Drug Abuse in Children - Causes, Symptoms & Preventive Measures

A 10 – year-old school-boy was brought to the child guidance clinic by his parents with problems related to petrol sniffing. A detailed evaluation revealed that he started to inhale it accidentally by applying his face against the keyhole of the petrol tank of his father’s motorbike to the point that it became a daily habit. The parents became aware of the drug abuse only after the child burnt his face while pressing it against heated parts of the engine in order to inhale more. The ensuing strict vigilance and the punitive measure could not deter him to continue.

After sniffing, he looked dull and remained drowsy for 2 hours. On a few occasions of heavy doses of inhalation, he had become transiently stuporous. The parents also reported that during this period, any confrontation would make him quarrelsome, aggressive and sometimes destructive. Temperamentally, he was an active child with intense mood shifts and poor attention span though he was adequately adaptable. [Know - Child Abuse Impact & Things to Do]

2nd case, A 17-year-old, tenth class drop out presented with multiple drug abuse including cannabis, alcohol, codeine, cough syrup, sniffing typewriter ink and whiteners and stealing sleep medications for the past 3-4 years.  He felt a very powerful intoxicating effect of the fluid with temporary unawareness of surroundings, visual hallucinations, odd behaviour and paranoid ideas lasting for about 3- 4 hours. He consumed up to 3-4 bottles of correction fluid every day and was preoccupied with the same craving and difficulty in controlling himself. He had frequent altercations, physical fights and legal problems due to his behaviour under the influence of fluid.

Drug Abuse in Children

Substance abuse among adolescents has become a major health and social problem in India.  Longitudinal research in adolescent alcohol and drug abuse suggest that consumption of alcohol and drugs in adolescence has important consequences during young adulthood including delinquent behaviour, physical and psychological disturbances, unstable work patterns and higher divorce rates.

Children from alcoholic families demonstrated more disturbed school careers, impulsivity, rebelliousness and non- conformity. Children whose mothers consumed alcohol during pregnancy suffered from Foetal Alcohol Syndrome (FAS). It was noted that children suffering FAS turned out to be long term drug abusers.

Symptoms of Drug Abuse in Children

Here is the parent checklist or indicators of child & adolescents substance abuse/drug abuse

Physical Changes

• Eyes bloodshot; extremely large or small pupils; watery, with blank stares or nystagmus
• Deterioration in physical appearance; rapid weight loss; evidence of unexplained injury (e.g., cuts, bruises); unusual body breath or body odours

Emotional Changes

• Extremes of energy and lethargy; insomnia and excessive sleep or fatigue; dramatic appetite fluctuation
• Marked or rapid changes in school grades, social activities, or peer groups; irresponsibility with money
• Clinically significant levels of depressions or anxiety, or onset of multiple deviant behaviours not evident in childhood

Health Changes

• Chronic coughing, sniffing, black phlegm
• Evidence of Intravenous drug use (needle tracks) or inhalation (perforated nasal septum)
• Skin boils or sores; nasal bleeding

Behavioural Changes in School

• Attendance- truancy, suspension, expulsion
• Academic performance- Decreased grades, decreased comprehension, decreased motivation
• Problems with authority and peers

Behavioural Changes in Family

• Withdrawal- decreased contact and expressiveness
• Conflicts- Arguments, lying, running away

Behavioural Changes in Social Functioning

• Behaviours- Fights, Decreased communication
• Peer Group- changes in friends or  peer drug use
• Sexuality- Promiscuity, teenage pregnancy
• Reckless behaviour

Possible Risk Factors and Causes

Many risk factors and causes are associated with substance abuse:

Modelling - the effects of modelling and social reinforcement on the initiation of adolescent alcohol and drug abuse seem indisputable. For example, the majority of adolescents drink alcohol for the first time with parents or relatives at home and parental modelling has a significant impact on the adolescent’s attitude toward alcohol. Further, Peer support and instruction are responsible for a substantial portion of initial substance abuse as well as decisions to continue to use after initiation.

Family Functioning - Family environment also appears to be related to adolescent substance use. Children who report a lack of closeness, support and affection from their parents are more likely to use drugs and to maintain the abuse of those drugs. Children abuse substances as an escape route instead of facing problems head-on. Poor knowledge of coping skills within the family is a common pattern in children drug abuse. [Know - Teach These 10 Ways to Protect Child From Molestation]

Other family factors associated with adolescent substance/ drug abuse include parent-adolescent conflict and lack of family cohesiveness. Three main major areas of disturbance among families are adolescent problem drinkers are...

• parental deviance or anti-social behaviour
• parental disinterest and lack of involvement with the child
• lack of affectionate and supportive interaction between parents and children

Conversely, a positive, loving bond between parent and child is linked to a reduced likelihood of child drug abuse. Thus, family functioning is crucial in the initiation of substance use and progression from use to abuse.

Social Support - In the absence of adequate social supports, modelling and reinforcing alternative coping efforts, some teens begin to use alcohol and other drugs to cope with stress. Adolescents with a substance-abusing parent may be especially likely to use drugs as a coping technique. The combined experience of parental substance abuse and dysfunctional social modelling may lead to inadequacies in social functioning including impaired ability or willingness to solicit support from persons within and outside the family. Additionally, these adolescents not only acquire behaviour patterns consistent with their resource network but also develop beliefs and values consistent with a drug- use lifestyle.

Temperament & Personality - The cluster of traits usually seen in an adolescent drug user is rebelliousness, autonomy striving, liberalism, willingness to try new experiences and independence. Other temperamental traits that precede substance abuse include high sensation seeking, low self- esteem, poor impulse control, behavioural disinhibition and non-conventionality.

Emotional Health - Adolescent substance abuse is associated with a variety of deviant behaviours including several forms of psychopathology. They commonly display disruptive problem behaviours, acts of criminality such as stealing, assault, and malicious damage and symptoms of depression, including suicide ideation, anxiety and anger.

How You As Parents Intervene?

Parental intervention is crucial in dealing with Substance/ drug abuse. Intervention is along two major lines...

•    Prevention &
•    Psychological Intervention

Ways with Which You Prevent Drug Abuse

It is common knowledge that it is safe than to be sorry.

• Educate yourself and your child about the effects of substance/drug abuse. Attend substance abuse prevention camps with your adolescent. Ajay, sober for 6 months revealed in de-addiction therapy that he, his peers and his family were unaware of the effects of substance abuse. The more you know the better armed you are to handle a crisis due to substance abuse. Discuss the effects of substance abuse openly during family discussions. Challenge their thinking by asking their opinions on issues related to substance abuse
• Visit De-addiction centres to expose your adolescent about the issue. Create Playgroups where children are exposed to tasks such as poster making, paintings or which revolve around the substance abuse theme.
• Maintain loving and cohesive relationships within the family - A home should reflect a circle of love, support, respect, forgiveness and balance. Apart from functioning as a family each parent, child and sibling need to invest in healthy one to one relationships amongst each other.
• Remember apple does not fall far from its branch - If you are abusing any sort of substance, socially or every day, at home or outside, be aware; your child is watching you. Seek help if you are struggling with substance abuse. Change your patterns of shame, guilt, failure and disappointment. Achieve balance.
• Teach Coping Skills to deal with loss, trauma, failure, rejection, fear and anxiety. Teach your child to live in the ‘here and now’. Help your child with the bigger questions in life. Communicate with your child about issues best done through listening. Save your judgements for a time when the child is calm and not emotionally high.

If you have recently discovered that your child is abusing substances, I would recommend to:

• Remain Calm - Do not panic. Very little is achieved by being worried or afraid. Breathe. Compose yourself because you need to help your child.
• Open Channels of Communication - Address the issue calmly. Speak about the issue openly by saying, “I discovered that you are smoking, I am wondering if we could talk. It is natural to try things at this age but understand that all the things you try may not be good for you.”
• Seek Professional Help - Counselling and psychotherapy are crucial in dealing with emotional disturbances and destructive behaviours.
• Consider Family Therapy - Even if your home reflects love and support, it’s possible that when the family addresses the issue together, the chances that your child feels as a pariah is significantly reduced.

Last but not least: Always be hopeful - Remind your child and your family that no matter what you will tide over the difficult time. Reassure that the problem is not just the problem of the adolescent but that of the entire family.