It is well-established that teenagers and young adults tend to be more vulnerable to addiction and other forms of reckless behavior compared to other age groups. And when they do become addicted, the consequences are often more severe.

A group of neurologists convened recently to discuss these problems at “The Addicted Brain and New Treatment Frontiers: Sixth Annual Aspen Brain Forum.” The forum was presented by Science Translational Medicine and the New York Academy of Sciences.

According to the 2015 Monitoring the Future survey, 35 percent of 12^th grade students admitted to drinking alcohol in the past 30 days. Almost 40 percent said they had been drunk in the past year. And six percent said they smoke marijuana – every single day.¹ That’s more than the number who smoke tobacco cigarettes (5.5 percent), which has been on the decline for several years now.

Since neurologists specialize in the brain, the body’s most complex organ, the science behind their discussions tend to be highly specialized and complex. But in a briefing by The New York Academy of Sciences, certain conclusions about addiction among teens and young adults can be made based on new research, and new ideas about how to prevent and treat addiction among teens and young adults also are emerging. Here are five takeaways from the forum.

1. Arm young people with facts about addiction, not just slogans like “Just Say No.”

Today’s generation of young people want to understand the science behind why things are. That means breaking it all down in ways that they understand, and believe, when it comes to the hazards of drug and alcohol use.

In a nutshell, the brains of young people are still forming. “Studies suggest that young people who are heavy drinkers and use marijuana could have reductions in brain volume and impaired cognitive performance,” per the briefing.²

Because the prefrontal cortex has not fully developed, young people have difficulty making rational decisions and regulating their emotions – both of which can spell danger when coupled with offers to try drugs and alcohol.

In young people, there are weak connections among the prefrontal cortex itself, as well as weak connections between the prefrontal cortex and nucleus accumbens, a component of the limbic system involved in the brain’s reward system, explained Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, in her keynote address. “Volkow, who has pioneered the use of brain imaging to study how drugs affect the brain, explained how even children…who grow up in a supportive environment can become addicted,” the briefing from the Aspen Brain Forum explains.

Cheryl Healton of the New York University College of Public Health discussed how “little emphasis has been put on public education and cultural tactics to prevent people from trying drugs in the first place,” per the briefing.

2. Use existing modern medicine and invest in research to develop new, more effective therapies.

We have vaccines to protect our children against everything from tuberculosis to HPV. Why not vaccinate them against addiction? Believe it or not, such vaccines are in development, including a vaccine to protect against cocaine addiction. Existing medications for helping children and young adults beat substance use disorders already are available, but seldom are prescribed.

In animal models, researchers have found ways to study brains to determine how habits become compulsive behaviors. In the laboratory of Barry J. Everett at the University of Cambridge, “his team has created a system in which rats receive a mild foot shock if they press the levers for (administering themselves) cocaine,” the brief explains. “Even after training on the task for several weeks, about 20 percent persist despite the punishment. Everitt and other researchers have observed several factors associated with this compulsive behavior in rats, including low dopamine D2 receptors in the ventral striatum, a smaller nucleus accumbens and lower activity in the frontal cortex. These findings suggest strategies for treating addiction, such as transcranial magnetic stimulation and cognitive behavioral therapy, which could help restore inhibitory control,” Everitt said.

3. Spread the truth about marijuana’s effects among teens and young adults.

The bottom line is that today’s marijuana isn’t the same strength that was available in the 1960s. Yet as marijuana legalization sweeps the nation, young people understandably are left asking: What’s the big deal?

Think about prescription medications. Different medicines do different things. And in the era of medical marijuana, different strains affect different people differently. A hyperactive person should not smoke a strain meant to stimulate someone who is depressed, just as a person with heart problems wouldn’t be described a stimulant. Yet most people have no idea what they are smoking, legally obtained or not.

“The dose, the strain, the potency, these things may be giving us very different effects,” said Susan R.B. Weiss of the National Institutes of Drug Abuse.

In a story published by Healthline News, cannabis scientist Andy LaFrate presented findings at a meeting of the American Chemical Society regarding marijuana from Colorado that he had tested in a laboratory. Not only was it “dirty” and covered with fungi, but its THC levels were also more than two to three times the levels they were three decades ago.³

What’s that doing to young brains? While some research is conflicting and therefore hard to generalize, “data are more consistent on psychosis, with several studies suggesting that early cannabis use could increase the risk of developing schizophrenia in people who have genetic risk factors for the disease,” according to the briefing.

4. Teach children early how to deal with stress in a healthy way.

Many young people grow up hearing, “Wait until you feel the stress of the real world.” But in fact, the stress of being an adolescent can be just as awful. And let’s face it – not every child grows up in a peaceful home. When hanging out with friends, the pressure to conform — which may mean drinking, smoking weed or even trying pain pills raided from a parent’s medicine cabinet at a party — could be the start of a serious substance use problem. This is especially true for young people already genetically predisposed to addiction.

“There are some very good emerging articles on this that lead us to believe that with intervention we can alter trajectories for children who have been exposed to stress,” said Diana H. Fishbein of the University of Pennsylvania.

“One of those interventions is the PATHS Curriculum, which teaches self-regulation,” the brief explains. “In her study of students in kindergarten through second-grade in Baltimore city schools, she found PATHS improved inhibitory control, stress physiology and emotional regulation, thereby reducing behavioral problems.”

PATHS stands for Promoting Alternative Thinking Strategies. It teaches the life skills of self-control, emotional understanding, positive self-esteem, relationships and interpersonal problem solving.

5. ‘Making Mental Health Essential Health’

Despite improvements in the Affordable Care Act, the reality remains that mental health treatment accessibility is still not on par with access to physical health services. That was the point made in the closing keynote address by Patrick J. Kennedy, former U.S. Representative from Rhode Island.

“The biggest challenges to achieving improvements in mental health care are politics and bringing together disparate groups of clinicians,” said Kennedy, who has struggled with addiction, the brief explains. “No one in Washington is sounding the alarm about problems with mental health care, such as not having enough doctors, and poor reimbursement rates and prescribing restrictions for doctors that do provide care,” he said.

While some may judge Kennedy due to some of his views, such as favoring drug court over incarceration for people with addiction, he actually opposes the legalization of marijuana. He closed the forum with this comment: “If you are a progressive liberal who cares about public health, you cannot stand by and watch a new industry like big tobacco take over and addict poor people who don’t have access to (high-end treatment that includes addiction psychiatrists) like I do, and they are going to be out there struggling.”

---

^Sources

<sup>1. Johnston, L. et al. (2016, February). Key Findings on Adolescent Drug Use. Monitoring the Future National Survey Results on Drug Use, 1975-2015. Retrieved Jan. 4, 2017, from http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2015.pdf
2. Heitz, D. (2015, March 23). Colorado Marijuana Engineered to Get You Higher. Healthline News. Retrieved Jan. 4, 2017, from http://www.healthline.com/health-news/colorado-marijuana-engineered-to-get-you-higher-032315
3. The New York Academy of Sciences. The Addicted Brain and New Treatment Frontiers: Sixth Annual Aspen Brain Forum. Academy eBriefings. 2016. Retrieved Jan. 4, 2017, from www.nyas.org/addiction2016-eB</sup>

^{Written by David Heitz}