A number of factors seem to be involved. There is loneliness from living away from home, there is more personal responsibility to manage, there is a desire to escape the hard challenges of independence, there is fear of not finding an occupational foothold in the future, there is more availability and diversity of illegal substances, and there is much more partying with peers, for example. The last stage of adolescence can be a hard time to lead a sober life.
As last stage adolescents experience more of what it's like living in a drug-filled world, they can proceed through five progressively serious stages of use very swiftly. There is EXPERIMENTAL USE - when trying a substance to see what it is like. There is RECREATIONAL USE - when liking use and continuing it for intermittent enjoyment. There is EXCESSIVE USE - when enjoyment leads to accidental or intentional excess. There is ABUSIVE USE -- when use causes the user significant harm. There is ADDICTIVE USE - when there is remorseful awareness of harm being done but one cannot stop using.
The good news is that most last stage adolescents do not get into abusive or addictive use; the bad news is that some of them do.
Sometimes concerned parents will ask: is there such a thing as an "addictive personality?" I don't know. At most I can say that I have observed three kinds of self-defeating behavior that frequently characterize young people who, on referral for assessment, turn out to be substance addicted.
When it comes to COMPLETION, what they start they usually don't finish. When it comes to COMMITMENT, they fail to keep important promises they make to themselves and others. And when it comes to CONTINUITY, they make all kinds of resolutions to install healthy and constructive regimens of living, but they cannot maintain them.
What they frequently describe is a life where, despite constructive goals to the contrary, they spin their wheels, they can't catch hold, they don't get anywhere, and they are constantly letting themselves or others down.
To understand how deeply painful addiction can be, let a voice of youthful addiction speak for itself. What follows is from a letter I received years ago in response to a newspaper column I had written about adolescence and substance use. It reads thus.
"Dr. Pickhardt, several years ago, just out of college and curious to see what it was like, I accepted an injection of an opiate. My life has gone one direction since. Down. I blame no one but myself and I can live with that responsibility. But what I find increasingly impossible to live with are the losses I brought upon myself. Not monetary or possession losses, though both have been catastrophic. But personal and emotional losses which have left me unbearably alone. I feel isolated and abandoned. My heart feels frozen. I trust no one. I long for the desire to be interested in work, in friends, in just getting out and spending money on something fun, instead of looking at everything and everyone in terms of how they might enable me to get a drug. Recently my parents visited from out of town and confronted me about my use of drugs and some legal problems that have resulted. They kept saying I must be physically addicted. I insisted I was not physically addicted, but as I pressed this point with them I realized I was only confusing and frightening them more. Because if I wasn't physically dependent on drugs, how else could they or I explain my behavior? What I could not bring myself to tell them was about my psychological addiction, my love affair with the needle, a love more powerful than my love for anyone. After they left I began to ask myself why am I living my life this way? Why do I need to torture myself and those I care about with this drawn-out suicide? Then it came to me that one reason is power. The power to destroy myself gives me a kind of power over other people, like my parents, who are made powerless to help me.
"Another reason is anger. Inside of me is a competent, intelligent, caring, even successful person whom I refuse to let out. I only permit myself to do enough to get by. And that makes me so angry that every time I stick the needle in my vein it is like saying ‘I hate you world! I'll show you how much I hate you by doing something hateful to myself!' I've lost so much - my self-respect, friends, something undefinable inside. I feel as though my heart is frozen. I withdraw around people. I don't want to be touched nor do I want to touch. Yet I am so very lonely. I'm dying inside. My pain is so deep that on the rare occasions that tears fall I feel as though they are being yanked from me. I am becoming less and less. I am so tired of having no choices. ‘It's never too late to recover.' That's what you said in your article. You were right. There is always a choice. I guess that is why I am writing you now. Because I realize I have two choices - to stay on the bottom or go up. To die or to recover. I don't know which choice I shall make, but I do know this. No one can know what addiction is really like unless he has been there. No agony has been greater, no struggle so difficult, no guilt or self-hate so intense. If I grow well, perhaps I'll write and let you know."
I never heard further from this person, but the painful and courageous honesty of his or her words gave me hope that perhaps the relief that was sought was found in a life affirming and not a destructive way. The letter itself struck me like a word to the wise, perhaps capable of telling other young people that even though they don't think addiction can happen to them, it could.
Should this eventuality occur, older adolescents need to know that active addiction (becoming compulsively dependent on the self-destructive use of a substance to survive) need not be irreversible.
Addiction is a highly complicit disease because the addict's choices are partly responsible for the habit forming dependency. That's the good or hopeful part of addiction because it is by claiming some degree of personal choice and responsibility that recovery becomes possible.
Enrolling in an in-patient or outpatient treatment program can be helpful. And, of course, profiting from the support, guidance, and sponsorship of Alcoholics Anonymous or derivative 12-step groups is still the mainstay of most recoveries.
For parents, it's important to remember that although a young person's choices do lead him into addiction, he did not choose to use in order to become addicted. From repeated episodes of use and from a growing craving for what the substance can provide, a chemical dependency has developed.
So don't blame your child for becoming addicted, but do support his getting help to break addiction's hold if that is what he wants to try to do.
Next week's entry: Early Adolescence and the Negative Mindset