The Underdiagnosis of Substance Use Disorders in Young People

What are Substance Use Disorders?

Most of us are familiar with the term “substance abuse,” or “addiction,” to refer to someone who has a drug or alcohol-related problem. The term “substance use disorder” is a bit less familiar to many. It’s a little bit different than words like “addiction,” in the sense that it encompasses a wider range of severity levels. This term acknowledges that there is a difference between problem use, dependence, and addiction.

Briefly, here’s a breakdown of these different ranges of substance abuse:

1) Problem use

  • Problems fulfilling obligations, resulting in poor work or household performance or repeated absences.
  • Results in substance-related legal problems, like DUI convictions or being written up for disorderly conduct while under the influence.

2) Dependence

  • Experience withdrawal.
  • Increased tolerance for the substance.

3) Addiction

  • Compulsive use.
  • Loss of control over use.

Why is this important?

Tabloids and other media frequently portray fictionalized, or sensationalized, instances of substance abuse. Because the cases that are most often reported are the extreme ones, many people fail to realize that their substance use may be verging on, or actually is, more like addiction than they believe.

These extreme cases shape our cultural perception or notion of “addiction,” causing many people to overestimate what addiction looks like. This can have dangerous consequences when people fail to get the help they need.

The younger population is especially vulnerable, as they are frequently presented with social pressures to engage in risky behavior, like drug use and overconsumption of alcohol. Many people, and lifestyles portrayed in the media, view that experimentation with risky behavior is a normal part of growing up.

In college-like settings, it can be easy to judge yourself against the behavior of your peers, and discount your own problems because you’ve seen worse in others. College-age people are not always great at seeing the link between their present behavior, and future outcomes, so judging their own patterns of behavior becomes difficult.

This time of life characterized by heavy peer pressure is also frequently the first time young people have been without much direct guidance from parents and other adults, like high school teachers. Worse, many colleges tolerate a culture of substance abuse, even at the level of alumni, deans, and other administrators. Substance abuse should not be considered a “rite of passage.”

Early detection is the key to recovery from substance abuse disorders, so it’s crucial to be able to recognize when things are starting to go bad. Nearly 23 percent of college students meet the criteria for substance abuse disorders, according to USA Today. That’s more than double the rate of substance abuse sufferers in the rest of the country’s population.

The type of socialization that goes along with college (alcohol and binge drinking, party drugs), plus the stress of school work (Adderall and other prescription drugs) is perhaps the largest contributing factor to substance abuse disorders in young people. In addition, some folks have other risk factors that may make them especially vulnerable.

Risk factors for Substance Abuse:

  • Poor impulse control
  • Untreated mental health issues
  • Low perception of dangers involved with drug use
  • Aggressive behavior in early childhood
  • History of trauma or abuse
  • Boredom
  • Proximity to neighborhoods with high crime

College campuses provide a lot of information about alcohol safety, and provide anonymous hotlines to report an incident without culpability, which helps more people get the emergency responder help they need.

But what about stopping the problem before it occurs? There’s not a lot of information for young people, in college or otherwise, about what addiction looks like.