Polysubstance abuse - a case study

Adolescence, Winter, 1996 by Scott D. Segal, Halford H. Fairchild

Over the last twenty years we have seen an increased effort to understand and solve the adolescent drug abuse problem. Researchers have developed a number of models to explain why adolescents have become involved in drug use. Studies have shown that children of alcoholics (COAs) have a higher risk of becoming involved with drug abuse than do non-COAs (Chassin, Rogosh, & Barrera, 1991; Parker & Hartford, 1988; Sher, Walitzer, Wood, & Prent, 1991). Peer pressure has also been well documented as another important factor (Alberts, Hecht, & Miller-Rassulo, 1992; Brown, 1982; Dinges & Oetting, 1993; Sherry & Stolberg, 1987). Many of these findings have been used to develop preventive strategies that are now used in the public schools and in the media. At the same time, rehabilitation programs have succeeded in helping some adolescent drug users with their addictions. However, in spite of progress that has been made, adolescent drug abuse remains an ongoing problem.

Adolescents typically derive a sense of ethics from their parents, while peers tend to be used for establishing social status (Biddle, Bank, & Marlin, 1980). While COAs are struggling with the need for social acceptance and dealing with peer pressure, they are also faced with a dysfunctional family life. COAs are subject to a substantial amount of stress at home and frequently view their families as having little or no cohesion, organization, expressiveness, consistency, or ability to communicate (Jarmas & Kazak, 1992). Alcoholic parents who suffer marital disruption over alcohol abuse may neglect to provide a moral foundation for their children who may grow up to believe that parental abuse and substance abuse are normal parts of life. It should come as no surprise, then, that COAs are more likely to use drugs than are non-COAs. In addition, drug use is often accompanied by delinquency, depression, low self-esteem, lack of self-control, and a high level of social enstrangement (Downs & Rose, 1991; Priest, 1985; von-Knorring, 1991).

Stuck and Glassner (1985) examined a drug abuser's transition to recovery. Their study provided a number of insights into the onset and duration of substance abuse and the transition to a drug-free lifestyle, but it was comparatively lacking in relevant information with regard to the maintenance of that lifestyle. The current study attempted to provide more information about the process of rehabilitation.

Antonio (a fictitious name) is a 23-year-old male who was involved in drug use for a period of four years. He reported a history of abusing alcohol, marijuana, Robitussin DM (Dextromethorphan Hydrobromide), LSD, and amphetamines. He also sold drugs and was arrested several times on drug-related charges. After a binge on amphetamines, Antonio concluded that he had to give up drugs, which he has done for several years. The case of Antonio demonstrates some of the ways adolescents conquer their drug problems.

CASE HISTORY

Family Dynamics

Antonio was born in San Rafael, California, and grew up in a dysfunctional family with a younger brother, an enabling mother, and an alcoholic father. According to Antonio:

By the time I turned seven or eight years old you could basically say that I could find [my father] at a bar right by our house from like twelve o'clock until dinner time. Then he'd come home, and you could never really tell that he was totally drunk. Or I couldn't, because I suppose that I just got used to him being drunk. [It was] an everyday thing.

Because of his father's alcoholism, Antonio's parents were continually arguing:

My parents started fighting a lot; hardly ever physically, but once in a while [there was hitting]. It became a nightly thing where they would be yelling at each other when I came home. It was always my mom complaining to my dad because my dad screwed things up. She had to sit there and watch him deteriorate from someone who she knew at one time and fell in love with, to this person who could no longer control his own life and was dominated by alcohol. She was always telling him to get off the stuff and point out his weak spots. Of course, my dad would get all defensive and it would escalate into a big argument.

At that time, Antonio was developing a network of friends in Huntington Beach, California. He was a dedicated athlete and also enjoyed considerable academic success. Antonio said, "As long as I lived in Huntington Beach, I never got mixed up with the wrong friends." He recalls how difficult it was for him to move to Redlands, California at the age of twelve:

He [Antonio's father] had created a lifestyle that allowed him to drink everyday and still work. But in the long run, it affected him really badly and he lost all his money by making some really bad investments with some people that he met at the bar. He lost the house, the car. When I made this transition from Huntington Beach to Redlands, our first house was a condominium. It was a drastic change: [one minute] we were living a mile from the beach and then all of the sudden we're living on the outskirts of town. I think it was at that point in my life, with all the pressure of moving and everything that I started hanging out with people I probably wouldn't have hung out with otherwise. And I didn't concentrate as much as I should have on school.