Adolescent Drug Research Articles

Predictors and outcomes of adolescent alcohol and drug use: a scoping review

Abstract Background Adolescence is a pivotal life stage marked by educational advancement, entry into the workforce and formation of lasting relationships. Globally, adolescence is also the peak period during which individuals first engage in alcohol and/or drug consumption. This scoping review aimed to summarize existing longitudinal research on factors and outcomes related to adolescent substance use to identify gaps in existing evidence. Methods A scoping review was conducted in accordance with the PRISMA extension for scoping reviews. A systematic literature search was conducted on PubMed. Additional studies were identified through hand-searching key reference lists and Google Scholar searches. A narrative synthesis was completed. Results 123 studies were included; 12 reviews and 111 cohort studies. 60% of cohort studies originated from North America, 29% Europe, 7% Australia/New Zealand, 2% South America and 2% Asia. Factors consistently associated with increased risk of ASU include male sex, increasing age, externalizing disorders, adverse childhood experiences and peer or parental substance use. Few studies considered wider community or neighbourhood factors. Early initiation and higher frequency of adolescent drug use were predictive of later-life substance use patterns, education derailment, contact with the justice system and mental health disorders. Conclusions The body of longitudinal evidence on adolescent substance use is rapidly expanding yet significant research gaps exist. Rising levels of cocaine use and its substantial health impacts motivate further research on all potentially important factors associated with cocaine use to guide interventions for prevention and treatment. Key messages • There are important gaps in existing research on adolescent substance use. • These include neighbourhood influences and factors associated with initiation of illicit drugs other than cannabis.

Non-medical use of tranquilizers and sedatives by 15-16-year-old adolescents in Estonia, 2003–2019

Abstract Background Non-medical use of prescription drugs has become a global concern in recent decades. This study aimed to explore trends in non-medical tranquilizers and sedatives use (NTSU) among adolescents in Estonia from 2003 to 2019. Methods Utilizing data from the cross-sectional European School Survey Project on Alcohol and Other Drugs (ESPAD) conducted in 2003-2019, study included 15-16-year-old Estonian schoolchildren (n = 11,328; 48.6% boys). Cochran-Armitage test was employed to assess changes in NTSU trends, with statistical significance set at p < 0.05. Prevalence rates and 95% CIs used as outcome measures. Results From 2003 to 2019, the lifetime prevalence of NTSU significantly increased for both genders, with girls consistently showing higher rates. Among boys, NTSU rose from 5.0% (95% CI 3.8-6.5) to 11.3% (95% CI 9.6-13.3), particularly among those reporting NTSU 1-2 times, from 3.0% (95% CI 2.1-4.2) to 8.2% (95% CI 6.7-9.9), p < 0.001. Similarly, for girls, NTSU rose from 12.6% (95% CI 10.7-14.7) to 17.5% (95% CI 15.4-19.7), p < 0.001. There was an increase among girls reporting NTSU 1-2 times from 7.5% (95% CI 6.0-9.2) to 10.6% (95% CI 9.0-12.4), p < 0.001, and those reporting NTSU three or more times, from 5.1% (95% CI 3.9-6.6) to 6.9% (95% CI 5.6-8.4), p = 0.017. Among boys reporting medical tranquilizers and sedatives use (MTSU), NTSU rose from 21.1% (95% CI 13.9 to 30.0) in 2003 to 41.4% (95% CI 32.3 to 50.9) in 2019, p = 0.006. However, there was no statistically significant change in NTSU among girls reporting MTSU, remaining at 44.1% (95% CI 36.0 to 52.4) in 2019, p = 0.951. Conclusions Study reveals a significant increase in lifetime NTSU from 2003 to 2019, with girls consistently showing higher prevalence. Targeted interventions are needed to address adolescent non-medical prescription drug use, particularly among girls. Moreover, substantial NTSU among those reporting MTSU highlights the need to monitor and address non-medical usage in this subgroup. Key messages • Estonian adolescent non-medical tranquilizers and sedatives use surged from 2003 to 2019, particularly among girls, highlighting the need for targeted interventions. • The high prevalence of non-medical tranquilizer and sedative use among those reporting medical tranquilizer and sedative use underscores the necessity for vigilant monitoring.

Socioeconomic inequalities in substance use among Norwegian adolescents between 2014 and 2022

Abstract Background Increasing use of substances is observed among adolescents in recent years. Early onset of substance use dramatically increases the risk of substance use disorder, dependence, and poorer psychological, social, and physical health, and is thus a public health concern. We explore trends in socioeconomic inequalities in past year use of cannabis and other illicit drugs between 2014 and 2022 among Norwegian adolescents. Methods This study is based on data retrieved from five waves of the nationwide Norwegian Ungdata survey (2014-2022) among adolescents attending upper secondary education (N = 282,259; 51 % girls). Trends in socioeconomic inequalities were assessed using the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII). Results The use of cannabis and other illicit drugs increased among boys (from 13% to 19%, and from 2% to 5%, respectively) and girls (from 8% to 14%, and from 1% to 3%, respectively) between 2014 and 2022. Higher prevalence’s was observed among the least affluence girls between 2020 and 2022, both in absolute and relative terms (SII: 0.01 to 0.06, RII: 0.97 to 1.52, p < 0.001). No inequalities were observed among boys during this time. While relative and absolute inequalities in use of other illicit drugs decreased in boys, absolute inequalities increased in girls. Boys were more likely than girls to have used cannabis and other illicit drugs, although the gender gap in cannabis use narrowed slightly during the study period. Conclusions Our data suggest increasing use of cannabis and other illicit drugs among Norwegian adolescent boys and girls between 2014 and 2022. Future studies should examine the potential causes of increasing substance use as a basis for understanding, and distinguishing between, the many intertwining factors that influence adolescent drug use behaviors. Key messages • The use of cannabis and other illicit drugs increased between 2014 and 2022 among Norwegian boys and girls. • While inequalities in the use of cannabis and ither illicit drug use increased in girls, small or no inequalities was observed among boys.

Understanding the Mechanisms Mediating the Relationship Between Delinquent Peer Association and Adolescent Drug Use in the Greater China Region

Prior research on delinquent peer association and adolescent drug use predominantly examines the direct link between the two factors from the differential association/social learning perspective. The current study, based on survey data among 8,027 secondary school students sampled from three major cities in the Greater China Region, aims to elucidate this relationship further by identifying key mediators derived from several major criminological theories and perspectives, including social learning theory, lifestyle/routine activity theory, general strain theory, and the opportunity perspective. This study finds that significant mediators include pro-drug use attitudes, crime victimization, and drug availability, with pro-drug use attitudes exerting the most substantial influence on adolescent drug use. These results underscore the complexity of the relationship between delinquent peer association and adolescent drug use, advocating for a multifaceted theoretical approach for comprehensive understanding.

What can we know about legal minors who inject drugs? Exploring register data in three high-income countries

Background Research on legal minors who inject drugs is rare and beset with methodological problems. We explore the potential of register data for researching this population and present illustrative analyses contributing to the knowledge base. Method We obtained register data with national coverage from three high-income countries and assessed its analytic potential across two research themes. Descriptive analyses of the obtained data explored prevalence, mean age of debut, delay to accessing services, and treatment needs. Results There were differences in register types and variables collected within and between each country. The analytical potential of register data was assessed as good. Prevalence of injecting debut before the age of 18 (IDU < 18) was 29% (Sweden), 23% (Switzerland), and 5%–9% (Wales). IDU < 18 took longer to access services in each country than those with debut as adults. Complex treatment needs were identified, including mental health, education, and housing. Conclusion Register data is a viable method for better understanding this small, ‘hidden’ population, albeit with important caveats. Adolescent drug services may need to deliver or link to a range of treatment responses beyond drug use. Innovative outreach, and legal and policy change may be needed to ensure harm reduction access while injecting continues.

To study impact of drug abuse in adolescence

Adolescent drug usage can lead to a variety of outcomes that are different from those associated with adult drug use. Alcohol is a common illicit substance in youth, and the molecular mechanisms behind alcohol-induced neuro inflammation, brain injury, and behavioural dysfunction caused by ethanol are not fully understood. In the adult brain, alcoholism is associated with a higher chance of neuropsychiatric diseases. Adolescent alcohol use can cause long-lasting modifications to the control of cytokines and the sensitivity of the hypothalamic-pituitary-adrenal (HPA) axis, which can impact neuropathology and behaviour long into adulthood... Synthetic androgens used for muscle and strength gain, especially in adolescence, are called alcoholic androgenic steroids (AAS). Adult neuropathology and alcoholism can be prevented and treated using AAS, an anabolic steroid.

Explanatory models of illicit drug use in adolescents: A qualitative study from India.

Illicit drug use is a growing concern in India, with a high treatment gap of 73%. Explanatory models can provide valuable insights into the patient's conception of disease and inform help-seeking, treatment, and recovery. Of the studies that examine adolescent drug misuse in India, none have developed a socio-cultural explanatory model. The aim of our study was to develop an explanatory model to better understand the causal beliefs, social context, and self-perception of illicit drug misuse amongst adolescents in India. We conducted semi-structured interviews with 23 adolescents seeking treatment for drug use disorders and 25 healthcare providers recruited across three sites in India. Thematic analysis was used to analyse data. Most adolescent participants reported using multiple drugs, often in combination with cannabis. Frequent usage was reported i.e., daily at multiple times. Causes of initiation and continued use were peer influence, curiosity and pleasure, psychosocial stressors, family conditions, and systemic risk factors (e.g. socioeconomic instability). Drugs were acquired from various sources, including fellow users and pharmacies. Adolescent participants perceived negative impacts of drug use on physical and mental health, family relationships, and everyday functioning. Our findings on common reasons of drug use initiation, importance of peer relationships in continuation of use, impact of use on various aspects of life and the relationship of illicit drug use with socioeconomic status are consistent with previous research done in India on the subject. Understanding how adolescents and caregivers perceive drug use can help inform patient-clinician rapport, improve treatment compliance and understand intervention effectiveness. Such an explanatory model holds crucial implications for shaping interventions and clinical approaches to address adolescent drug use in India.

The Impact of Family Relations on a Sample of Egyptian Patients with Substance Use Disorder

Abstract Background Substance use disorders (SUD) present a complex condition characterized by uncontrolled substance use despite adverse consequences, often intertwined with social and family problems. Dysfunctional family relationships, including violence, stress, parental drug use, and poor communication, have been linked to adolescent drug use. The current study investigates the association between family relation dysfunction and substance use, aiming to understand the quality of this connection. Aim of the Work This case - control study aims to examine the relationship between family relations and substance use, assessing the impact on the type and severity of substance abuse. Specific objectives include exploring the association between family dysfunction and SUD, comparing family interaction in SUD patients and normal individuals, and evaluating variations in family interaction based on sociodemographic factors. Patients and Methods Seventy participants, comprising 35 SUD patients and 35 healthy controls, were recruited from EL-Abbsia Mental Health Hospital. Participants were assessed using socio- demographic data sheets, Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Quality of Family Relationships Scale (KOBI), and Addiction Severity Index. Urine tests were conducted for psychoactive substances. Statistical analysis involved various tests, including t-tests, Mann-Whitney, chi-square, and correlation analyses. Results The study revealed a significant prevalence of smoking among SUD patients compared to controls, along with longer smoking duration and higher daily cigarette consumption. SUD patients exhibited increased medical issues and higher incidences of substance use, particularly cannabis and heroin. Family rejection and non-acceptance were significantly higher in SUD cases, correlating with the severity and duration of substance abuse. Conclusion The findings underscore the significant connection between family relationship dysfunction and substance use. Rejection and non-acceptance within the family environment emerge as crucial predictors of addiction. The study highlights the need for comprehensive interventions addressing family dynamics in substance abuse treatment.

Model of Life Skills Based Drug Education on Knowledge About Drug Use, Self-Esteem, and Assertiveness Skills Among Indonesian Adolescents at Risk

Introduction: Adolescent drug abuse is a global concern, affecting young people's freedom and development. In Indonesia, illicit drug abuse has increased, causing severe social, political, and economic problems. Methods: A quasi-experimental design was used in this study to test the effects of life skills-based drug education on knowledge about drug use, self-esteem, and assertiveness skills. Teen participants were divided into experimental and control groups. Results: Language and Social Education (LSE) significantly influences students’ understanding of drug use and assertiveness training while also somewhat raising their self-esteem. On the other hand, it had no appreciable impact on Indonesia’s at-risk students in Semarang, Central Java Province. The report stressed that the first stages in an LSE program intended to stop teenage drug use are for students to gain knowledge and skills. To attain the best results in drug use prevention, more routes must be created. Conclusions: gaining information and skills improves attitudes and values, which in turn encourages drug use in a good way. Consequently, to support Indonesian students who are at risk of drug use in staying drug-free and developing into healthy, contributing members of society, these programs require further study and improvement.

Pharmacokinetics of anti-TB drugs in children and adolescents with drug-resistant TB: a multicentre observational study from India.

Drug-resistant tuberculosis (DR-TB) is one of the challenging forms of TB to treat, not only in adults but also in children and adolescents. Further, there is a void in the treatment strategy exclusively for children due to various reasons, including paucity of pharmacokinetic (PK) data on anti-TB drugs across the globe. In this context, the present study aimed at assessing the PK of some of the anti-TB drugs used in DR-TB treatment regimens. A multicentre observational study was conducted among DR-TB children and adolescents (n = 200) aged 1-18 years (median: 12 years; IQR: 9-14) treated under programmatic settings in India. Steady-state PK (intensive: n = 89; and sparse: n = 111) evaluation of moxifloxacin, levofloxacin, cycloserine, ethionamide, rifampicin, isoniazid and pyrazinamide was carried out by measuring plasma levels using HPLC methods. In the study population, the frequency of achieving peak plasma concentrations ranged between 13% (for rifampicin) to 82% (for pyrazinamide), whereas the frequency of suboptimal peak concentration for pyrazinamide, cycloserine, moxifloxacin, levofloxacin and rifampicin was 15%, 19%, 29%, 41% and 74%, respectively. Further, the frequency of supratherapeutic levels among patients varied between 3% for pyrazinamide and 60% for isoniazid. In the below-12 years age category, the median plasma maximum concentration and 12 h exposure of moxifloxacin were significantly lower than that of the above-12 years category despite similar weight-adjusted dosing. Age significantly impacted the plasma concentration and exposure of moxifloxacin. The observed frequencies of suboptimal and supratherapeutic concentrations underscore the necessity for dose optimization and therapeutic drug monitoring in children and adolescents undergoing DR-TB treatment.

Cannabidiol or ketamine for preventing the impact of adolescent early drug initiation on voluntary ethanol consumption in adulthood.

Few studies have previously evaluated the long-term impact of initiating the combined use of alcohol and cocaine early-in-life during adolescence. Our preclinical study characterized changes in affective-like behavior and/or voluntary ethanol consumption emerging later on in adulthood induced by a prior adolescent drug exposure, as well as tested therapeutical interventions (i.e., cannabidiol or ketamine) to prevent the observed effects. We performed three independent studies with male and female Sprague-Dawley rats, treated in adolescence (postnatal days, PND 29-38) with non-contingent paradigms of ethanol, cocaine, their combination or vehicle. Later on, adult rats were (1) scored for their affective-like state (forced-swim, elevated-plus maze, novelty-suppressed feeding, sucrose preference), (2) allowed to freely drink ethanol for 6weeks (two-bottle choice), or (3) treated with cannabidiol or ketamine before given access to ethanol in adulthood. No signs of increased negative affect were observed in adulthood following the adolescent treatments. However, adolescent ethanol exposure was a risk-factor for later developing an increased voluntary ethanol consumption in adulthood, both for male and female rats. This risk was similar when ethanol was combined with adolescent cocaine exposure, since cocaine alone showed no effects on later ethanol intake. Finally, rats exposed to adolescent ethanol and pretreated in adulthood with cannabidiol (and/or ketamine, but just for females) reduced their ethanol voluntary consumption. Our data provided two therapeutical options capable of preventing the impact of an early drug initiation during adolescence by decreasing voluntary ethanol consumption in adult rats.

Safety and efficacy of biologic drugs in children or adolescents with atopic dermatitis: A systematic review and meta-analysis of randomized controlled trials.

Children and adolescents suffering from moderate-to-severe atopic dermatitis (AD) face a significant disease burden that greatly impacts their quality of life. Treatment options for AD are currently limited. To assess the safety and efficacy of biologic drugs, dupilumab, lebrikizumab, or tralokinumab, in improving outcomes in patients with moderate to severe inadequately controlled AD. We searched PubMed, Embase and Cochrane databases for randomized controlled trials (RCTs) comparing dupilumab, lebrikizumab or tralokinumab to placebo in patients with AD. We computed odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs), random effects model was used and a p-value <0.05 was considered as statistically significant. We analysed data into Review Manager 5.4. A total of five RCTs and 973 patients were included, of whom 592 were prescribed a biologic drug. Compared with placebo, patients receiving a biologic drug had a greater improvement, achieved an Investigator Global Assessment (IGA) score of 0 or 1 (OR 5.05; 95% CI 3.08-8.29), Eczema Area and Severity Index (EASI) 75 (OR 6.87; 95% CI 4.71-10.02), EASI 50 (OR 8.89; 95% CI 6.18-12.78) and EASI 90 (8.30; 95% CI 4.81-14.31). The proportion of patients with 3 points or more (OR 6.56; 95% CI 4.34-9.90) or 4 points or more (OR 8.09; 95% CI 5.19-12.59) improvement from baseline in peak pruritus NRS was significantly higher with biologic drugs than placebo. There were no significant differences between groups regarding adverse events (OR 0.79; 95% CI 0.58-1.07), and conjunctivitis (OR 2.08; 95% CI 1.00-4.33). In this meta-analysis, dupilumab, lebrikizumab, and tralokinumab have shown significant improvements in signs, symptoms and quality of life in children or adolescents with moderate to severe AD. Larger studies may be needed to continue evaluating the safety and efficacy of these biologic drugs in this patient population.

Neurological Disorders Induced by Drug Use: Effects of Adolescent and Embryonic Drug Exposure on Behavioral Neurodevelopment.

Clinical studies demonstrate that the risk of developing neurological disorders is increased by overconsumption of the commonly used drugs, alcohol, nicotine and cannabis. These drug-induced neurological disorders, which include substance use disorder (SUD) and its co-occurring emotional conditions such as anxiety and depression, are observed not only in adults but also with drug use during adolescence and after prenatal exposure to these drugs, and they are accompanied by long-lasting disturbances in brain development. This report provides overviews of clinical and preclinical studies, which confirm these adverse effects in adolescents and the offspring prenatally exposed to the drugs and include a more in-depth description of specific neuronal systems, their neurocircuitry and molecular mechanisms, affected by drug exposure and of specific techniques used to determine if these effects in the brain are causally related to the behavioral disturbances. With analysis of further studies, this review then addresses four specific questions that are important for fully understanding the impact that drug use in young individuals can have on future pregnancies and their offspring. Evidence demonstrates that the adverse effects on their brain and behavior can occur: (1) at low doses with short periods of drug exposure during pregnancy; (2) after pre-conception drug use by both females and males; (3) in subsequent generations following the initial drug exposure; and (4) in a sex-dependent manner, with drug use producing a greater risk in females than males of developing SUDs with emotional conditions and female offspring after prenatal drug exposure responding more adversely than male offspring. With the recent rise in drug use by adolescents and pregnant women that has occurred in association with the legalization of cannabis and increased availability of vaping tools, these conclusions from the clinical and preclinical literature are particularly alarming and underscore the urgent need to educate young women and men about the possible harmful effects of early drug use and to seek novel therapeutic strategies that might help to limit drug use in young individuals.

Differences in clinical signs and severity of intoxication due to street drugs in adolescents and young adults treated in emergency departments

Differences in clinical signs and severity of intoxication due to street drugs in adolescents and young adults treated in emergency departments

Prospective Intergenerational Associations between Parents’ and Children’s Illicit Substance Use During Adolescence

Objective Intergenerational studies have identified relations between adolescents’ and their future offspring’s cannabis and alcohol use, but rarely have examined the association for other illicit drug use. Given the low prevalence of such use in community populations, we pooled data from three prospective intergenerational studies to test this link. Method Participants were 1,060 children of 937 parents who had been repeatedly assessed since early adolescence. Children and parents reported on their use of cocaine, stimulants, hallucinogens, sedatives/tranquilizers, and opiates/narcotics from ages 10 to 18 years. Intergenerational similarities in any versus no use of these drugs were formally modeled using logistic regression. Patterns also were descriptively analyzed. Results Parent illicit substance use was associated with significantly higher odds of child use (adjusted odds ratio [95% confidence interval] = 2.682 [1.328–5.416], p = 0.006). However, intergenerational continuity was modest; 87% of children whose parent used illicit drugs in adolescence did not use such drugs, and 77% of parents of children who used illicit drugs had not themselves used these drugs during adolescence. Conclusions The use of illicit substances by parents during their teenage years poses a risk for their offspring’s similar behaviors. However, the discontinuity of these behaviors across generations implies children are largely resilient to or protected from this risk, and conversely that other aspects of parents’ and children’s experiences or characteristics may be more powerful risks for children’s illicit drug use than this transgenerational influence.

Street adolescents in low income setting exposed to hepatitis B and C, and disadvantaged by lifestyle: a Togolese cross-sectional study

BackgroundIn Togo, few data are available on viral hepatitis in street adolescents, a vulnerable population due to their lifestyle. The aim of this study was to describe the lifestyle of street adolescents (sexual practices and drug use), to estimate the prevalence of hepatitis B and C viruses, and to describe their HBV immunization profile in Togo.MethodsA cross-sectional study was conducted in Lomé (Togo) in July 2021. Street adolescents aged between 13 and 19 years were included. A questionnaire was used to document lifestyle. ELISA tests were performed for Hepatitis B surface antigen (HBsAg), Hepatitis B core and surface antibodies (anti-HBc, anti-HBs), and antibodies against hepatitis C virus (anti-HCV).ResultsA total of 299 adolescents (5.4% female) with a median age of 15 years (IQR: 14–17) were included. Of these, 70.6% (211/299) were sexually active and 70.6% (149/211) had not used a condom during their last sexual intercourse. Drug use was reported by 42.1% of the adolescents. The most used substances were cannabis (39.0%), cocaine (36.6%), glue solvents (19.5%), and tramadol (11.4%). However, cocaine use may have been overestimated due to information bias. Current HBV infection (HBsAg+) was detected in 3.7% (95%CI: 1.9–6.5) of the adolescents. Isolated anti-HBc + was present in 5.3%. All three HBV markers (HBsAg, anti-HBs, and anti-HBc) were negative in 71.6% of adolescents. Anti-HCV was detected in 4.7% of adolescents.ConclusionNearly one in 10 street adolescents has markers for HBV contact/current infection, and approximately 72% of street adolescents may still be infected with HBV, as they have no HBV markers. HCV is also circulating in this population. Given the reported high-risk sexual practices and high levels of drug use, there is an urgent need to develop integrated strategies to prevent infections, including HBV, and drug dependence in this population.

Validity and Reliability of the Indonesian Version of the Internalized Stigma Mental Illness Instrument: Substance Abuse in Adolescents

The prevalence rate of drug abusers in adolescents in Indonesia is relatively high. There is no valid and reliable instrument in the Indonesian language to measure stigma in drug users in adolescents. Therefore, this study aims to measure the validity and reliability of the self-stigma questionnaire in adolescent drug users. This cross-sectional study involved 59 teenage drug users who, at the time of the study, were in good health and could read and write to answer the questionnaire. Data were collected between March and September 2020 using Internalized Stigma Mental Illness (ISMI): Substance Abuse questionnaire. Pearson’s correlation coefficient, r, was used to measure the cross-validity value of the correlation between item scores and total statement scores. Meanwhile, researchers used Cronbach’s Alpha to assess the internal consistency of the questionnaire. Pearson’s r values for 29 statements showed that 1 statement was invalid. After eliminating the invalid statements, 28 statements with valid results at rcount ≥ 0.256 and Corrected item-total correlation &gt;0.3 with a confidence level of 95% (rcount 0.323-0.642) and reliable Cronbach Alpha &gt; 0.700 (Cronbach Alpha If Items Deleted: 0.888-0.895) with a 95% confidence level were used in the instrument. The ISMI is a valid and reliable version of drug abuse that can be used as an assessment and evaluation tool for adolescent drug abusers in clinical, rehabilitation, research, and community settings.

Adolescents' Participation in Drug Addiction Interventions, Individual Perceptions, and Attitudes towards Recovery: A Scoping Review

Introduction: Adolescents recovering from substance use problems face significant psycho-social challenges. These challenges can affect their recovery progress, overall well-being, and integration into the society. Due to paucity studies, this study aimed to identify the perceptions and attitude towards recovery among adolescents participating in drug addiction interventions. Methods: This systematic review study applied a complete search of relevant databases, including Scopus, Embase, Cinahl, and PubMed/Medline using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was limited to articles published in English language, between 2013 and 2023, and focused on adolescents drug addiction. Twelve articles were critically appraised using Critical Appraisal Skills Programme (CASP) for qualitative studies and Joanna Briggs Institute (JBI) tools. The results were synthesised using a thematic analysis. Results: The findings identify that adolescents in addiction recovery face several challenges, including stigmatisation, social isolation, self-doubt, and difficulties accessing and maintaining treatment. The findings also point out that supportive relationships, culturally sensitive treatment approaches and interventions to combat self-stigma can play a critical role in promoting resilience and recovery for adolescents in recovery. Conclusion: The comprehensive review brings us up to speed on the challenging experiences young people recovering from addiction in different addiction intervention go through, it underscores the importance of supportive relationships and encourages strengthening of interventions that mitigate against stigmatization.

A valid and reliable self-peace scale with indicators of love, care and fearlessness for adolescent drug users

Self-peace is a crucial component for individuals/teenagers/students to live happily and recover from drug use. However, self-peace isn't wholly owned by individuals affected by drug use or recovering from drugs. Peace counsellors measure self-peace as a form of the addiction counsellor's role in the growth of self-peace due to drug use. This research aims to develop a valid and reliable self-peace scale. The research method uses a sequential exploratory mixed method from the qualitative data analysis process supported by quantitative data. The research targets were three expert validators and N=151 subjects among students/individuals/adolescents. Qualitative descriptive analysis compiles grids and statement items and provides expert input in developing the self-peace scale. Quantitative data analysis from the expert assessment with Aikan-V and instrument testing with confirmatory factor analysis will be used to determine the validity and reliability of the self-peace scale. The results of the data analysis compiled a blueprint of the peace scale (sub-aspects of caring, courage and love) and 12 statement items that were included in the very feasible category (Aikan-V ≥0.888). Validity of statement items with 12 valid statement items with factor loading ≥0.5, KMO=0.793 ≥0.50, reliability score 0.842 (high criteria). School counsellors can use student problem assessments to analyze student problems and needs. Counsellors, psychologists and researchers can use the self-peace scale to determine the development of an individual's self-peace to recover from drug use with four answer choices. The analysis results can be applied to further intervention in peace counselling. Keywords: self-peace, scale, validity, reliability

The Mental Health of Young Brazilians and its Correlation with Substance Abuse

Background: The mental health of adolescents in Brazil is influenced by a complex interplay of social, familial, and academic pressures. The transitional period from childhood to adulthood introduces significant challenges, which some adolescents attempt to navigate through the use of psychoactive substances. This coping mechanism can adversely affect their mental health, leading to increased vulnerabilities to mental disorders such as depression and anxiety. Methods and Materials: This research utilized a mixed-methods approach, incorporating both qualitative and quantitative data collection. The study involved literature reviews, statistical analyses of existing health records, and structured interviews with healthcare professionals and adolescents. Various regions across Brazil were included to ensure a comprehensive understanding of the urban and suburban contrasts in adolescent mental health and drug use dynamics. Results: The findings indicated that drug use among adolescents often serves as a maladaptive strategy to cope with emotional and social stressors. Key determinants of substance use included academic stress, lack of familial support, and the need for social belonging. The psychosocial impacts of substance use were profound, exacerbating conditions like anxiety and depression, and hindering adolescents' social and academic development. Conclusion: Addressing the mental health issues of Brazilian adolescents requires a multifaceted approach that involves families, educational institutions, and healthcare providers. Prevention and intervention strategies must focus on strengthening familial support, enhancing coping mechanisms, and providing accessible mental health resources. Public policies need to support these initiatives by integrating mental health services within school and community settings to foster a supportive environment for youth development.