Berks County Medical Society Medical Record Fall 2021 - 14

The BCMS Pat Sharma P r esident 's S chola rship
Substance Abuse and the COVID-19 Pandemic
continued from page 13
tobacco, other drugs, and mental issues
which pose a barrier to a student's success "
( " Student Assistance Program (SAP) " ).
SAP's primary goal is to support students
facing these obstacles with the help and
resources they need by administering
assessment surveys and offering
recommendations based on the issue the
teen is facing. Many local organizations
such as the Caron Treatment Center offer
SAP liaisons to schools in Berks County and
have provided students with presentations
during the school year to educate them on
substance use and prevention (Steed). Yet,
due to the nature of online school, many
students did not receive the education and
exposure to resources that should usually be
available. Guest speakers that are normally
invited to schools for presentations were
unable to participate live, leaving some to
be pre-recorded and played during online
school, while some were canceled altogether
(Steed). Drug and alcohol education
programs that are usually encouraged and
implemented by schools in Berks have also
been unable to continue to the same extent
as before. Though most programs remain in
place, they are conducted virtually which
drastically lessens the impact that group
sessions normally have (Trevena). Prevention
specialists have stated that via online
communication, the groups are deprived of
the interactive nature that usually engages
students in-person (Trevena). Even SAP
surveys had to discontinue for some time
during the Pandemic because assessments
were typically administered in schools,
and without in-person schooling due to
quarantine protocols, specialists could not
evaluate or assess the students (Trevena).
Since the Pandemic, there has been
a significant decrease of adolescent
participation in prevention programs
(Trevena). A factor that further complicates
the struggles of being an online student
and contributes to a lower engagement
with such prevention programs is that
not all students have access to devices and
the internet to attend virtual prevention
programs or even their daily classes. For
example, students at Wyomissing Area were
much better able to attend and keep up
with classes through their school-provided
iPads, whereas students at Reading were
not provided devices by their school
district (Trevena). If students do not
own computers or iPads at home, they
cannot communicate with their teachers
and specialists, which becomes an extra
14 | w w w .berkscms .or g
obstacle for them in having equal access
to prevention and treatment programs
as other students in Berks County. This
accounts for the growing gap in substance
use education between the two school
districts, and depicts how the wealth of
an area directly impacts the resources of
substance abuse prevention and treatment
available to their students. Economically
disadvantaged students tend to experience
more issues with substance use disorder and
have less access to help, fueling the cycle of
poorer communities encompassing more
" troubled " students ( " Poverty and Addiction
Relationship " ). Without school-issued
technology, prevention specialists are having
difficulty connecting with these students, let
alone being able to assist them in gaining
access to the resources and education they
need (Trevena).
HOW DO WE RECOGNIZE,
DIAGNOSE, AND TREAT
SUBSTANCE ABUSE IN
TEENS IN THE MIDDLE OF A
PANDEMIC?
The way to recognize substance use
disorders in teens during the Pandemic
is following a procedure similar to that
involved in discerning underlying anxiety,
depression, and other mental health issues
(Radosh). Isolation from friends and
family, excessive mood swings affecting the
teen's ability to function, and struggling
performance/attendance are three of the
most important indicators of a developing
SUD in teens (Radosh). Although these
overlap with other pandemic-culture
stressors, they are still key characteristics to
look for when diagnosing a substance use
disorder.
In diagnostic assessments, professionals
look for difficulty of controlling use,
continued use despite consequences, use in
risky situations, and tolerance or withdrawal
symptoms (Radosh). All of these manifest in
the teen's behavior and are therefore much
more difficult to recognize over virtual
appointments than they would in person.
Subsequent to the Pandemic, both the
quality of and access to treatment options
have declined significantly. Teens typically
do not seek treatment if they believe they
do not have a substance use issue (Radosh).
Instead, they begin to seek treatment after
noticing problems at school or at home,
developing physical illness, or for legal
reasons (MassGeneralHospital). The goal is
to motivate teens to come for an evaluation,
a process that may be initiated by a clinician
(e.g. their pediatrician or family physician)
or by parents having a discussion with their
child about their concerns (Radosh).
Different forms of treatment
include counseling, medication, family
involvement, and peer support; it takes
a team to incorporate these elements
into a routine that will help treat
adolescents with a substance use disorder
(MassGeneralHospital). In this instance
the Pandemic has greatly affected access
to treatment such as therapy, family
involvement, and peer support-all of
which are crucial as medications alone are
not enough. For treatment to be effective,
a social aspect is necessary and COVID-19
has made that incredibly difficult in the
last two years since people could not
travel or see others for fear of spreading
the virus. If teens were unable to see their
extended families and friends, that limits
a lot of support and personal contacts that
would otherwise surround them. Although
therapy has continued virtually during the
Pandemic, many limiting issues arise at
home including interfering factors such
as loss of privacy and confidentiality, not
to mention the lack of in-person patientcounselor
interaction that makes therapy
personal and effective.
Considering how isolation is a primary
risk factor for teens to develop a substance
use disorder, the isolation that millions
around the world experienced during
quarantine as a result of the Pandemic
only accentuated those risk factors and
the mental health issues that place teens at
higher risk of substance abuse in the first
place. Local addiction specialist Dr. Lee
Radosh says only 5-10% of his patients
are teens: " It's sad because it shows not
many teens seek treatment for a multitude
of reasons " ranging from being too scared
of their parents finding out to not having
insurance to see a clinician. Most referrals
for his teen patients come from their
primary care physicians, which are typically
pediatricians. Although Pennsylvania laws
do not require a parent to know if their teen
is seeking treatment or seeing a clinician
for substance abuse care, certain challenges
come with confidentiality such as treatment
appointments appearing on insurance bills
that are typically paid by parents, not the
teen patients themselves.
http://www.berkscms.org
Berks County Medical Society Medical Record Fall 2021

Table of Contents for the Digital Edition of Berks County Medical Society Medical Record Fall 2021
