What is it?
People use a wide range of substances without problems, from coffee in the morning to a glass of wine with dinner. Just because a child or youth is using substances doesn't mean they have a substance use disorder, but it is important to talk to them if you are concerned they may have a problem.
Types of substances:
- stimulants - also called uppers (cocaine, speed, nicotine)
- depressants - also called downers (alcohol, Xanax, Valium)
- opioids - (such as fentanyl or prescription drugs such as Oxycontin)
- hallucinogens - also called psychedelics (LSD (acid) and magic mushrooms)
- cannabis - also called marijuana, pot or weed
The way a substance affects you depends on:
- the type of substance (tobacco, alcohol, etc.)
- your nature (age, gender, drug use history, mental health, etc.)
- the context (how much, how often, method of use, atmosphere, other drugs)
Some important words and their meanings:
If a person uses a substance often, they may develop a tolerance and need to use more and more to feel the same effect.
- Physical dependence is when a person's body has become tolerant to a substance and they have negative physical symptoms (withdrawal) when they stop taking it suddenly.
- Psychological dependence is when a person believes they need the substance in order to function properly, but they are not physically dependent.
When a person who is physically dependent on a drug stops taking it suddenly, they may have physical symptoms. Anyone can feel the withdrawal symptoms after one use as our bodies are always trying to maintain a balance. Examples: experiencing a hangover after drinking, nicotine cravings from smoking or vaping, or low mood after using MDMA.
This means using large amounts of a substance in a short time. It often results in falls, accidents, violence and unwanted sexual activity. An example of heavy use is binge drinking.
To some people "addiction" means that a person has developed tolerance to a substance and has withdrawal symptoms when they stop using it. But not all substances cause tolerance and dependence. People can also become psychologically dependent on a substance but they do not experience physical withdrawal symptoms if they stop using it. There are many other issues related to the use of the term "addiction". We prefer to use the phrase "substance use problem" or "problematic use" for when a person is experiencing negative consequences as a result of their substance use.
How substance use can become a problem
Some youth start to use substances to help them cope with stress, anxiety or depression. There may be conflict at home, school or among their peers. They may be questioning their sexuality. Some children and youth are also more likely to take risks than others. And, sometimes they begin using substances such as nicotine because they think it will lower their appetite.
Age is also important. The younger a person starts experimenting with substances, the more chance they'll develop problems.
When a child or youth use substances, they usually don't understand that it can lead to emotional problems or make problems worse. This is especially true if they are at risk for developing a mental health disorder. When someone has a substance use problem along with a mental illness it is called a concurrent disorder.
Stages of substance use:
- Non-use: not using at all.
- Experimental use: when a person tries substances for the first few times. They may be curious, want to fit in or believe that nothing bad will happen.
- Social or recreational use: the person seeks out and uses a substance to enhance a social occasion. Use is irregular, infrequent and usually occurs with others.
- Regular use: means substance use has become part of the persons life. They may not give it much thought before they use and they may find it difficult or not want to engage in certain activities without using substances. The person may begin to develop tolerance or dependence on the substance during this stage. Regular use as a child or youth could lead to substance use problems later in life. It is important to point out that a sip of wine with a parent or caregiver on New Year's Eve or some other special occasion is not considered "regular use".
- Problematic Use: means the use of substances is having negative consequences on the person's daily life and may begin to affect their health. The person may think about getting or using drugs a lot of the time and using as much as possible. They may develop tolerance and dependence to the substances and experience withdrawal if they stop using (this depends on the substance(s) being used).
Types of Substances
How do I know?
A child or youth may try alcohol or other substances to see how it feels or as a way of pushing boundaries. It doesn’t mean they are bad or have a substance use problem. But, it is still important to talk with them about their substance use as it always carries some risk.
Here are some of the warning signs that a child or youth may be using substances. It’s important to remember that these could also be signs of something completely different. And, a child or youth may not have any of these changes but could still be using substances.
- change in overall attitude or personality for no other reason
- changes in friends, new hang-outs, avoids old crowd, doesn't want to talk about new friends, friends are drug users
- change in activities or hobbies
- drop in grades at school or performance at work, skips school or is late for school
- change in personal grooming, habits at home, not interested in family and family activities
- difficulty paying attention, forgetfulness
- loss of motivation, energy, self-esteem, "I don't care" attitude
- temper tantrums, sudden oversensitivity or resentful behaviour
- moody, irritable, paranoid, silly or giddy.
- extreme need for privacy, hard to reach, secretive or suspicious behaviour
- car accidents
- unexplained need for money, stealing money or items
- drug equipment
- changes in appetite or eating habits, unexplained weight loss or gain
- slow or staggering walk, poor coordination
- problems sleeping, awake at unusual times, unusually lazy
- red, watery eyes, pupils larger or smaller than usual, blank stare
- cold, sweaty palms; shaking hands
- puffy face, blushing or paleness
- smell of substance on breath, body or clothes
- hyperactive, extremely talkative
- runny nose, hacking cough
- needle marks on lower arm, leg or bottom of feet
- nausea, vomiting or excessive sweating
- tremors or shakes of hands, feet or head
- irregular heartbeat
Here are some signs that a youth is using drugs in a risky or harmful way:
- using to deal with negative moods
- using daily
- using before or during school or work
- using while driving or during physical activities
- using more than one drug at one time (called "polydrug use")
- using as their main way to have fun and relax
- using while aware of the harm it is causing
If you know your child is heavily or regularly using a substance, it could be a sign of trouble. They may be struggling with their relationships, school, work, sexuality or something else. It could also mean that they have been using a drug for so long that it has become a habit.
What can be done?
Model healthy behaviour. Children and youth are most likely to use substances in the same way as adults in their lives.
Model healthy communication skills. Be a good listener and respect the child or youth's right to have an opinion. Don't lecture or exaggerate the harm from substances. Allow them to talk openly about their experiences.
Encourage healthier choices:
- Encourage activities that make it harder to use drugs such as a sport or hobby that requires clear thinking and a healthy body.
- Explain the dangers of driving after drinking or using substances.
- Show how to turn down offers to use substances without feeling embarrassed.
- Teach what to do if something goes wrong. Suggest alternatives like asking you for a ride home from a party or taking a taxi home from a concert.
Be open, loving and involved. A youth who feels loved will have more confidence. They will handle pressure better and be more able to overcome problems at home and school.
Handle problems responsibly. If your child comes home drunk or high:
- Stay calm. Let everyone get some sleep before you have a big discussion.
- Notice their condition. Try to find out what they have been using and how much. That way you can judge if they are in trouble or just need time to sober up.
- Find out how they feel about the substance(s) they are using or have tried. Ask when, how often and with whom they have used substances. Get them to explain why they use substances, or what benefits they are getting out of it. This will help you create a new bond and keep the lines of communication open.
- Talk about your concerns. Explain how you feel and why you are worried about their substance use.
- Discuss healthier choices. Offer some ideas that have a different kind of rush or excitement like rock-climbing and mountain-biking. A fun goal to work toward may distract their attention away from substances.
Where to from here?
Sometimes love and attention aren't enough to prevent a substance use problem. If your child is struggling, you can get information about treatment and resources in BC by calling:
- The Alcohol and Drug Information Referral Service at 1-800-663-1441 (toll free in BC) or 604-660-9382 (in Greater Vancouver).
There are different types of treatment available including:
- Individual and family counselling with a psychologist or counsellor.
- Day treatment programs - your child is there during the day but comes home at night.
- Residential programs - your child stays at the treatment program site.
Children and youth usually don't need medical supervision while they go through withdrawal. If they do need supervision, they may have to attend a detox program before they enter a treatment program.
Most treatment programs want a child or youth to be referred for treatment by an alcohol and drug counsellor. The most important first step in getting a referral is to call the phone number above.