Any substance that changes the behavior, perception, thought, affect and consciousness of the person or affects the central nervous system of the person with another definition and can cause abuse and addiction is called psychoactive substance. Adolescence is very important in the emergence and therefore prevention of cigarette, alcohol and substance use, and it is known that substance use in adolescence increases the risk in the development of substance use disorder (SUD) (1,2). Although the number of epidemiological studies on the subject in Turkey is low, there is very little data on substance use in children and adolescents who do not continue their education. In a study conducted by Ögel et al. in 2004, substance use among children living on the street was 72%, and paint thinner was the preferred item.
Dr. Deniz YILDIZ said “Clinical evaluations are made by child and adolescent psychiatrists to diagnose substance use disorder. In these evaluations; Factors such as individuals' craving for the substance, the need to use more and more substances to achieve the same effect, the effort and time spent on this subject, previous control efforts, the problems caused by the current process in their daily life and relationships, and the physical and psychological problems that the person experiences when they do not use substances are reviewed and diagnosis is made accordingly. ''
There are some identified risk factors for substance use.
Among these, absenteeism from school and inadequacies in the academic field are at the forefront of the issues that should be emphasized, and children who are out of the school system are more exposed to the risk factors that await them. In addition, problems such as untreated depression, behavioral disorders, attention deficit and hyperactivity disorder, anxiety disorders, and post-traumatic stress disorder increase the risk of substance use disorder in children and adolescents that we observe in clinical settings. These children, who could not reach treatment under appropriate conditions, sometimes start to use cigarettes and sometimes drugs to cope with their current problems, and these uses turn into addiction if not intervened in a short time. In addition to all these individual factors, familial factors should not be ignored;
Substance abuse is a brain disease that unfortunately progresses chronically, has serious biopsychosocial consequences and can be treated with it.
It continues throughout life, especially if not intervened. The treatment process should be planned by considering the above-mentioned risk factors. In this context, the process should be planned to include the family, social environment and, if any, other existing psychopathologies of the child and adolescent. There are outpatient treatment programs developed for this process. Treatment programs include psychoeducation, drug therapy, cognitive-behavioral interventions and family interventions. Inpatient treatment programs can also be tried in cases where the outpatient treatment process is not successful or the person has difficulty in being involved in the outpatient treatment processes. Thus, the process is carried out in structured environments, and then studies are carried out so that individuals can carry the process to their own individual environments. In this context, it is obvious that a significant amount of time and effort should be spared for the treatment process. Considering all these, it is striking how valuable it is to make arrangements to prevent the development of substance use disorder in the first place.
1. Kumra S, Kranzler H, Gerbino-Rosen G, Kester HM, De Thomas C, Kafantaris V, et al. Clozapine and 'High-Dose' Olanzapine in Refractory Early-Onset Schizophrenia: A 12-Week Randomized and Double-Blind Comparison. Biological Psychiatry 2008; vol. 63, no. 5, p. 524–529.
2. Jordan CJ, Andersen SL. Sensitive periods of substance abuse: Early risk for the transition to dependence. Developmental Cognitive Neuroscience 2017; vol. 25th pp. 29–44.
3. Ögel K, Yücel H, Aksoy A. Characteristics of children living on the street in Istanbul. Re-Science Research Reports 2004; Istanbul Publication no 7.
