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Adolescence is a time of many physical and psychological changes and is a period of curiosity, risk-taking and challenging behavior. Teenagers look for new experiences, with a certain resistance to established rules. They do not pay particular attention to warnings about long-term health risks. It is normal to experiment and search for new feelings and emotions during this time. When they come into contact with a number of harmful substances, teenagers may be tempted by their euphoric, stimulating or sedative effects.

A one-off use of a substance does not necessarily result in addiction. However, use at a young age is a negative factor which increases the risk of addiction.

Addictions are brain pathologies defined by a dependency on a substance or activity, with harmful consequences. The most common addictive substances are tobacco and alcohol. These are followed by cannabis, and far behind opiates (heroin, morphine), cocaine, amphetamines and synthetic derivatives. Addictive activities include gambling, video games, sex, compulsive shopping or sports that are unsupervised or poorly regulated.

The diagnosis of addiction (or dependency) is based on well-established criteria, set by international mental health bodies. These criteria include the loss of self-control, the interference of consumption on school work, or prolonged consumption, in spite of being made aware of the problems it creates.
What are the main categories of addictions specific to teenagers?
During adolescence, the brain is still immature, and is therefore more vulnerable. The earlier consumption begins, the more harmful the long-term effects are.

ALCOHOL
Some teenagers may consume large quantities of alcohol, a trend which is known as binge drinking. The immediate consequences may be very serious, with teenagers becoming comatose. In this case, they must receive emergency treatment in a hospital facility immediately.
This massive consumption of alcohol may result in the destruction of two to three times more neurons that in an adult and it affects the creation of new neurons. Furthermore, early access to alcohol, prior to becoming a young adult around the age of twenty, increases the risk of alcoholism by two.

TOBACCO
Tobacco consumption increases the risk of disease: cancer, chronic bronchitis and heart disease. These risks are very often ignored both by parents and by teenagers themselves, as they are only visible in the very long-term, several decades after smoking commences.

CANNABIS
Regular cannabis consumption slows the development of neurons, affects cognition (the ability to think and memorize) and as a result modifies academic performance, motivation, risk-taking and psychomotor skills. It also increases exposure to psychiatric disorders. Smoking cannabis increases the negative effects of other substances consumed such as alcohol or amphetamines and the consequences can be very severe if a person drives a car or a motorbike under the influence.

ADDICTIVE ACTIVITIES
Teenagers lose the idea of time and spend an inappropriate amount of time on this activity. They give up hobbies, their social relationships suffer, and some may even begin to truant from school. When teenagers are not able to engage in this activity, it is felt in their mood; they may be sad, defiant or even aggressive.
What are the warning signs?
PHYSICAL SIGNS
Some substances create a dependency in the body. Stopping use triggers physical signs which reflect what are known as “withdrawal symptoms”, which vary according to the substance used: - Hunger (smoking), - Shaking (alcohol), - Pain and sweating (opiates such as heroin, methadone or other codeine-based drugs)

PSYCHOLOGICAL SIGNS
An addict cannot go without use of the substance. Abstinence is accompanied by edginess, anxiety and a feeling of unease. Any consumption of a substance or practice of an activity which becomes regular and which changes lifestyle (such as withdrawal from social life) must be considered as a warning sign of addiction, namely a genuine dependency on the substance or activity. For teenagers in school, any drop in academic performance should be taken seriously by parents.
How to avoid high-risk behavior?
The difficulty in prevention lies in the identification of high-risk behavior, without overacting when a teenager experiments, and yet not ignoring these initial cases of consumption.

1. Prevent the start of substance use or delay the age of starting: parents play a major role in this primary form of prevention. Alcohol, for example, should not be introduced within the family home until the end of adolescence. Inevitable video games – even for the very young – must not postpone the time they go to sleep. It is advisable, where necessary, to take away all digital items, tablets and telephones, from the bedrooms of children aged under fifteen and to try to supervise their use – with their agreement – for young people aged over fifteen.

2. Never stop the parent/child dialogue: parents’ availability at this pivotal age of adolescence is the best protection against abuse. Try to maintain shared leisure activities in order to have a better understanding of your teenager’s expectations and to keep up contacts.

3. Avoid regular use: by improving identification and taking action early. A drop in academic performance and isolation in relation to peers are signs which should alert parents.

4. Avoid damage to health and social relations: a first experience of expatriation for children aged between 12 and 18 may contain a risk. At an age when teenagers feel they are in a gang of friends, teenagers must be supported if moving to another country to avoid any risk-taking. Expatriation must be fully accepted as an opportunity by all family members.
What to do?
For substances, age is an aggravating factor and increases the risk of addiction. The age of initiation must therefore be postponed as much as possible. Early detection is the only effective prevention strategy. The main course of action to help a teenager is family: being there, talking with them, taking interest in their activities, making them feel good about themselves and providing guidance are the best protection against the risk of addiction. If a teenager becomes addicted, parents very often feel helpless and do not know how to tackle the problem. In this case, the teenager and the parents must seek help.

PSYCHOLOGICAL OR PSYCHIATRIC SESSIONS
There are several types of therapies.
- Cognitive behavioral therapy proposes alternative strategies to manage situations which play a part in the transition to addiction.
- Psychoanalysis works on boosting self-confidence.
- Family therapy provides support for parenting.

MEDIUM/LONG-TERM HOSPITALIZATION
When outpatient care is insufficient, hospitalization can deal with all the physical and psychological repercussions of withdrawal and can even support teenagers in resuming their studies.
How can MSH International support you?
MSH INTERNATIONAL can help you to locate facilities in the region you have selected for your child’s treatment. In terms of psychological sessions, MSH has set up an agreement with an on-line psychotherapy service: EUTELMED, accessible from any country and in many languages.
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