The Diagnostic and Statistical Manual of Mental Disorders (DSM) offers help to facilitate the differentiation between what might be considered use vs. abuse or dependency.
- Experimentation: first use of psychoactive substance, most commonly alcohol, marijuana, or inhalants
- Non-problematic use: sporadic use, usually with peers and without negative consequences
- Problematic use: adverse consequences first appear (e.g., decline in school performance, suspension, accident, injury, arguments with parents or peers)
- Abuse: defined by one or more of 4 criteria occurring repeatedly over the course of the previous 12 months, but not meeting criteria for diagnosis of dependence:
Use of substance in hazardous situations (e.g., driving a car)
Substance-related legal problems
Continued use despite problems or arguments with friends or family
- Dependence: defined by meeting any 3 of 7 criteria during the past 12 month:
Withdrawal, which may be either physiological or psychological
Using more of substance or for longer periods than intended
Unsuccessful attempts to quit or cut down use of substance
Spending a great deal of time obtaining, using, or recovering from effects of the substance
Giving up important activities because of substance use
Continued use of substance despite medical or social problems caused by the substance
It is important to remember that all substance use is goal directed, whether to enhance socialization with peers or to manage sad, lonely, depressed feelings. If left unaddressed, any first time use can progress to continued use. Arguably, all adolescent substance users demand some form of intervention. The level and scope of the intervention depend on the severity of the substance use. All too often, adolescents are prescribed treatment that do not match their treatment needs. It is a travesty to provide experimentation level of intervention for someone requiring dependence level of care. The same holds true for providing abuse level intervention for someone only needing non-problematic-use level of care. This is usually the case when agencies or organizations lack the funding to provide the appropriate level of adolescent substance use and mental health treatments. Simply put, too little is as detrimental to successful treatment outcomes as too much! CEASE understands this! Therefore, CEASE’s first line of intervention with adolescents referred to our program is to provide a thorough assessment to determine their risk level and appropriate level of substance use needs.