New Insight into the Ties Between Mental Health Issues and Youth Substance Abuse

For years, the pervasive conventional wisdom was that powerful social pressure and a desire to "fit in" were at the root of teenage drinking and drug use. Certainly there are individual instances in which peer pressure has led an otherwise straight and narrow youth into troublesome situations. New research from Finnish scholars, however, shows that the conventional wisdom may be dead wrong when it comes to wider trends: rather than increase youthful substance abuse, social phobia (a heightened fear in situations that could involve scrutiny by others) appears to actually decrease this problematic behavior in teens. Instead, the study revealed a more subtle culprit: general anxiety puts teens at nearly three times more risk of becoming problem drinkers. Without seeking the proper help, untreated anxiety can lead to irresponsible drinking and even drug use, which substantially raises the odds of a youthful drunk driving arrest or other serious offense that can have far-reaching consequences.

Understanding the Research

Published in the journal Alcohol and Alcoholism and authored by Sari Fröjd, Klaus Ranta, Riittakerttu Kaltiala-Heino and Mauri Marttunen, the Finnish study sought to explore how social phobia and anxiety affect adolescent alcohol and marijuana use. Finnish students aged 15 to 16 were surveyed to study the relationship between these mental health issues and substance abuse problems. A set of psychological questionnaires widely accepted in the field were used to indicate clinically significant symptoms of social phobia and general anxiety. In addition, depression, a factor strongly associated with both teenage substance abuse and anxiety, was also measured and controlled for. Finally, the researchers established criteria to delineate frequent problem drinking and marijuana use from normal experimentation. In total, 903 boys and 1,167 girls participated in the research. A two-year follow-up was conducted to gauge the progression of substance use problem behaviors over time.

It may come as no surprise that researchers found general anxiety increased a youth's risk for troublesome behavior. What may be less intuitive is the fact that general anxiety seemed to exacerbate the problem even when disassociated from likely contributing demographic and personal factors: after controlling for sex, family structure, parental educational levels and depression, general anxiety was still correlated with a higher incidence of frequent alcohol and marijuana use in the pool of teens studied. Among those teens who drank weekly at the beginning of the study, 65 percent with general anxiety were still drinking weekly two years later, a proportion considerably higher than for their peers who did not show signs of anxiety.

Perhaps more surprising were the results related to social phobia. In contrast to previous research, those who showed signs of social phobia were actually less likely to drink weekly. The authors of the Finnish study noted, however, that the prior findings only pertained to people who were legally old enough to purchase alcohol, and surmised that perhaps the elevated social acumen required for teenagers to obtain alcohol illegally was an insurmountable obstacle for adolescents suffering from social phobia.

How the Data Can Help

The authors of the Finnish study cited two likely theories regarding the link between substance misuse and anxiety: the self-medication theory suggests alcohol and drug use is a tool used by untreated youths to manage symptoms of anxiety, while an alternate theory poses that substance use may alter brain functions in such a way as to make individuals more susceptible to stress.

Link Between Substance Abuse and Criminal Activity

While the order of progression between anxiety and substance abuse is not fully understood, what is well understood is the link between juvenile substance use and crime: a five-year report released from the National Center on Addiction and Substance Abuse found that some 80 percent of youths involved in the juvenile justice system had used alcohol or drugs immediately preceding their crimes, were detained for an alcohol or drug offense, or admitted substance abuse problems. Yet, in the American system, a stunningly low number of youthful offenders are offered any form of substance abuse treatment.

The authors of the Finnish study hope that doctors, health officials, and parents can utilize their research to intervene at the outset, when signs of the problems underlying substance abuse first appear. If teens' mental health issues are targeted early, they can be treated before alcohol and drug use become risk factors for dangerous or even criminal behavior.

If your child shows signs of worrisome behavior or has gotten in trouble with the law - even with something as seemingly minor as a minor in possession of alcohol offense - it may be important that you seek professional help. Often, there are many treatable issues underlying a youth's questionable behavior. With the proper assistance, you can deal with your teenager's legal difficulties and be able to focus on a holistic, treatment-oriented approach to help them address the real problems.