What are the Links Between Mental Health Issues and Teen Substance Use?

teens-mental-health-issuesSubstance use is a recurring problem among large numbers of U.S. teens and younger children. Substance abuse experts and mental health professionals know that, broadly speaking, the presence of certain psychiatric problems increases the likelihood that people in these age groups will start drinking or taking drugs. In a study published in December 2013 in the journal Addiction, researchers from two U.S. universities examined the connection between three specific psychiatric problems — conduct disorder, depression and anxiety — and the onset of substance use among teenagers, preteens and younger kids. The researchers also looked at how the specific timing of these problems affects the risks for substance use.

Substance Use Rates

Every year, the National Institute on Drug Abuse and the University of Michigan track the rates for alcohol and substance use among U.S. eighth-graders, 10th-graders and high school seniors. The latest figures, gathered in 2012, indicate that roughly 13 percent of all eighth-graders, 28 percent of all 10th-graders and 42 percent of all seniors drink alcohol in any given month. In any given year, approximately 16 percent of all eighth-graders, 30 percent of all 10th-graders and 41 percent of all seniors use some sort of illicit/illegal drug or medication. Among high school seniors, the 14 most commonly used drugs and medications are (in descending order) cannabis (marijuana or hashish), synthetic marijuana, the opioid painkiller Vicodin (hydrocodone), the ADHD medication Adderall, the plant salvia, all tranquilizers, all forms of mind-altering cough syrup, MDMA (Ecstasy or Molly), all other hallucinogens, the opioid painkiller OxyContin (oxycodone), all sedatives, all inhalants, all forms of cocaine and the ADHD medication Ritalin.

Conduct Disorder, Depression and Anxiety

Conduct disorder is a serious childhood condition centered on symptoms such as purposeful violation of conduct norms or established rules, violence or aggression focused on animals or people, use of deceit as a tool for interpersonal manipulation, and property destruction (up to and including acts of arson). Depression most commonly refers to major depressive disorder, a serious illness that exerts a strongly negative influence on one’s mental outlook; it may also refer to several other conditions that feature a strikingly “down” mental state as a prominent or dominating symptom. Anxiety is the collective term for a range of disorders that make a person feel scared, panicked, threatened or insecure in circumstances that don’t trigger such reactions in the average individual. Children affected by conduct disorder often also have notable symptoms of depression and/or anxiety.

The Impact of Mental Health Issues

In the study, researchers from the University of Pittsburgh and Columbia University used information gathered from 503 boys to assess the connection between the presence of depression, anxiety or conduct disorder and the chances for initiating substance use. These boys, all participants in a long-term project called the Pittsburgh Youth Study, were tracked from age 7 to age 19. During this roughly 12-year interval, they were assessed for relevant psychiatric problems in each individual year, the presence of psychiatric symptoms over longer periods of time and involvement with either alcohol consumption or marijuana intake.

After finishing the study’s main phase, the researchers found that four psychiatric factors help predict the onset of involvement in alcohol use among teens, preteens and younger children: the presence of anxiety symptoms in any given year, the presence of conduct disorder in any given year, the presence of conduct disorder over longer periods of time and the presence of depression symptoms over longer periods of time. They also found that the presence of conduct disorder in any given year and the presence of conduct disorder over longer periods of time both help predict the onset of marijuana use in the same age groups.

Significance and Considerations

The study authors noted that recent anxiety symptoms, recent and cumulative conduct disorder symptoms, and cumulative depression symptoms were associated with earlier alcohol use onset. Recent and cumulative conduct disorder symptoms were associated with marijuana use onset. Recent anxiety symptoms were only associated with alcohol use onset among African-American participants.

On a broader level, they note that, while the connection between psychiatric problems and the onset of substance use is obvious, the specific nature of that connection is not fixed. Instead, it depends on the combined influence of the substance in question, the presence of specific mental health issues and the timing of mental health-related symptoms in any given individual. Addiction specialists, mental health experts and other professionals can use this kind of information to improve their understanding of substance use in teens and younger children, and also to potentially help prevent the onset of substance use in these age groups.