades. Anything short of perfect was pretty much frowned upon and considered “less than my best.” It became impossible for me to actually enjoy anything but the school subjects I excelled in (math, physics, chemistry). It wasn’t until I graduated from college and did some of my own exploration that I learned to appreciate art, English, and history as worthwhile pursuits. It’s a well-know fact in developmental psychology that you don’t reward behaviors that are supposed to be appreciated in their own right. If you do reward them do so with small gifts, nothing large. Big gifts take away the perception that the activity itself brought about enjoyment.

Advice #2 – Parenting requires consistency and openness, but leave the preaching for church.

This constant need for perfectionism also lead to the repression of many issues in my family.

My parents fought often when I was a kid, screaming loud enough for me to take my sister away often and go play. We never talked about the fights so I never managed to learn about conflict, relationships, or resolution. We never talked about my stealing either, whether I was stealing from my family (mainly my father’s porn) or from the neighborhood toy store. The one time I got caught, my father sternly told me to return my new toy and to never be caught stealing again. I began stealing away from my neighborhood; it would be years before he’d hear about me stealing again. It probably would have been better to sit down and talk about what just happened.

Later on, when my mother would find my weed in my room, she would hide it so that my dad won’t find it because he would get mad. We call that enabling. When I was caught stealing at my work, my father didn’t want to tell my mom, so as not to upset her, so he never brought it up again. We call that denial. Neither of these work since they don’t teach a child anything except how to hide things properly and that even responsible adults lie.

But research shows us that preaching is not a good parenting technique so stay open and talk about struggles without being hypocritical and trying to teach lessons that are obviously forced. Kids and teens pick up on that very quickly but they’re ready to learn from their parents.

Advice #3 – Don’t let your sense of pride, or your ego, prevent you from dealing with real issues with your children. Parenting requires you to be the adult in the relationship with your children even when things don’t go your way.

By the time my parents were forced to confront reality, things in my life had spiraled way out of control. They received a call from my LA lawyer telling them that their son had been arrested for some pretty serious drug dealing. My bail was set at $750,000 and I was facing 18 years in prison. That’s pretty difficult to ignore.

Ironically, my arrest, court case, and the year I spent in jail brought my family closer together than we had even been during my teen years or my later drug addiction phase. Having to actually confront many of our issues allowed us to bring some actual intimacy into the family I had run away from so many years before. The important thing was that my parents didn’t pull out the “we told you so” card but rather helped me confront my demons and treat them. It was the best parenting I’d received in my life and it worked.

My parents did the best they could. I know that. Still, I can’t help to wonder if worrying a little less about how things “should be” and a bit more about the reality of parenting their deviant son may have prevented the latter part of this story. Then again, there’s no guarantee of that either. That’s the most important parenting advice I can give when it comes to teens and drugs…

How much alcohol is too much drinking? Knowing your BAC can be key!

There has been some research suggesting that training people to better estimate their Blood Alcohol Content (BAC), can help reduce accidents and improve risk-taking while drinking among college students (see here and here respectively).

I’m including a recent piece from one of our readers, telling us about her first over-21 drinking experience in Las-Vegas. I think this story exemplifies that young adults may often consume more alcohol than they are aware of while underestimating its effects Continue reading “How much alcohol is too much drinking? Knowing your BAC can be key!”

Antisocial personality disorder – Drug policy and court mandated addiction treatment

gavelA recent study conducted by a group at the University of Maryland found that court-mandated addiction treatment is especially helpful for those with Antisocial personality disorder (ASPD).

Using 236 men, it was found the overall success for participants without ASPD was high (85%) whether the treatment was court mandated or not. However, for those with ASPD, a whopping 94% remained in court-mandated treatment, though only 63% stayed in voluntary programs!

ASPD is relatively rare in the general population, but it’s estimated that its prevalence is relatively high (some estimate the prevalence as high as 50%) among addicts in drug treatment programs. I personally doubt that ASPD prevalence is that high even among treated addicts but it is certainly higher.

The Maryland team’s findings have two important implications for substance abusers with ASPD that should be noted:

  1. Judicial mandates offer a way to keep them in addiction treatment programs.
  2. Voluntary participants may require special interventions to keep them actively engaged in therapy.

Recently, a colleague shared with me some great insight about research into the effectiveness of mandated treatment: Mandated treatment can be effective if implemented well, which may sound simple but isn’t within a system that is used to putting down prisoners and not building them up. However, without aftercare, even the best mandated treatment loses its impact quickly. When it comes to aftercare, when trying to determine the best form of it (outpatient, residential , intensive, medical, etc.) the best thing to do is to ask the released client – if the match between the client’s desires and the treatment provided is high, the results are significantly better.

Citation:

The interactive effects of antisocial personality disorder and court-mandated status on substance abuse treatment dropout. Journal of Substance Abuse Treatment 34(2):157-164, 2008

Will you get addicted? Signs of drug abuse

Everyone wants to know if they can become addictedEveryone wants to know if they, or someone they love will get addicted to alcohol or drugs.

• Parents want to know if their children are likely to become addicts, especially if there is a family history of addiction.

• Teens wonder if trying a drug will lead to a life of crime and shame.

So what are the signs of drug abuse?!

Unfortunately, I have to start with the answer you probably don’t want to hear: no single factor can be said to fully predict substance abuse. Instead, the equation can be thought of as an interplay of risk-factors and protective-factors.

Having family members with alcohol- or drug-abuse problem is an example of a risk-factor. The more risk-factors a person has the more likely it is that person will become addicted. Some risk factors interact to make the likelihood of addiction much greater than either factors alone.

Protective-factors are life events or experiences that reduce or moderate the effect of exposure to risk factors. Some examples of protective factors are: parental-monitoring, self-control, positive relationships, academic competence, anti-drug use policies, and neighborhood attachment.

Risk Factors Vs. Protective factors – An implicit battle

There are five categories of risk and protective factors including individual, school, peer, community and family. Examples of protective factors within the individual category include social skills and responsiveness, emotional stability, positive sense of self, problem solving skills, flexibility, and resilience.

Other aspects of the individual category include the gender and ethnicity of a person. Men are generally more likely to become addicted (likely because they are less prone for internalizing issues like depression). American-Indians are genetically more sensitive to the effects of alcohol, while about 20% of the Jewish population may have genetic variations that protect them against alcoholism. Overall, estimates regarding the genetic influence on addiction risk range from 40% to 80%. Much of that genetic risk lies in changes related to the functioning of neurotransmitters that play a part in the development of addiction such as GABA, serotonin, dopamine, NMDA. Those with mental disorders of all types are at an increased risk for developing an addiction.

Some factors, like stress, can be considered part of multiple categories. Individual variability in stress response (via the HPA Axis) would be part of the individual category, while levels of environmental stress can be part of the other four categories.

questioning-terrierThe home and school life of a child (part of the non-individual categories) can play a large role as either risk-, or protective-factors. If a child sees elders using drugs, they may view drugs as harmless, but children who are well prepared by their parents may better resist peer-pressure to use drugs. As we stated before, the earlier a person begins to use drugs, the more susceptible they are to harmless effects on brain structures and other bodily functions.

Certain methods of using drugs can also be considered risk-factors. Smoking or injecting a drug causes it to be more quickly absorbed into the bloodstream, producing an almost instantaneous high when compared with eating or drinking a drug. However, the quick rush of euphoria may soon dissipate and leave the user feeling the “rebound effect” making them crave the high again. This quick, short lasting, cycle is believed to encourage the user to want to the drug again in hopes of reaching that high.

Overall there is no one thing that can predict or protect against addiction. Instead, a combination of factors are always at play and the more aware a person is of these factors the more able they are to protect themselves.

Co-authored by: Jamie Felzer

Citations:

http://www.psychiatry.ufl.edu/aec/courses/501/risk%20and%20protective%20factors.pdf

http://www.drugabuse.gov/scienceofaddiction/addiction.html

http://www.aadac.com/documents/profile_youth_risk_protective_factors.pdf

 

420, smoking weed, and drug problems : Marijuana facts

Co-authored by: Jamie Felzer

It’s April 20th, or 4-20, and anyone who smokes marijuana knows what that means – It’s time to smoke weed- a lot of weed!

In honor of this “stoner” holiday, or perhaps in reverence of its implications, I wanted to put together a post that explored some recent findings having to do with the most commonly used illegal substance in the U.S.
These two studies deal specifically with smoking weed, teenagers, and drug problems.

Study 1 – Misconceptions of marijuana use prevalence

An article in the Journal of Studies on Alcohol and Drugs has revealed that most young adults greatly overestimate how many of their peers smoke weed. Teens surveyed believed that 98% of their peers smoked marijuana at least once a year – In reality, only 51.5% off the teens reported actually ever smoking marijuana.

To make matters worse, even though only 15% of the teens reported using once a month or more, the estimate among peers was closer to 65%!!! Since we know that perception of peer behavior affects adolescents greatly, such misconceptions can easily lead to false peer-pressure towards marijuana use.

So next time instead of assuming everyone smokes weed, think again.It’s one of the most commonly used drugs but the notion that everyone smokes weed is simply wrong.

Reference: Kilmer, Walker, Lee, Palmer, Mallett, Fabiano, & Larrimer (2006). Misperceptions of College Students Marijuana use: Implications for Prevention. Journal of Studies on Alcohol and Drugs, 67, pp. 277-281.

Study 2 – Teens reducing use can reduce marijuana dependence risk

This next study dealt with early patterns of weed smoking as possible predictors of later problems use. They followed more than 1500 respondents from adolescence (ages 15-17) into young adulthood (ages 21-24).

The article revealed some interesting overall patterns, but I’ll keep the results short and simple, it is 4-20 after all…

The good news? Teens who reduced their use during the first phase of the study (the teens years) were at a significantly lower risk for marijuana dependence and regular use in early adulthood. This suggests that successful interventions may be effective at reducing later problem use.

The bad news? All marijuana smokers who used at least weekly showed the highest risk for later problems even if they reduced their use… This is not that surprising of a finding though since dependence usually involves regular use.

The bottom line? Reducing marijuana use at any stage will lower your risk for later problem use, but those who find themselves smoking often are most likely to end up in some trouble even if they try to cut down. Knowledge is power, so if you think you might be at risk and are concerned, talking to someone can’t hurt. Knowing marijuana facts can’t hurt either.

Reference: Swift, Coffey, Carlin, Degenhardt, Calabria & Patton (2009). Are adolescents who moderate their cannabis use at lower risk of later regular and dependent cannabis use? Addiction, 104, pp 806-814.

For a different view on 420, see this video:


The cost of quitting alcohol and drug addiction – treatment tips for addicts

Many users are discouraged by the cost of drug and alcohol addiction treatment programs. The treatment programs that advertise, which are normally the only ones most people hear about (you know them: Passages, Promises, Betty Ford and more) may offer services that are worthwhile, but they may not and consumers have no way to evaluate this as they’re asked to spend tens-of-thousands of dollars per month (as much as $80,000 in some cases). Unfortunately, inpatient treatment is the only form of treatment most people have ever heard of and even though research does show that individuals can get a greater benefit from inpatient treatment, it usually makes a significant difference only for the most difficult addicts to treat, and I mean difficult – injecting drug users, those with numerous previous attempts, multiple time felons, and such. Still, when families contact me, it seems that they overwhelmingly believe that residential is the only way – But they’re wrong.

Many health insurance companies will help cover certain outpatient treatment programs (Like Matrix; Kaiser Permanente has their own) that can  help put the vast majority of those who are seeking addiction treatment on the right track. Many outpatient programs offer great bang-for-your-buck, delivering intensive treatment protocols that are evidence based and can help most addicts get better at a far reduced cost of only a few thousand dollars a month. Anything is better than doing nothing, and taking the first step is always the hardest move. Fact is, many insurance companies will not pay for inpatient or residential addiction treatment until outpatient options have been tried and failed. If clients feel they need the added security of a safe, drug free, residence they can combine outpatient treatment with a good sober living facility (but DO NOT pursue this option for patients with serious mental health issues until you’ve seriously consulted with professionals).

If you’re thinking about quitting, simply making your way to a 12-step meeting in your area can end up opening a whole new world of possibilities, but if that doesn’t work know that there are many more options. If you’re wondering about specific options for yourself or someone you love, feel free to contact me and I’ll do my best to help guide you. If you’re looking for a more anonymous, automatic way of doing some of this searching, make sure to check out our Rehab-Finder, it should help guide you in the right direction. We’re currently going through a real verification process to do some of the quality-assurance legwork for you!