Social Media and Substance Use: What Should We Be Recommending to Teens and Their Parents?

With social media increasingly integrated into the lives of today’s teenagers, there are two urgent needs: for further research on online exposure to substance use and for clear recommendations to mental health practitioners, adolescents, and parents about the need to assess and monitor teens’ online exposure to substance use | Journal of Adolescent Health

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Image source: Roey Ahram – Flickr // CC BY-NC-ND 2.0

Teens and Social Media

In 2015, 92% of teens aged 13 to 17 years reported going online daily, 24% were online “almost constantly,” and 71% used more than one social networking sit. Social media use is associated with mental health problems including depression, sleep disturbance, and eating concerns among young people. Social media perpetuates social comparison in a world where everything is curated, which is particularly problematic for teens who may be more prone to depressive cognitions in the face of such social comparison.

Social Media and Substance Use

Substance use is rampant and often glorified by celebrities and others on social media. There have been reports of social media being used as a strategy for selling drugs, with hashtags facilitating the process of pairing buyers with sellers. Tobacco, electronic cigarette, and alcohol industries have widely integrated social media platforms into marketing strategies that are fully accessible to teens. In this way social media has opened up doors for these industries to market to youth even when direct marketing to minors is against the law or supposed to be internally regulated. The burgeoning cannabis industry is opening up even more opportunities for teens to have exposure to advertising through social media. Exposure to substance use imagery is associated with subsequent onset in use, which is why drinking alcohol and using drugs in movies warrants an R rating. Social media is harder to regulate.

Full reference: Costello, C.R. & Ramo, D.E. (2017) Social Media and Substance Use: What Should We Be Recommending to Teens and Their Parents? Journal of Adolescent Health. 60(6) pp. 629–630

Bullying’s lasting impact

A new study found that kids who are bullied in fifth grade are more likely to suffer from depression in seventh grade; and have a greater likelihood of using alcohol, marijuana or tobacco in tenth grade | ScienceDaily

legs-407196_960_720Although peer victimization is common during late childhood and early adolescence and appears to be associated with increased substance use, few studies have examined these associations longitudinally — meaning that data is gathered from the same subjects repeatedly over several years — or point to the psychological processes whereby peer victimization leads to substance use.

“We show that peer victimization in fifth grade has lasting effects on substance use five years later. We also show that depressive symptoms help to explain why peer victimization is associated with substance use, suggesting that youth may be self-medicating by using substances to relieve these negative emotions,” Earnshaw said.

Read the full overview via ScienceDaily here

The original research abstract is available here

Substance use, subjective well-being and interpersonal relationships among young people in foster care and private households

Long S.J. et al. (2017) BMJ Open. 7:e014198

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Objective: To investigate the association of living in foster care (FC) with substance use and subjective well-being in a sample of secondary school students (11–16 years) in Wales in 2015/16, and to examine whether these associations are attenuated by the perceived quality of interpersonal relationships.

Conclusions: Young people living in FC experience significantly worse outcomes than young people not in care, likely due to a range of care and precare factors, which impact adversely on subsequent social relationships. The analyses are consistent with the hypothesis that the associations of FC with substance use and life satisfaction are partially explained by poorer quality social relationships. Large scale, longitudinal studies are required to investigate the relationship between being in care and health, educational and social outcomes. Mental health interventions and interventions to reduce substance use and improve well-being in FC should include a focus on supporting healthy social relationships.

Read the full article here

Specialist substance misuse services for young people

A rapid mixed methods evidence review of current provision and key principles for commissioning

Public Health England (PHE) commissioned The Children’s Society to undertake scoping research in early 2016, to understand some of the opportunities and challenges currently facing those now responsible for commissioning and delivering young people’s specialist substance misuse services and to outline some critical good practice principles.

Four main commissioning principles have been developed for the commissioning and provision of specialist substance misuse provision for young people, based on the findings, research and evidence based guidelines.

This document is designed to provide prompts around some core principles for consideration when local authorities are commissioning specialist substance misuse provision, but is not intended to be a comprehensive commissioning guide.

Full review available here

Children who witness violence or are sexually abused are more likely to inject drugs as adults

ScienceDaily | Published online: 2 November 2016

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Researchers from NYU School of Medicine and The Center for Drug Use and HIV/HCV Research used a nationally representative sample of more than 12,000 Americans to explore associations between nine childhood traumas and adult drug use. Additionally: the association between sexual abuse during childhood and injection drug use was more than seven times as strong for males as females.

“Screening for and addressing childhood trauma may be an important strategy to prevent initiation of drug use,” said lead researcher Kelly Quinn, PhD, MPH, assistant professor at NYU School of Medicine’s Department of Population Health. “And for drug users, trauma-informed interventions throughout the life course are important for treatment and mitigation of relapse.”

Additionally, data found that neglect, emotional abuse, parental incarceration and parental binge drinking were associated with 25-55 percent increased odds of prescription pain reliever misuse.

Read the full research overview here

Substance abuse and personality disorder comorbidity in adolescent outpatients: are girls more severely ill than boys?

Korsgaard, H.O. et al. Child and Adolescent Psychiatry and Mental Health. 2016. 10:8

Background: Substance use disorders (SUDs) constitute a major health problem and are associated with an extensive psychiatric comorbidity. Personality disorders (PDs) and SUDs commonly co-occur. Comorbid PD is characterized by more severe addiction problems and by an unfavorable clinical outcome. The present study investigated the prevalence of SUDs, PDs and common Axis I disorders in a sample of adolescent outpatients. We also investigated the association between PDs and SUDs, and how this association was influenced by adjustment for other Axis I disorders, age and gender.

Methods: The sample consisted of 153 adolescents, aged 14–17 years, who were referred to a non-specialized mental health outpatient clinic with a defined catchment area. SUDs and other Axis I conditions were assessed using the mini international neuropsychiatric interview. PDs were assessed using the structured interview for DSM-IV personality.

Results: 18.3 % of the adolescents screened positive for a SUD, with no significant gender difference. There was a highly significant association between number of PD symptoms and having one or more SUDs; this relationship was practically unchanged by adjustment for gender, age and presence of Axis I disorders. For boys, no significant associations between SUDs and specific PDs, conduct disorder (CD) or attention deficit hyperactivity disorder (ADHD) were found. For girls, there were significant associations between SUD and BPD, negativistic PD, more than one PD, CD and ADHD.

Conclusions: We found no significant gender difference in the prevalence of SUD in a sample of adolescents referred to a general mental health outpatient clinic. The association between number of PD symptoms and having one or more SUDs was practically unchanged by adjustment for gender, age and presence of one or more Axis I disorders, which suggested that having an increased number of PD symptoms in itself may constitute a risk factor for developing SUDs in adolescence. The association in girls between SUDs and PDs, CD and ADHD raises the question if adolescent girls suffering from these conditions may be especially at risk for developing SUDs. In clinical settings, they should therefore be monitored with particular diligence with regard to their use of psychoactive substances.

Read the full article here

Psychiatric diagnoses in young transgender women

ScienceDaily, 21 March 2016.

Image shows  ink and watercolour illustration depicting the brain of someone suffering from depression.

About 41 percent of young transgender women had one or more mental health or substance dependence diagnoses and nearly 1 in 5 had two or more psychiatric diagnoses in a study of participants enrolled in a human immunodeficiency virus (HIV) prevention intervention trial, according to an article published online by JAMA Pediatrics.

Transgender youth — including adolescent and young adult transgender women assigned a male sex at birth who identify as girls, women, transgender women, transfemale, male-to-female or another diverse gender identity on the transfeminine spectrum — are a vulnerable population at risk for negative mental health and substance use outcomes.

The authors report prevalence for:

  • Lifetime and current major depressive episodes were 35.4 percent and 14.7 percent, respectively
  • Past 30-day suicidality was 20.2 percent
  • Past 6-month generalized anxiety disorder and posttraumatic stress disorder were 7.9 percent and 9.8 percent, respectively
  • Past 12-month alcohol dependence and nonalcohol psychoactive substance use were 11.2 percent and 15.2 percent, respectively

Read the full commentary here

Read the original research abstract here