ALCOHOL DEPENDENCE IN CHILDREN AND ADOLESCENTS

What is the definition of addiction?

The definition of addiction syndrome was made for alcohol for the first time and it was defined as Alcohol Dependence Syndrome (ABS). The syndrome has 6 distinct elements that have been defined. It is accepted that each of these has a different importance and impact in the addiction process. It should also be kept in mind that each of the elements that make up the syndrome may take on a different appearance due to individual and cultural factors.

What are the main structures of addiction?

  • Increasing Tolerance to the Substance:The appearance of tolerance occurs either in the form that the effect of the substance is less than expected / usual despite the use of repeated doses, or in the form of the need to consume the substance in higher amounts in order to achieve the usual "same effect".

  • Recurrent Discontinuation Symptoms : This phenomenon is closely related to the previous one. It usually occurs following and depending on the absence of the substance and/or a period in which a dose below the usual dose is taken. The timing of the emergence of withdrawal symptoms and the severity of the symptoms depend on the substance used / type of addiction.

  • Impulsive Ingestion of the Substance and Subjective Awareness: Mentally, the individual is aware of the use of the substance. He is intensely preoccupied with the substance, thinks about the changes the substance causes in his psyche, and increasingly turns to obtaining the substance.

  • Intensity of Drug Seeking Behavior: The Cause of Addiction Following the development of the drug, the mere provision of the relevant substance has a specific and important meaning for the individual. His daily behavioral repertoire gradually decreased and was reduced to a few behaviors, primarily "substance use" behavior. Depending on this narrowing and limitation, individual and social responsibilities, roles, duties, etc. second, third etc. had to be pushed to the background.

  • Improvement/Prevention of Withdrawal Symptoms: Once the individual is "acquainted" with the withdrawal symptoms, the next step is to see how they change by using the substance. and was impressed is learning. Depending on this learning, the behavior that affects/changes cutting becomes established and is used to control cutting as a behavioral pattern. For example, advanced alcohol addicts reserve an appropriate amount for the next morning, even if it means drinking a little less.

  • Narrowing of Substance Use Repertoire: As addiction progresses, substance use behavior becomes increasingly "stereotypical" in the repertoire of daily behavior. The most well-known example of this is observed in alcohol-type addiction. For the social drinker, alcohol use behavior is irregular in time. Sometimes he drinks from one cocktail to another, sometimes for several days in a row, and sometimes in long spontaneous breaks. However, in the form of drinking that develops towards addiction, drinking behavior turns into weekly / daily repetitions and becomes stereotypical, almost appearing as a certain, necessarily repeated "daily activity". Drinking behavior is limited to time during the day and is a constant routine.

  • What are the most commonly used drugs among children and adolescents in our country?

    All studies conducted in our country show that the most frequently used drug is marijuana. Cannabis is a substance that can cause psychological addiction. However, its addiction potential is lower compared to other substances. It is known that there is traditional use of cannabis in various regions of our country. On the other hand, there is a common belief that marijuana is not addictive. Its physical effects appear later than others and cause less damage. For this reason, it can be thought that marijuana is used more fearlessly among young people. However, as stated above, marijuana is a substance that can cause psychological addiction, not physical addiction. In recent years, the use of synthetic marijuana (bonzai, jameka) has been increasing, especially in our region. These substances not only show the addictive properties of marijuana, but also cause life-threatening harm to the body due to their synthetic structure.

    The second most frequently used drug is volatiles. These are also items we can collect. Among these, we can count adhesives such as Bally and UHU, solvents such as Thinner, and volatile substances such as gasoline and gas. Among volatile substances, Thinner and Bally are the most frequently used ones. These are very easily found everywhere and can be purchased by anyone who wants. These substances are substances that begin to be used at a young age. Since it has direct toxic effects on the brain, very serious consequences may occur as a result of its use at young ages.

    The use of ecstasy (methamphetamine), one of the substances collected under the name of synthetic drugs, is becoming increasingly widespread in our country. Ecstasy is used for entertainment purposes, especially in social segments with better economic conditions. This item is sold at very high prices. The use of LSD, a substance that has been used all over the world for many years, is not very common in our country. However, it is used in certain areas, especially for testing purposes. It is quite difficult to obtain.

    Other frequently used drugs are heroin and cocaine, respectively. The rate of students who used heroin at least once in their lifetime was found to be 0.8% (?). Heroin is the most widely used "hard drug" in our country. Although the prevalence rate is much lower compared to other countries, heroin use can have serious consequences for the individual and society. Because the addictive effect of heroin is very high. A person can become addicted in a short time. Therefore, even trying it once can pose risks. Heroin addiction is very difficult to treat. The burden addicts bring to society is high. Compared to other substances with high addiction potential, the price of heroin is quite low in our country.

    What are the risk factors that lead to substance addiction?

    Gender: All studies show that men use drugs more

    Socioeconomic status:Studies conducted around the world show that drug addiction is more common in poor people. It has been stated that usage rates decrease at higher socioeconomic levels. Moment However, especially substances considered stimulants and synthetic substances used for recreational purposes are used by the high socioeconomic class. The majority of studies conducted in our country are far from reflecting various segments of society.

    Family:The importance of family and family characteristics in drug use cannot be underestimated. It has been reported that substance use is higher especially in children of separated or divorced families and in environments where family communication is impaired. Extensive alcohol or substance use was more frequently detected in the fathers of substance users.

    Psychiatric disease: Before substance use, especially Attention Deficit Hyperactivity Disorder, Behavior Disorders, Depression and Self-Confidence problems, substance use and It paves the way for addiction.

    School success: School success of students using substances has been found to be lower. Likewise, school absenteeism is also higher. However, two comments can be made here. The first can be interpreted as substance use reduces school success, and the second can be interpreted as substance use being high in students with low school attendance and school success. Both seem to affect this situation.

    What are the factors that will keep people away from substance use?

    Strong and positive family ties, Parents are aware of their children's friends and what they are doing Having clear rules within the family and everyone obeying them, Parents being interested in their children's lives, Being successful at school, A strong bond established with institutions such as schools and clubs, Providing accurate information about drug use.

    In what situations should families suspect their children?

    The first change observed in young people who start using drugs is the changes they make in their environment. New friends replace old friendships. He usually starts making friends with people at school with whom he can easily find substances. He is emotionally volatile. Sometimes he can be cheerful, sometimes angry and restless. While you were previously a very successful student at school, you now become a low-achieving student. He may have come to. . He started to stay alone at home. He locks his room door and never wants to go out. He begins to limit his relationships with his family as much as possible and wants to spend less time at home. He starts spending more money than usual. His self-care has decreased. Nervousness, tension and problems in interpersonal relationships begin to occur. Absence and carelessness increase.

    What should be the general attitudes of families towards substance use?

  • Change the Environment: Do not let your relatives use substances, Being in environments where alcohol is used may cause the desire to use again and cause addiction. A change of environment can be useful to stay away from reminders.

  • Support the Positive Aspects: Behaviors that are rewarded and appreciated are more likely to be repeated in the future. Appreciate their positive aspects to motivate them.

  • Set Your Boundaries: Having clear boundaries in family relationships and parent-child relationships reduces uncertainty and eliminates conflicts.

  • Let Them Choose: Another way to ensure the continuity of the rules is to offer options.

  • Give Responsibility.

  • Establish Healthy Communication.

  • Don't Avoid Arguing with Your Child: Argument and conflict are generally seen as a situation to be avoided. Conflict is not a sign of a mistake, but of a situation that needs to be overcome. It allows for new learning and improving the relationship. Perhaps it provides an opportunity for the necessary change in the family.

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