Adolescent vs. Adult Addiction

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Monitoring the Future – Michigan

MTF provides a wealth of data on the behaviors, attitudes and values of American youth since 1975. Funded by NIDA and NIH, the surveys are based at the University of Michigan.

Habilitation (learning drug-free skills) for adolescents vs. rehabilitation (re-learning previous skills) for many adults. The age of onset for addiction affects the prognosis and severity of addiction because of differences in the way the brain operates at different times in life.

The adolescent brain is often likened to a car with a fully functioning gas pedal (the reward system) but weak brakes (the prefrontal cortex). – NIDA

The National Institute on Drug Abuse (NIDA) has a wealth of information and publications about adolescent substance use disorder. Most of what we know about addiction is based on observation and treatment of adults. Signs of addiction in young people can include:

  • Changes in friends and personality
  • Increase in family conflict
  • Disciplinary action at school
  • Decline in academic performance
  • Decline in health
  • Loss of mental compass

Because the brain isn’t fully developed until about age 25 and patterns of behavior and personality are being laid down, it’s more susceptible to the distractions of drug effects. Cannabis, stimulants such as Adderall, and opioids are being used with increasing frequency. Alcohol has always been available. Because the adolescent pre-frontal cortex, which governs decision-making and moderates social behavior, isn’t fully developed, young people are more likely to experiment with substances that can interfere with the growth and stabilization of the pre-frontal cortex functions.

Timmen Cermak, MD, former President of the California Society of Addiction Medicine, who has specialized in treating adolescents with cannabis issues, says that “Addiction is a pediatric disease.”

The latest research and clinical experience suggest that young people should be put into treatment as soon as drug-addled behavior appears. Parents should not wait until they hit “bottom” as has been the rule for adults. Kids need habilitation, i.e. to learn good habits; adults need re-habilitation, i.e. to (presumably) re-learn good habits. Adult pre-addiction psychological pathology is an important assessment criteria.