Drugs and Alcohol - Effect on Juvenile Mental Health

Many of the young people in the juvenile justice system suffer from numerous personal, family and mental health issues when compared to the general youth population. In addition, these young offenders have higher rates or drug and alcohol use and report using drugs on a regular basis. Some of these minors report using drugs heavily and suffer from extreme substance use disorders. In many cases, minors will have both substance abuse and mental health disorders and have unique treatment needs. As experts learn more about brain development and how to effectively treat addiction and mental health disorders in minors, juvenile courts are applying these methods to help addicted youth receive appropriate treatment.

Traditionally, juvenile offenders were treated like adult offenders and were placed in locked juvenile detention facilities as a means of punishment. The main difference was that juvenile offenders were separated from adult prisoners for their safety, but were otherwise treated like prisoners.

Studies have shown that detention in locked juvenile facilities can be especially harmful to juvenile offenders and can lead to permanent psychological and physical damage. In addition, juvenile detention facilities have been shown to have little effect on recidivism rates and may actually cause juvenile offenders to be more likely to re-offend and to have become adult offenders.

Juvenile detention facilities also are not the appropriate place for minors with mental health or substance abuse disorders to receive treatment. Increasingly, courts are recognizing this and are placing juvenile offenders into community treatment programs. Many of the juvenile offenders passing through the juvenile justice system may suffer from substance abuse and mental health disorders that have gone untreated throughout their lives. This is often the underlying cause of the minor’s criminal behavior and, if appropriately treated, the minor can develop into a functioning law-abiding member of society.

In many cases, youth offenders may have substance abuse disorders and have coexisting physical, behavioral and psychological conditions. Typical drug or alcohol treatment may not be effective for these minors and specialized services may be required.

Some minors with chronic physical conditions and illnesses can be considered at risk for substance abuse disorders. This is especially true for young people who have pain-related ailments such as sickle cell anemia, migraines, arthritis or other conditions which are traditionally treated with opioids. Opioid abuse is rampant among minor offenders who often may abuse prescription painkillers or turn to illegal street drugs such as heroin once painkillers become unavailable. Determining appropriate pain treatment can be difficult, especially given the tendency to develop tolerance to large doses of narcotics. When treating minors, it is critical that the court ensures that the minor is receiving appropriate medical treatment but is not abusing prescriptions. Frequent testing is often necessary and the court may require that one trusted physician supervise the minor’s treatment and progress. When it is suspected that the minor has a substance abuse disorder and a medical condition, the minor’s treatment team must assess and treat both problems. There is often a tendency to focus on one disorder over the other which can lead to the minor receiving inadequate or ineffective treatment.

Coexisting substance abuse and mental disorders are increasingly common in juvenile offenders. It is critical that all disorders are treated as attention to the treatment of only substance abuse or other disorders may not produce optimal results. Studies have shown that minors treated for substance abuse often suffer from conditions such as depression, conduct/oppositional defiant disorder, and attention deficit disorder.

When a young person with a mental health disorder begins to use drugs or alcohol, both problems tend to get worse. Many young people use drugs or alcohol to treat depression or anxiety and there is often a rebound effect on the coexisting disorder is substance use is suddenly stopped. Having trained and experienced professionals involved in all stages of the treatment process is critical in minors with coexisting diagnoses.