A substance can be anything that is ingested in order to produce
a high, alter one's senses, or otherwise affect mood, perception
Substance use can be common in young people, and individuals
have different patterns of use (bingeing, occasional or continual)
and reasons for use (for example as an 'experiment', for 'fun' or
to 'escape', to 'join in' with peers, or to get through a certain
situation- such as the desire to stay awake). Where use is
prolonged, heavy, or creating social or personal problems it may
meet a 'diagnosis' for a substance use disorder: substance
dependence or substance abuse (1).
In substance abuse a person experiences harmful changes in their
behaviour as a result of repeatedly using a substance, that
negatively affects their work/school responsibilities, social
relationships, and can lead to increased risk taking and other
personal or social problems. In substance dependence, a person
relies on a substance despite the problems caused by continuing its
use. In addition to the social and personal problems of substance
abuse, dependence leads also to cognitive, behavioural and physical
symptoms if a person continues using.
Burden and onset of substance use disorders in young
Substance use is common among young people, and alcohol is the
most common substance used by youth. A survey of Australian
secondary students aged between 12 and 17 years, found that 80
percent had tried alcohol, 14 percent had used cannabis, and 19
percent had used inhalants at some time in their lives (2).
People with substance use disorders often don't recognise or
seek help for the problem, and may not be screened for substance
abuse when they seek treatment for other health conditions, which
means that substance abuse and dependence disorders are often
under-recognised and undertreated. Despite this, substance use
disorders are among the most common of mental health disorders
experienced by young people. In Australia, 12.7 percent of people
aged 16-24 are estimated to have a substance use disorder, with
higher rates among young men than young women (around 16% of males
and 10% of females) (3). Harmful use of alcohol
was the most commonly reported substance use disorder (at around
Overall, about half of people with substance use disorders first
experience substance use issues by the age of 20 (5). Substance use disorders in younger
adolescents are most commonly harmful use or abuse; substance
dependence remains less common until later in adolescence/early
adulthood (5, 6).
Substance use disorders can result in significant short and
long-term ill effects. These consequences arise from the type of
substance and the way it is used (for example, respiratory problems
resulting from smoking and spread of infections such as Hepatitis
via injecting); from the immediate effects of intoxication (such as
overdose, traffic accidents and falls, risky sexual behaviour,
violence and aggression); from the longer terms physical effect of
the drug (such as brain damage, liver disease, cancer) and the
significant mental distress caused associated with drug dependence
There is a close relationship between substance use disorders
and other mental disorders, and use of some substances may increase
the risk of developing certain disorders, however it is often
unclear whether one issue causes the other. It is common for young
people with substance use issue to have one or more co occurring
mental health disorders, such as anxiety, depression and
A number of factors can increase the likelihood that a person
will have a substance use disorder (9-11).
They include the following:
- Related to the individual:
- Possible genetic predisposition (eg. a substance use disorder
in another family member)
- Personality (for example, social isolation, difficulty
accepting rules and authority)
- Poor coping skills
- Educational problems
- Early age of first use
- Strong personal motivations to use
- Traumatic experiences (for example, abuse as a
- Low socioeconomic status
- Poor peer or community support
- Adverse peer influences.
- Related to the family:
- Patterns of negative communication, low family cohesion
- Parental monitoring, discipline or family management
- Poor family relationships
- Parental role modelling (for example, seeing parents engaging
in drug use)
- Related to the community and society:
- Traumatic environment
- Legislation and law enforcement policies
- Availability of drugs
- Acceptability of substance use
1. American Psychiatric
Association. Diagnostic and Statistical Manual of Mental
Disorders, 4th. Edition. (DSM-IV). 1994 1994.
2. White, V, Smith, G. Australian secondary school students' use of
tobacco, alcohol, and over-the-counter and illicit substances in
2008 Drug Strategy Branch, Australian Government Department of
Health and Ageing 2009.
3. ABS. Australian Bureau of
Statistics. 2007 National Survey of Mental Health and
Wellbeing: Summary of Results. (Document 4326.0). 2008.
4. Reavley, NJ,
Cvetkovski, S, et al. Help-seeking for substance use, anxiety and
affective disorders among young people: results from the 2007
Australian National Survey of Mental Health and Wellbeing. Aust
N Z J Psychiatry. 2010 Aug;44(8):729-35.
5. Kessler, RC,
Berglund, P, et al. Lifetime prevalence and age-of-onset distributions
of DSM-IV disorders in the National Comorbidity Survey
Replication. Arch Gen Psychiatry. 2005 Jun;62(6):593-602.
JW, Stockwell, T, et al. Interventions to reduce harm associated with
adolescent substance use. Lancet. 2007 Apr
7. Canadian Centre
on Substance Abuse. Substance Abuse in Canada: Youth in Focus.
Canadian Centre on Substance Abuse, Ottawa. 2007.
8. Armstrong, TD,
Costello, EJ. Community studies on adolescent substance use,
abuse, or dependence and psychiatric comorbidity. J Consult
Clin Psychol. 2002 Dec;70(6):1224-39.
9. Hawkins, JD,
Arthur, MW, et al. Preventing substance abuse. In D.
Farrington & M. Tonry (Eds.), Crime and Justice, Volume 19:
Strategic Approaches to Crime Prevention. Chicago: University of
Chicago Press 1995.
10. Spooner, C,
Hall, W, et al. ANCD research paper 2-Structural determinants of
youth drug use. Australian National Council on Drugs. 2001.
11. Frisher, M,
Crome, I, et al. Predictive factors for illicit drug use among young
people: a literature review. Research Development and
Statistics Directorate, Home Office, United Kingdom. 2007.