by Wes Bertrand
Adolescents have to make many choices, including forming a certain view of self and life. A cultural message often sent to them is that they cannot be trusted to make good decisions for themselves and act responsibly. This paper examines the issue of adolescent substance use and abuse amidst this cultural climate. Various risk factors and prevention programs are investigated and understood in the context of a society that still views some drugs, such as alcohol, to be acceptable and appealing; the double standards regarding drug laws are also examined. Finally, the treatment approach of family therapy and an emphasis on profound philosophical changes, entailing rational values for adolescents, offer ways to deal with problematic drug use and abuse.
Adolescent Substance Use and Abuse: An Issue of Choice
Adolescence, like later life stages, is a time characterized by many choices. It lies somewhere between childhood and adulthood, which can be tough for those searching for a coherent philosophy to guide them through this period. They typically lack the necessary knowledge to make more adult choices, and they still retain the carefree energy from the lesser responsibilities of childhood. Thus, a metamorphosis is required that entails restructuring not only relationships to others of various ages, but also of ones own values and goals.
Oftentimes the philosophy that adolescents accept is somewhat sketchy; there may be blind spots and undeciphered meanings. Many of their ideas and beliefs about self, others, and the world are held implicitly, and therefore only exposed indirectly through behavior. Other influencessuch as edicts from parents, suggestions (or taunting) from peers, images and portrayals from the media, instructions and advice from teachers, and so ontend to pull the adolescent in different directions.
Oftentimes the persons own inner voice gets drowned in a flood of new experiences and points of view. In turn, it can be difficult to make ones fundamental assumptions about life explicit and to really understand the meaning and implications of ones behavior. The adolescent person may just go with the flow most of the time, and the cultural osmosis effect may guide many of his or her choices.
A Harmful Cultural Message
Certainly one of the worst cultural messages sent to adolescents is that they are incapable of making proper choices for themselves: They must be controlled by adults and punished if they break the adult-formulated rules. This lack of trust in adolescent functioning can only have harmful consequences for both adolescents and society. Adolescents are told to properly obey the commands and laws of society while being told that they are incapable of making the right decisions (i.e., until they reach a certain age).
Paradoxically, adults expect adolescents to exercise proper judgment not to break the rules, even though many of the rules are designed because adolescents supposedly lack the proper judgment in the first place. This obviously presents a severe double bind, in which some may conclude that they need not be very responsible and make good choices for themselves. A range of the moment, pleasure-seeking mentality may even arise. Thoughtless, careless, and reckless behavior sometimes occurs among those who have been told in so many ways that they are not to be trusted and will be penalized for "misbehaving."
Dealing with Substance Use and Abuse
Probably the most salient example of this cultural situation concerns the topic of this paper: Adolescent substance use and abuse. Some researchers in this area (Thomas & Schandler, 1996) have stated that "it is important to differentiate experimental and recreational use from problem usage and to determine problem severity; i.e., use, abuse, misuse, or dependence" (p. 3). This is done in order to ascertain the proper assessment and, hence, treatment requirements, because use, misuse, abuse, and dependence have different behavioral outcomes. Thomas and Schandler (1996) outlined various risk factors involved in the process of substance abuse. In general they encompass the biological, the psychological, and the sociocultural.
All sorts of contextual factors are involved in utilizing substances too, and they are typically taken into account when implementing methods of primary prevention (reducing the chances of use and abuse beforehand) and secondary prevention (minimizing the damage already done and halting further maladaptive behavior). A variety of community-based programs and projects have been initiated to deal with targeted risk factors such as academic failure, antisocial behavior (and alienation, rebelliousness, and lack of social bonding), family management problems, and community laws and norms partial to drug use (Harachi, Ayers, Hawkins, Catalano, & Cushing, 1996). Wodarski and Feit (1995) outlined a comprehensive program of education through concrete tasks and exercises involving students and parents; they advocate a multifaceted approach that gets adolescents thinking about the reasons and consequences for drug use.
Despite these extensive efforts, some have criticized the various prevention programs that emphasize education of adolescents. Jones (1992) stated:
Isolating Reasons for Drug Use
Many have often noted that peer influence plays an important role in drug use (although it is not necessarily a strong predictor (Weinberg, Rahdert, Colliver, & Glantz, 1998)); they have also noted that acceptance by peers especially and fear of rejection are key factors in the choice to do drugs (Beman, 1995). However, the very choice of ones peers and why that choice was made is rarely addressed. To say that peers influenced the adolescents decision to use, tends to deny the initial motivations to befriend those who engage in and encourage drug use in the first place.
The literature reveals that poorer family relationships, lower self-esteem, and general deviant personality characteristics are more common in those who use substances on a more frequent basis (Andrews & Duncan, 1997). The genesis of the trait of deviance is a vast topic; numerous factors of family and culture affect the choices of some adolescents to pursue self-destructive, and other-destructive, activities.
Related to the idea of self-esteem is self-efficacy, which entails a personal belief in ones own competence and coping skills in particular life areas. Measures such as the Situational Confidence Questionnaire have shown that ratings of self-efficacy tend to be lower for those adolescents who abuse substances; additionally, these ratings tend to be good predictors of substance use leading to abuse (Kirisci & Moss, 1997).
In various studies reviewed by Jones (1992), it was found that the status of an adolescents identity formation yielded strong probabilities of whether he or she was motivated to experiment with drugs, and continue using them. Adolescents formulate identities by way of different combinations of their degree of exploration and level (or lack) of commitment to certain ideologies and styles of behavior. While this is an interesting perspective to take, it still falls short of discovering how different identities are formed and how that affects the desire to use drugs.
Yet another correlation has caught the interest of researchers: A consistent link has been found between academic motivation and substance usean inverse relation. The higher the academic motivation the lower the rate of substance use (and conversely, the lower the academic motivation, the higher the rate of substance use). However, this finding does not hold for alcohol use, which seems to be a reflection of its social acceptability (Andrews & Duncan, 1997).
A Specific Substance of Interest
Alcohol is unique in our culture in terms of general expectations and acceptability. People usually talk about drugs and alcohol, implying that alcohol is in a class by itselfwhile drugs are those more mysterious substances that really alter a persons mind, behavior, and basic lifestyle. (A similar case can be made about cigarettes because, albeit recognized as harmful in many ways, they still are not commonly seen as a drug.)
Alcoholthough being by far the most destructive type of drugis still legal to use and sell (although not for adolescents). The amount of hypocrisy concerning this societal situation cannot be overstated. Adolescents are shown in myriad ways that consuming alcohol is a valuable way to pass ones timein order to get a "buzz" (euphemistically called "social drinking") or even to get drunk (i.e., high). The main reason given as to why they should not partake in this activity immediately is that they have not reached the "proper" age. By this standard, what better way is there to prove that one is older than ones years than to start using alcohol?
From the media, festivals and celebrations, sporting events, college campuses, bars, and dinner parties, to the actual people who make, distribute, and advertise the numerous kinds of alcoholic drinks, the acceptable nature of alcohol consumption is continually stressed. Certain caveats are provided for the uninitiated thoughfor example, "Dont drink and drive" (just drink) and "Know your limit."
A curious person might ask why alcohol is legal and other drugs are not. Further, since the laws ostensibly preventing illicit drugs from being used and sold are enacted for the "publics" good, why are not lawmakers (in concert with their lobbyists) also passing laws to prevent alcohol from harming the public? As Wodarski and Feit (1995) stated, little light can be shed on this issue by politicians and their supporters: "To explain the rationale behind the schedule of drugs and the determination of drugs which are illicit and licit often defies logic and credibility" (p. 204). To be sure, there are vested interests in keeping such socio-legal double standards intact.
Yet a deeper question concerns why adults do not trust adolescents with any type of drug by allowing free access to them. In this regard adults might be falsely attributing the main problem. Rather than the problem being with the person deciding to consume the substance, drugs themselves such as alcohol are blamed (Davies, 1997). In other words if drugs were legalized, adolescents might succumb to the evil effects of them (and drug pushers) and become mindless robots whose lives are then run by drugs.
On the other hand, those who lack belief in adolescents capacity for self-responsibility cannot even keep drugs a safe distance from them. Most teenagers have ready access to an assortment of mind-altering substances. This merely confirms the principle that it is futile to make a product in the free market illegal, specifically drugs (which of course have no clear and present danger issue like nuclear, biological, or chemical weapons). Peopleincluding adolescentswill seek out alternative ways to acquire the product they desire.
Legalizing drugs necessarily would lead us to focusing on why drugsincluding alcoholare seen as desirable and supposedly useful for living. We also could determine how individuals and society can reevaluate such desires, yielding beneficial outcomes.
Determining Proper Treatment
As discussed, many factors surround the issue of substance abuse in adolescence. Before much headway can be made in substantially reducing the high rates of drug use and abuse, our culture needs to rid itself of all the contradictory messages sent to adolescents. Trying to develop and embrace a philosophy that leads to a healthy, happy, and productive life becomes much more difficult when adults are unsure of their stance on using substances that alter ones mental functioning and perception of reality, and their stance on the particularly "pleasurable" feelings associated with these practices. Harboring a covert notion that drugs are a forbidden fruit definitely undermines the current mantra of educators, "Just say no." Furthermore, the "Do as I say, and not as I do" phrase (implied in drinking age laws) has worn pretty thin in a society with adolescents as cynical and wary of authority (and as astute) as ours.
In a review of the literature and meta-analysis, Stanton & Shadish (1997) stated the superiority of family therapy (not support groups or psychoeducation of the family) over other treatment modalities for adolescent substance abuse disorders. Family treatment approaches that include wider and surrounding ecological systems should prove even more useful, because they deal with more influences.
Regardless of all the factors that are seen as contributors to substance use and abuse, the primary one in prevention inevitably lies within the adolescents own mindspecifically in the values adopted and the philosophy of life entailed in those values. A hypothesis that the degree of belief in selfthat is, ones level of confidence and self-respect, as well as the feeling of being worthy of happinessdirectly affects ones choice to use and abuse drugs could be explored in research. Additionally, when a rational philosophical outlook that is in service of ones own life and well being is recognized, it should reveal that adolescents who are taught and shown this perspective, and as a consequence strive to maintain it, also avoid substances that ultimately serve little benefit.
A rational philosophy upholds comprehending and functioning in objective reality, not reality as perceived through the distorted lens of a particular drugs influence. Long-term, life-giving values are certainly not facilitated through lowering ones awareness of self and reality or escaping from it. Each adolescent knows, at least on some level, that short-term "pleasures" are no substitute for happiness and self-esteem. Our task as adults is to encourage the transformation of this knowledge into action.
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