Berks County Medical Society Medical Record Fall 2021 - 12

mEdiCal rECord FEaturE
Substance Abuse and
the COVID-19 Pandemic:
Impact on Prevention and
Treatment for Adolescents
by Layla Abousaab
Berks County Medical Society 2021 President's Intern
Advisors: Jaclyn Steed; D. Michael Baxter, MD; Lucy J. Cairns, MD
Research Question: What impact did the COVID-19 Pandemic have on prevention efforts for teens
(12-17) with substance use disorder? How did COVID-19 impact treatment access for teens?
A
ddiction has never been an easy
discussion for doctors to have with
families and adolescents, and this
was particularly true during the pandemic.
In the last year and a half, we have all felt
some degree of isolation, fear, and anxiety
throughout the progression of COVID-19.
It has taken a toll on everyone's mental
health in one way or another, whether it was
financially, the inability to see family and
friends, or paranoia of catching the virus.
Mental health issues are a leading cause
of substance use disorder because drugs like
alcohol, marijuana, and tobacco are readily
accessible and used to self-medicate. Such
use can become a habit in coping with
stress, anxiety, depression and Attention
Deficit Hyperactivity Disorder/ADHD
(Radosh). Those struggling with mental
health issues are predisposed and more
likely to develop a substance use disorder by
essentially turning those negative feelings
into euphoric drug-induced ones.
Since the brain is more sensitive to
drugs and alcohol in the teenage years,
adolescence is a crucial time for developing
an addiction. Teens have a 25% higher
chance of adapting to drug dependence
than adults (MassGeneralHospital). Given
all of the high school social drama and
opportunities to drug exposure, the path to
addiction for teens is a rather easy one to
follow.
In addition to predisposing more
teens to substance abuse and dependence,
the Pandemic has limited the efficacy of
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prevention and treatment options that are
normally accessible to teenage students.
Thus, conditions imposed by the Pandemic
significantly degraded the ability to
effectively educate, prevent, and treat teens
exposed to substance use issues. Since
COVID has had such a profound impact
on the substance use disorder/addiction
community, my project is focused on the
specific burdens imposed on substance
abuse prevention and treatment efforts for
adolescents.
HOW DO WE DISTINGUISH
SUBSTANCE USE, ABUSE,
AND ADDICTION?
Although many of these terms are
used interchangeably, each describes a
different intent and degree of substance
exposure and usage. Substance use refers
to " any consumption of alcohol or drugs "
( " Addiction Knows No Boundaries " ).
This term can be used to describe typical
experimentation and the initial stage
of trying drugs, which is a common
experience for many teens. By the time
teens become high school seniors, about
70% of students have tried alcohol and
50%, an illicit drug (NIDA). " Substance
abuse " carries a heavier weight, indicating
consumption at unnecessarily large and
frequent amounts and with the intent
of feeling the drug's direct psychoactive
effects (Smith). Similarly, substance use
disorder (SUD) is the condition in which
excessive use affects one's quality of life
and impairs daily function ( " Help With
Addiction and Substance Use Disorders " ).
Substance use disorders can be characterized
by the continuation of use despite negative
consequences and missing work/school/
events. In the most severe cases, it is labeled
as addiction (Radosh).
There exists a fine line between
experimentation and a substance use
disorder, which imposes a large challenge
when identifying substance abuse in teens,
especially during this Pandemic. Addiction
medicine specialists evaluate this line by
deciding if the use is affecting the teen's
quality of life. For example, is it impacting
their academic performance or social
interactions? Other common signs to look
for are absence from commitments such
as work, school, or social engagements;
symptoms of withdrawal such as excessive
anxiety and shakiness due to dependence;
or hanging out with new friends unfamiliar
to parents. Despite being the typical
conditions to look for, the Pandemic
has blurred the line of identifying
substance use disorders as almost all
of the aforementioned signs have also
been common responses to the storm of
stress, anxiety, and depression brought by
COVID-19.
With the switch from in-person
interactions to complete virtual
communication (e.g. the Zoom platform)
throughout the Pandemic, it has become
much more difficult to evaluate students'
behavior and body language, factors which
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Berks County Medical Society Medical Record Fall 2021

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