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Screening kids for mental health issues can prevent drug addiction
“I want to be a drug addict when I grow up,” said no child ever.
Yet during the past two decades, there has been a meteoric rise in the number of people diagnosed with substance use disorders, as well as overdose deaths. According to the National Institute on Drug Abuse and the Centers for Disease Control and Prevention, there were more than 64,000 drug-related deaths in 2016, which is more than three times higher than in 2000.
Beyond the statistics, stark reminders of this ongoing crisis include the high-profile drug overdose deaths of Heath Ledger, Michael Jackson, Amy Winehouse, Whitney Houston, Prince and Tom Petty. These names are well known and therefore used for emphasis, but the tens of thousands who died during the same period, in the same manner, were no less important to their families and friends.
How do we begin to address this disease from a prevention standpoint? Well, I have some ideas, both clinical and personal. These are by no means comprehensive, nor will they guarantee success. However, my hope is that they will spark a debate amongst my peers, elected leaders and anyone else with the desire, intellect and courage to tackle this immense epidemic affecting our nation.
The first step in preventing addiction is to start prioritizing mental health as much as physical health. This would allow us to better identify those already struggling with psychiatric disorders, like depression, anxiety, ADHD or bipolar disorder. This is important because people with pre-existing psychiatric disorders have an increased risk for addiction. "Addiction" or drug use, abuse and dependence, all fall under psychiatric diagnoses too.
Moreover, we must further examine addiction to better understand its origins. No one intentionally plans to become an addict. It’s frequently the unfortunate result following years of emotional pain, physical pain or both. Many have significant trauma histories that altered their lives forever. They often seek the escape that drugs offer, rather than facing the pain.
Commonly, the easy escape offered by drugs becomes an inescapable burden, with the person requiring the drug to feel normal or to function. With early intervention, we could conceivably prevent that pain from becoming overwhelming and possibly avoid addiction entirely. This is the most important step because it could also reduce the alarming increase in American suicide rates, which closely resemble that of addiction.
Second, we must implement an evidence-based approach to prevent addiction. To echo a recent New York Times article, we should "treat addiction like we treat cancer," with prevention being the most effective and cost-efficient medicine of all. This can be accomplished by establishing standardized screening guidelines, both universal (everyone) and selective (those more at risk), to implement during childhood.
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Multiple programs, like those described above, already exist. However, the varying programs take different approaches, aren’t widely known and are in competition for the same limited amount of funding. The first course of action should be to establish a single agency to oversee the coordinated research, policy and practice of these screening guidelines. This should include both the medical establishment and schools, with implementation on a community level. Mandatory vision and hearing tests are already used in grade school to benefit our children’s health. With the goal of preventing addiction, existing health checks should include mental health screenings.
Third, we should learn from and employ proven results observed elsewhere. For example, Iceland previously confronted issues with teenage substance abuse and largely succeeded. During the past 20 years, a nation roughly a quarter the size of Louisville Metro reduced adolescent substance abuse from as high as 42 percent to approximately 5 percent or lower. This model cannot be simply "transposed" onto the U.S. with the same success due to the varying needs and resources of different localities. However, it does offer a wealth of valuable information.
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During Iceland’s decades-long analysis using anonymous surveys of children ages 10-16, the strongest predictors for avoiding adolescent substance abuse were "affiliations with family, peer group effects and types of recreational activities available." In my opinion, the same holds true in the U.S. Therefore, a powerful solution lies in fostering a stronger connection to others, family and community via structured, supervised activities for our youth. Basically, connection and community are addiction’s kryptonite.
Lastly, and on a more personal level, we must set good examples for our children and not hold them to higher standards than we hold ourselves. We must learn to "listen with the purpose of understanding" them and not simply to reply, especially on the little things. For if they don’t feel validated on these, then they’re much less likely to discuss difficult, headier topics like drugs.
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Dr. Charles Noplis is medical director of Renew Recovery with four offices located throughout the state of Kentucky. He is board certified in psychiatry and dedicated to treating addiction as well as all other types of psychiatric disorders.
In order for a family to keep their kids or loved ones off of drugs, they must first talk about drugs and do it often. In fact, talk about it so often that they get tired of it. However, it must be a truthful and balanced conversation. Second, actively engage them about their lives, stressors, friends and social life without any judgment. This makes them more comfortable opening up and it also builds trust. Third, try to find someone relatable who has also struggled with addiction. Look at their favorite music artists, professional athletes, or anyone else they readily admire. Chances are, one of them has a moving story or even years of sobriety under their belt already. This shows that it’s a battle that can be won. Overall, the goal of this ongoing discussion on drugs is to stop demonizing drug addiction so those who are struggling actually seek the help that they need early on.