The Lodestar

Teenagers represent a highly vulnerable age group, grappling with various challenges to their sense of identity and purpose. In a world of information overload, their bodies and minds are constantly in turmoil. In the realm of substance use, "the calm before the storm" describes a brief phase of seeming stability or tranquillity that comes just before a significant episode of substance use, a crisis, or a relapse.

Substance Abuse—A Major Health Concern

The magnitude of substance use among young people varies globally and is a significant public health concern. This includes the use of alcohol, tobacco, cannabis, prescription medications, and illicit drugs.

Surveys reveal that a significant number of adolescents and young adults begin using substances during their teenage years. Alcohol and tobacco are the most commonly used substances, with cannabis and other illicit drugs following behind. In some regions, the misuse of prescription drugs has also become more prevalent. Several factors influence this behaviour, including peer pressure, family environment, mental health issues, and socioeconomic status, all of which can affect the likelihood of starting and continuing substance use. Early engagement with these substances is associated with increased risks of addiction, impaired brain development, academic difficulties, and social or legal challenges. The extent of substance use varies across countries, cultures, and demographics, including age, gender, and urban or rural residence. Early signs of substance use among young people typically include behavioural, emotional, and physical indicators. These signs may manifest as changes in mood, social circles, academic performance, and the students' physical health.

Early Warning Signs

Common early warning signs include the following:

• Sudden changes in behaviour or personality, such as increased secrecy, irritability, or mood swings.

• Withdrawal from family, friends, or previously enjoyed activities.

• Decline in academic performance or loss of interest in school activities.

• Changes in social groups often occur when associating with peers who use substances.

• Neglect of personal hygiene or appearance.

• Physical symptoms include bloodshot eyes, unexplained bruises, frequent nosebleeds, and changes in appetite and sleep patterns.

• Increased risk-taking behaviour and defiance of authority.

• Use of paraphernalia related to substance use (e.g., rolling papers and small containers).

These signs are vital early indicators that may point to experimentation or ongoing substance use among young people, requiring prompt attention and intervention. Early signs of mental illness often appear alongside covert substance use and need early intervention.

Shift in Spiritual Focus

Young people who become dependent on substances may start to question their faith, possibly withdrawing completely from church activities due to feelings of shame and guilt. Changes in their circle of friends, especially those outside the Church community, can be a strong indicator of potential drug involvement. Given these factors, a sensitive and nuanced approach is crucial to support young individuals who are struggling beyond their capacity. Families, society, and the Church must collaborate to address this challenge.

(Stephen Amarjeet Jiwanmall is Professor of Psychiatry at Christian Medical College, Vellore, Tamil Nadu).