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(7) Drugs & Child’s

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Natalia Yefimova

Natalia Efimova

How to Know If Your Children Do Drugs

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How do you define/where do you draw the line between use, abuse, and dependency/addiction?

 Drug use occurs when one has used drugs with no resultant established pattern of habitual use, adverse consequences, or signs of dependence. Abuse and dependence is generally seen on a continuum with more criteria fulfilled for a dependence diagnosis.

One has to first establish the presence of dependence, which when fulfilled for a specific drug, overrides a diagnosis of abuse. Abuse and dependence share the presence of a compulsive pattern of drug use and loss of control over use with adverse consequences. Dependence is further characterized bythe presence of either or both psychological dependence and physiologic dependence.

Psychological dependence is established when one experiences craving and a perceived inability to function without using the drug. Physical dependence is characterized by the presence of signs and symptoms of withdrawal and/or tolerance. Tolerance is experienced after repeated drug use, when the amount of the drug being used does not effect the same high or the amount needs to be increased over time to achieve the same high. Withdrawal occurs when certain body reactions or symptoms, sometimes specific for a particular drug, are experienced after discontinuing use of the drug.

 Term:

 Psychological dependence - Loss of control (obsessive preoccupation) and the need to use a drug without the necessary physiologic change. It is manifested as craving or loss of sense of control over use.

Abuse and dependence is generally seen on a continuum with more criteria fulfilled for a dependence diagnosis.

Does my child’s temperament play a role in his drug abuse?

Temperament, already evident and stable during infancy and early childhood, is defined as aspects of one’s personality that are inborn rather than learned. These are usually defined along observable behaviors. Children described as having a “difficult temperament” (being emotional, having difficulties with change, or being overly sensitive or finicky) are at higher risk. They in turn exhibit externalizing (like anger outbursts) and internalizing (like anxiety or depression) problems by middle childhood and adolescence.

Other challenges include reduced attention span, increased impulsivity, and irritability. These are conditions that are seen in kids with attention-deficit hyperactivity disorder (ADHD).

 What are the family and environmental risk factors associated with adolescent drug use?

 There are heritable traits as indicated by twin and adoptive studies. They include:

 Peer Factors

 1. Peer substance use

2. Peer attitudes about substance use

3. Greater orientation (attachment) to peers

4. Perception(s) of peer substance use/attitudes

Parent/Family Risk Factors

 1. Parental substance use

2. Parent beliefs/attitudes about substance use

3. Lack of closeness/attachment with parents

4. Lack of parental involvement in child’s life

5. Lack of appropriate supervision/discipline

I have family members who have used drugs before but do not now. Can this play a role in my child’s drug use?

This confers risk but at the same time can be taken as an advantage. If your son or daughter has a good relationship with family members who previously abused drugs, the relatives can set their own negative experiences with drug use as examples from which the adolescent can learn. Sometimes, these family secrets can be hard to talk about, but with sensitivity and support, it can be openly discussed. Twin studies also point to 40-60% heritability for drug abuse and alcoholism. Sons of fathers with Type II alcoholism are at a nine fold risk of developing alcoholism. Type II alcoholics are characterized by onset of alcoholism before age of 25, male gender, and aggression associated with or without alcohol consumption.

They are likely to get excitement from new experiences (high novelty seeking), be unfazed by risks (low harm avoidance), and not be motivated by rewards (low reward dependence). In addition, parental alcoholism also confers increased risk to other psychiatric conditions like ADHD; conduct disorder (CD) and overanxious disorder.

Interestingly, individuals with similar risks who are using drugs are more likely to spend more time together than that which can be explained by chance alone. They attract each other!

Terms:

Alcoholism - Alcohol addiction or dependence, where there is uncontrolled alcohol use with adverse consequences.

Type II alcoholism - Type of alcoholism characterized by onset of alcoholism before age of 25, male gender, and aggression.

 Interestingly, individuals with similar risks and who are using drugs are more likely to spend more time together than that which can be explained by chance alone. They attract each other!

 

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