Why young people's substance use matters for global health

Abstract

During puberty, when young people are completing their education, transitioning into employment, and forming longer-term intimate relationships, a shift in emotional regulation and an increase in risky behaviour, including substance use, is seen. This Series paper considers the potential effects of alcohol, tobacco, and illicit drug use during this period on: social, psychological, and health outcomes in adolescence and young adulthood; role transitions, and later health and social outcomes of regular substance use initiated in adolescence; and the offspring of young people who use substances. We sourced consistent support for causal relations between substance use and outcomes and evidence of biological plausibility from different but complementary research designs. Many adverse health and social outcomes have been associated with different types of substance use. The major challenge lies in deciding which are causal. Furthermore, qualitatively different harms are associated with different substances, differences in life stage when these harms occur, and the quality of evidence for different substances and health outcomes varies substantially. The preponderance of evidence comes from a few high-income countries, thus whether the same social and health outcomes would occur in other countries and cultures is unclear. Nonetheless, the number of harms that are causally related to substance use in young people warrant high-quality research design interventions to prevent or ameliorate these harms.

Childhood maltreatment, psychopathology and well-being: The mediator role of global self-esteem, attachment difficulties and substance use

“…Experimenting with tobacco, alcohol, and illicit drugs can be examples of risky behavior. However, early initiation of substance use increases risk of poly-substance use, violent behavior, anxiety, depression, suicide ideation, psychotic disorders, poor physical health, poor school performance and criminality, and is an important factor also from the global health perspective (120). Results from the ACE study show that childhood adversities are associated with early initiation of smoking and alcohol (121,122), and that the number of childhood adversities has a strong graded relationship with the risk of drug initiation from early adolescence into adulthood and with problems with drug use, drug addiction and parenteral use (123).…”

The importance of identifying, managing, and appropriately treating comorbidity in young people

“…For instance, treatment should be "youth friendly", include follow-up for missed appointments, easy to access, deliver prompt screening and assessment, have drop-in capability, be flexible, have strong links to other relevant agencies to ensure holistic treatment, and deliver interventions that recognise and cater to differences in cognitive developmental and maturational capacities (Health, 2008). Young people are not little adults (Hall et al, 2016). Young people are fundamentally different from adults in ways that are likely to affect treatment utilisation, adherence, and outcomes (Schwartz et al, 2005;McDermott et al, 2010;Winters, 1999;Masten et al, 2004) as such it would be inappropriate to simply replicate adult-focussed treatment for young people.…”

La autorregulación emocional en la depresión y el deterioro cognitivo de consumidores de sustancias psicoactivas

“…Los participantes mostraron un nivel de daño cognitivo elevado. La depresión, la edad de inicio y de consumo problemático y la falta de capacidad para regular emociones positivas explican un porcentaje El consumo de drogas es un problema social y de salud que afecta a la mayoría de los países desde hace varias décadas (Hall, 2015;Hall et al, 2016). Así, numerosos estudios se encaminan a analizar la morfología y características del problema de cara a intervenir eficazmente tanto con aquellas personas consumidoras de drogas como con aquellos colectivos que puedan iniciarse en el consumo y prevenir el mismo Aún son pocos los estudios que relacionan el consumo de drogas con otras variables autorreguladoras y motivacionales de la conducta como la positividad y la autoeficacia para la regulación emocional.…”