Kids, drugs, mental disorders

Substance abuse and mental disorders in kids

By Tracey Maxfield

Substance abuse and mental health problems often seem to go together.

That poses the question, which comes first, the chicken (mental illness/disorder) or the egg (substance use)?

Some mental disorders such as anxiety, depression and bipolar disorder may contribute to substance use and addiction.

Similarly, substance use and addiction can contribute to the development of a mental disorder such as depression. When a child/teenager has a mental disorder and a substance use disorder, it is called a dual diagnosis.

Treatment and management of a dual diagnosis is very specialized and intensive as both the substance use and mental disorder must be treated.

It is important to note, that if a child/teenager is diagnosed with bipolar disorder and substance use disorder, when the substance use stops and is managed appropriately, the mental disorder will not suddenly disappear.

Mental disorders and substance use disorder have a strong environmental connection. Some studies suggest that environmental factors interact with genetic vulnerability during the developmental stages and can increase the risk of mental disorder and/or substance use disorder.

Many environmental factors are associated with an increased likelihood of a child/teenager developing a mental disorder and a substance use disorder e.g. traumatic events, chronic stress, ACEs (Adverse Childhood Events).

For example, kids with PTSD (post traumatic stress disorder) may turn to drugs or alcohol to reduce anxiety, numb the pain and avoid dealing with the traumatic event.

Furthermore, certain mental disorders increase the likelihood of a child/teenager developing a substance use disorder e.g. depression, bipolar disorder, schizophrenia.

Many areas of the brain are affected by substance use disorder. For example, the frontal lobe, which is involved in risk taking, impulse control, decision-making and emotional responses, can be affected by addictive substances such as alcohol and opioids.

Opioids are known to create an initial high, however, long-term, their continued use increase depressive symptoms and suicidal thoughts.

When a child or teenager develops a mental illness, depending on where the changes occur in the brain pathways it may increase vulnerability for the use of substances by enhancing the effects of the frontal lobe:

  • reduces awareness
  • dulls feelings of sadness,
  • negativity
  • alleviates unpleasant symptoms and/or the side effects of prescribed medication.

It has been suggested that many kids with severe, mild or subclinical mental disorders may use drugs as a form of self medication.

Some drugs such as opioids, benzodiazepines can reduce the signs and symptoms of a mental disorder; however, the effect is only temporary and over time, the drugs will exacerbate the signs and symptoms and create a vicious cycle.

For example, a teenager with social anxiety disorder takes Xanax to help her relax. When the anxiety returns, she takes more but the anxiety keeps returning and is getting worse, so she increases the dose of Xanax and this cycle continues until the teenager is unable to function without taking dangerously high amounts of Xanax constantly.

Continued use of alcohol and drugs will inevitably result in depression and increased suicide risk.

A child/teenager who has a mental disorder and substance use disorder, the risk of suicide is five to six times higher.

One third of teenagers who died by suicide were intoxicated.

Research shows that kids with ADHD, ODD, CD are more predisposed to use drugs, sniff glue or gasoline, while kids with depression, bulimia, anxiety, PTSD, schizophrenia tend to abuse drugs such as fentanyl, heroin and/or alcohol.

There is also a strong association between cigarette smoking, depression and schizophrenia.

Teenagers and young adults with schizophrenia have higher rates of alcohol, tobacco and drug use disorders compared to teenagers with other mental disorders.

Other factors that can contribute to substance use and mental disorders include:

  • Bullying
  • Stigma
  • Side effects of psychiatric medications
  • Misuse of prescription medications
  • Some research studies have found that mental disorder may precede a substance use disorder, suggesting that better diagnosis of mental disorders in kids, may help reduce comorbidity.

What can you do?

  • Do not overreact, become angry, threatening or judgemental
  • Seek first to understand, why is your child/teenager using drugs/alcohol, what is the appeal?
  • Ensure any medications, alcohol are stored in a safe location
  • Talk with and listen to your child/teenager. Be understanding, objective and supportive, show love
  • Seek medical help e.g. physician, treatment centre, counselling
  • Work together as a team, a family

If you suspect your child/teenager is using substances

  • Check medications, alcohol in home, is any missing?
  • Observe body language and behaviour e.g. mood swings, isolation, declining grades, locking bedroom door
  • Check computer, phone and monitor on-line sites visited
  • Is money or items in home missing
  • Are there any new friends in life
  • Follow up with school, friends, family
  • Look for drug paraphernalia
  • Is there an increase in mail, parcels for child/teenager
  • Talk with a physician, counsellor, substance abuse specialist

?Tracey Maxfield is a nurse, speaker, author, peer specialist and mental health/stop bullying advocate and educator. In 2017, she wrote a column for Castanet called Dementia Aware and in 2018, she published her first book Escaping the Rabbit Hole: my journey through depression. You can check out her videos and blog at www.traceymaxfield.com. She can be contacted at [email protected] 


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