Research question: Is there any association between drug use and mental health problems among adolescents?
Comorbidity of drug abuse and psychiatric disorders in adolescence
Alcohol use/dependence and major depression
Nicotine and depression/anxiety disorders
Effects of drug use later in life
Increased depression among other psychiatric disorders
Alcohol dependence and drug use
Treating adolescent mental disorders
Screening mental health problems
Use of selective serotonin reuptake inhibitors (SSRI)
Severe side effects of antidepressants
No directionality in the association between drug use and psychiatric disorders in adolescents
Apply non-pharmacological treatments in clinical practice
A thorough understanding of the mental health problems resulting from drug and substance use among adolescents is important in paving way for proper prevention and treatment. This paper explores literature on the link between drug use and mental health problems among young people. A review of the effect of specific drugs on mental health has been focused with the aspect of comorbidity being appraised. The outcome of adolescence drug use later during adulthood is reviewed. Various available approaches to treatment of mental health conditions resulting from adolescence drug use have also been appraised.
Drug use, mental health, adolescents, psychiatric disorders, depression, and anxiety
Drug and substance use among adolescents and mental health problems
Drug and substance use among young people is a serious problem that exposes young persons to mental health problems since most drugs are psychoactive. Boys et al (2003) acknowledges that drug abuse among children and adolescents results to psychiatric comorbidity. Boys et al (2003) specifically identifies that smoking tobacco and/or nicotine is highly associated with psychotic disorders compared to the effects of alcohol use. Similar findings have also been reported by Farrell et al (2001) who identified higher incidences of psychiatric disorders among drug dependents compared to non-dependent individuals. While looking at the association between major depression and alcohol abuse and dependence, Fergusson, Boden and Horwood (2009) indicated that alcohol abuse or dependence led to development of major depression. This importantly dissociated the likelihood of major depression as leading to alcohol abuse and dependence and identified a good causal-link.
Looking into specific psychiatric disorders, Patton et al (1996) identified that there is a relationship between smoking, depression and anxiety among adolescents. Specifically, regular smokers are likely to record more depression and anxiety compared to occasional smokers. Rey et al (2002) reported an increase in depression among Australian adolescents who are regular users of cannabis. This study indicated an increase in cannabis use with age but noted adolescence as a climax age and depression also happens to be higher at this stage. Breslau, Kilbey and Andreski et al (1991) also reported nicotine dependence as being more associated with major depression among other mental disorders compared to alcohol and cannabis dependence. A pattern of comorbidity in drug and substance use and mental health conditions has been regularly reported. Regier et al (1990) for instance reported high prevalence of mental disorders among individuals who had alcohol use disorder. In addition, the likelihood of having a mental disorder increased tremendously with the use of more than one drug other than alcohol.
Individuals who had a drug or substance use disorder during their youth years are likely to suffer psychiatric disorders later in life. Kessler et al (1997) carried out a retrospective study among individuals with DSM-III-R disorders and identified that such persons were alcohol dependents in their youth years. The study thus concluded that it is almost certain that a NCS/DSM-II-R disorder has to occur in lifetime in association with alcohol disorders. In linking mental disorders among young adults, Copeland et al (2009) identified that psychiatric disorders that occur during childhood and adolescence are the highest predictors. This study further identified that adolescent psychiatric disorders such as depression mainly co-occur with substance disorders. Gibb, Fergusson and Horwood (2010) also identified psychiatric disorders suffered during adolescence to translate into serious problems including psychiatric-associated problems in adulthood. Fergusson and Woodward (2002) also affirmed that major depression as well as anxiety disorder occurs later in life among adolescents with drug and substance use.
Treating drug-related psychiatric disorders in adolescents
Assessing and treating mental disorders among adolescents is pertinent since these disorders are disastrous if left unaddressed. Williams et al (2009) acknowledge that the first step towards treating depression in adolescents is positively identifying the victims. The use of a strengths and difficulties questionnaire (SDQ) for screening psychiatric disorders in children has been suggested by Goodman et al (2000). Williams et al (2009) further states that use of selective serotonin reuptake inhibitors (SSRI) is the most widely used treatment. In recognition that there are cases of SSRI-resistant depression (about 40% of all cases), Brent et al (2008) have proposed the use of an SSRI in combination with cognitive behavioural therapy since it is a more promising intervention instead of changing into a different SSRI.
While considering use of antidepressants in treating adolescent psychiatric conditions, Birmaher and Brent (2008) caution that these drugs have serious side effects including suicidal ideation. This therefore calls for use of evidence-based treatment and supports the use of cognitive behavioural therapy. Zuckerbrot et al (2007) highlights that clinical practice should incorporate adolescent depression screening to prevent consequences of depression in adolescents and cites that this approach is highly accepted by patients.
Literature indicates a clear association between drug and substance abuse among adolescents and mental health problems. It is appreciable that later outcomes of drug and substance abuse have been studied. It is however unfortunate that there is paucity of literature on the direction of the relationship. Literature also reflects inadequate focus on screening adolescent depression thus treatment efforts are curtailed. It is important for further research to be done in order to identify whether psychiatric disorders result in drug and substance dependence or whether drug dependence lead to psychiatric disorders. Non-pharmacological treatments for mental disorders also ought to be highly applied in clinical practice