The Silencing of Adolescent Addiction: A New Public Health Crisis

Overview: Adolescent addiction has historically been disregarded due to cultural acceptance of experimentation with alcohol or other drugs. In a time when access to healthcare and the impact of addiction are so highly present, this vulnerable population continues to be overlooked. Adolescent addiction is a public health crisis that warrants attention.Proposal text:

Objectives: On average 9 out of 10 adolescents who misuse substances began using before the age of 18 (Welsh and Hadlands, 2019). Adolescent substance use has historically been categorized as typical teenage behavior, often referred to as experimentation (Van Wormer and Davis, 2018). Though the use of the term experimentation normalizes adolescent substance use, the long-term consequences of use beginning in adolescence can be detrimental to not only the adolescent but also the adult that they develop into (Welsh and Hadlands, 2019; Van Wormer and Davis, 2018). Epidemiologic surveys of adults suggest that substance use among adolescents frequently continues and worsens into adulthood (SAMHSA, 2014). Substance use, pre 15 years of age, demonstrates a variety of negative consequences including poor neurocognitive performance, atypical neuronal activation patterns, higher rates of mental health disorders and suicide attempts, increased risk for motor vehicle accidents, and decreased performance in academic settings (Otten et al., 2019). This presentation will address patterns and impacts of adolescent substance use both in NC and across the United States. It will reference a recent study that aimed to determine common characteristics of Substance use disorder (SUD)-related hospitalizations and patterns of discharge diagnoses among adolescents in North Carolina (NC).

Methods: Using the 2014 State Inpatient Database (SID), we identified discharge records associated with ICD-9-CM diagnostic codes for SUD. Adolescents between the ages of 13 and 19 were included. SUD and non-SUD groups were compared using the Student’s t-test for continuous variables and the χ2 test for categorical variables. A total of 1.1 million hospital discharges were analyzed. A uniform and a standardized coding system called Clinical Classifications Software (CCS) were used to identify cases.

Results: An estimated 3,276 teenagers associated with SUD were discharged from NC hospitals during the study year. Among adolescents with SUD, 53% were male, 62% were white, 24% were black, 8% were Hispanic (8%), and 6 % belonged to other races. Compared to patients without a SUD, patients with SUD had longer mean hospital stays (6.5 days vs 4.7 days; P < .0001). Adolescents with an SUD were commonly diagnosed with co-occurring mental health disorders. About 37% of the SUD-related discharges occurred in areas denoted in our study using zip code designations with mean household annual income < $38,999. A large proportion of the SUD-related hospitalizations (44%) were billed to Medicaid
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Conclusion: The literature reflects the connection between adolescent use and the propensity for continued use and diagnosis with an SUD in adulthood; it is evident that this is a growing public health crisis. The concerning data and literature identify a significant need to address prevention, treatment, and recovery services for adolescents not only in NC but throughout the United States. The need to educate current and future social workers on the existence of adolescent addiction as well as resources, treatments available, barriers to accessing treatment, and the importance of the provision of psychoeducation on alcohol and other drugs has never been greater in addressing this public health crisis.