Addictions

Addictions in Children and Adolescents

When we think of addictions we often think of smoking, chewing tobacco, alcohol, or illegal drugs.  More recently, we have seen different types of addictions in children and adolescents such as the Internet, gambling, pornography and shopping.

Addiction is considered a chronic disorder that occurs when a person develops an uncontrollable habit of using substances or participating in behaviours despite negative consequences. Many of these behaviours can become physically addictive, which means that the person’s body begins to crave the substance or behaviour. More of the substance or behaviour may be needed to achieve the desired effect. 

Addictions also have a psychological component that is often even more difficult to overcome. Psychological addiction includes the rituals and emotions that often surround using the substance or the addictive behaviour and the addiction may start to feel like it is a major part of who they are as a person. People can become addicted to almost any pleasurable activity and their behaviours become addictive when they lose control and “need” the substance or behaviour instead of wanting it. When a behaviour becomes an addiction, it always has some negative consequences, which at times may not be noticed immediately. Negative consequences may include failing in school, difficulties with family and friends, getting into legal trouble (dealing drugs, stealing) and problems with their physical or emotional health. The addicted child or adolescent is so caught up in their own behaviours that it is difficult for them to see how their behaviour impacts those around them.

The common addictions in children and adolescents are

Internet Addiction

Internet Addiction refers to the excessive use of the Internet for game playing (gaming) and other purposes and it interferes with everyday life and decision-making ability. The Definition is the inability to cut back on internet usage, preoccupation with online activities, and symptoms of withdrawal such as anxiety, boredom, or irritability after a few days of not going online. Internet addiction in children and adolescents is not necessarily about pornography or gambling; rather, it is about the excessive use of any online activity.  This can also include instant messaging, social networking (like Facebook, WhatsApp) and blogging.

Some studies suggest that boys appear to be at a higher risk of Internet addiction than girls.  In addition, those who use the Internet for more than 20 hours a week, every day for online gaming are at higher risk as well.

Signs and symptoms

Psychological Symptoms:

• Depression
• Dishonesty
• Feelings of guilt
• Anxiety
• Feeling of euphoria
• Inability to prioritize or keep schedules
• Isolation
• No sense of time
• Defensiveness
• Avoidance of work
• Agitation
• Mood swings
• Fear
• Loneliness
• Boredom with routine tasks
• Procrastination

Physical Symptoms:

• Backache
• Carpal Tunnel Syndrome
• Headaches
• Insomnia
• Poor nutrition
• Poor personal hygiene
• Neck pain
• Dry eyes and other vision problems
• Weight gain or loss

Treatment

Individual therapy, group therapy, family therapy, behaviour modification and cognitive behavioural therapy (CBT) are common psychological methods used to control Internet addiction.

Smoking/Tobacco Addiction

Smoking (Tobacco) in children and teens has decreased since the 1990s.  However, the rates of cigarette smoking among high school juniors and seniors are still higher than those of adults.  The younger the smoking begins, the more likely it is that the child or teen will smoke as an adult, and the harder it will be for them to quit.

Other forms of tobacco favoured by teens include flavoured cigarettes, bidis, cigars, and hookahs.

Cigarette smoking puts children and teens at risk of serious medical problems, including respiratory ailments, gum disease, poor lung growth and overall poorer physical health and fitness.  

Smoking cigarettes have also been linked to harmful behaviours such alcohol and substance abuse, aggressive behaviour, carrying weapons, attempted suicide, depression and hi-risk sexual behaviours.

Tips for Parents

• Talk with their children about the harmful effects of smoking.  
• Try to never use tobacco in front of your children,
• Talk about ways to say “no” to tobacco use, even if the child/teen has a friend who is already smoking.  
• Try to avoid threats
• Be supportive and offer some tips, such as deep breathing, drinking water.

Alcohol Addiction

Alcohol is the most frequently used drug in Kerala. The effects of alcohol use in adolescents are difficulty with attention and concentration, memory loss, the use of other substances like marijuana and the tendency to not pursue more years of education. Studies indicate that the younger the person is when they start drinking, the more likely they will develop a problem with alcohol.

Teenagers who develop drinking problems may present with family risk factors including minimal to poor parental supervision or communication, family conflicts, inconsistent or severe parental discipline, and a family history of alcohol or drug abuse. Individual risk factors include problems managing impulses, emotional instability, thrill-seeking behaviours and the perception that the use of alcohol does not present a great risk.

Tobacco (Smoking) or Alcohol Addictions are perhaps the two most significant drug addictions in children and adolescents.  Smoking and alcohol, though legal are often considered gateway drugs both can lead to other illegal drug usages such as marijuana and other illegal drugs. Research indicates that children and adolescents who smoke or drink alcohol are many times more likely to use marijuana than those who abstain.  In addition, the younger the age the smoking or drinking begins, the greater the risk of a serious health problem.  Cigarette smoking and alcohol consumption are also related to a higher risk of engaging in dangerous behaviours. 

Treatment

Alcoholism treatment is usually treated based on the stage of the addiction ranging from management of risk factors and education to out-patient treatment such as counselling by a psychologist to intensive residential treatment followed by long-term outpatient care.  There are medications that are considered effective in treating alcoholism.  Cognitive behaviour therapy and aversion therapy are also using in de-addiction treatment. Twelve-step programs, such as Alcoholics Anonymous (AA) and other programs specifically designed for teens have been proven most effective in the treatment of alcohol and substance abuse.  

Glue Sniffing Addiction

Glue Sniffing is one of the ways that teenagers and adolescents have found to get high. Glue when inhaled in a vapour form tends to have a toxic effect on the body. Teenagers and adolescents have found this way of getting de-stressed and simply passing time as it is very cost effective and is not easy to detect. Glue Sniffing Addiction can be quite detrimental to the health of the individual as it contains various toxic chemicals.

The most common way of sniffing glue is to empty the solvent in a plastic bag and wrap the plastic bag around their mouth and then inhale deeply. Some people also heat the glue and then inhale it. Due to the instant effects of glue sniffing people tend to start using it chronically leading to Glue Sniffing Addiction.

Long-term Glue Sniffing Addiction may lead to respiratory failure and even coma. Using high amounts of glue for sniffing may also lead to heart failure.

Symptoms:

• Smelling of glue always
• Always have a feeling being invincible and exhilaration
• Having problems with concentration
• Problems with doing tasks at work, home or school
• Deterioration in personal relationships
• Lack of interest in normal activities.

Treatment

Once an individual is identified as having Glue Sniffing Addiction then prompt treatment is necessary to prevent any long-term complications. Treatment is mainly aimed at reducing the physical and psychological dependency on glue sniffing so that any potential serious complications can be prevented.

Medications will be given to the patient to prevent any damage to the heart during the withdrawal phase of treatment for glue sniffing addiction. A process of detoxification will be carried to remove all the toxins of glue from the body which may have accumulated over time due to glue sniffing addiction.

Glue Sniffing Addiction is more of a psychological illness than a mere physical illness and hence admission to a de-addiction centre’s is recommended where a thorough counselling of the patient will be done so that the patient is able to understand the harmful effects of glue sniffing and can come back to lead a more normal sober life.