Poly Substance Use and Temperamental Risks Among Children

Poly Substance Use and Temperamental Risks Among Children
Substance abuse has been threat to human growth and well being. Bio psycho social factors play vital role as cause of the problem and elements of treatment. Recent researches focus more on temperamental issues and substance use. Study findings would help practitioners to frame early school based prevention. School is one of the prominent socializing agents of human behavior. Nature and nurture are two predictors of human behavior. Nature means biologically what we are and nurture means our socialization process. Socialization process is the process of transforming a biological being into social being. Both of these predictors influence a child to use or not to use substances. Certain temperamental traits are prone to develop substance use in unsafe environment.
Poly substance use has been recognized as use of more than two substances. Children usually start with tobacco products like beedi, cigarette, panparag, gutka (nicotine) etc. Then they initiate alcohol use. Curiosity and urge to experience more pleasure usually lead to other drug. They would try other substance like cough syrup (opioids), whitener (solvent) sleeping tablets (benzodiazepines) ganja joints (cannabis), brown sugar (opioids), pain killers (opioids). When a person starts using more than two substances regularly, they would be called as persons with poly substance use.
Temperamental traits are understood as a set of consistent response to environment till he/she reaches adulthood. Later in adulthood those traits would be defining personality. Children with Attention deficit and hyperactive disorders have mainly three types of difficult temperaments like hyperactivity, inattention and impulsivity. These temperaments lead them to poor academic performances and clashes with parents, siblings, peer group and school teachers. Such conflicts, non stimulating environment and relationships along with impulsivity lead to multiple asocial activities. Another cluster of temperaments are characterized as difficulty to follow social norms, rules and regulations; though they break such social control rarely they feel guilt or repentance. This set of behavior known as conduct disorders in children, might lead them to experiment with various stimulating substances. Yet another set of temperamental traits where they constantly have clashes with near and familiar authority figures. This is known as oppositional defiant disorders and it might lead to labeling of such children as “gone case” or “disobedient” or “bad boy”. Sometimes authority figures use harsh punishments as remedy to solve these high risk behaviors. It yields undesirable results. Above mentioned temperamental traits can be called as externalizing spectrum. Certain internalizing spectrum of traits such as anxiety, fear, dependence to near one, social phobia and obsession also might lead to substance use.
Children usually have high curiosity to know different things. That curiosity naturally leads to various experiments. If they are able derive pleasure in that experiment they are highly prone to continue the same behavior. Children with externalizing or internalizing spectrum of traits are likely to reward with pleasure by using substance. Regular substance use may lead them to form gangs or gang activities where they can easily procure and use. Poly substance use may be also a part of socialization in such gangs. Children with externalizing traits are accepted well in such gangs as “leader” or “hero”. Peer acceptance and stimulating experiences and environment would fix such children in those gangs. Children with internalizing spectrum traits may find poly substance use as a way of coping with internal crisis. Better social interaction after the use of substances reinforces them to continue use. Quite often later group may land up in above mentioned group as followers or dependents. It is also noticed that later group members turn as silent and lonely users. Another key factor in poly substance use is undesirable effect of one substance use is dealt by other substance. For example depressing effect of alcohol is tried to alter by smoking or chewing nicotine. The impulsive nature and less risk perception tempt them to use or experiment with various pleasure giving sources. So they are prone to all range of substances and other high risk behaviors like drug injecting or unprotected sex. Clinical experience shows that children with externalizing traits and family history of addiction are more vulnerable to develop dependence before the age of 25 years. Genetic reasons and social learning factors such as modeling are major reasons to this early dependence. Poly substance use is widely seen among adolescents who are out of school.
Early intervention would save children from grave crisis. Parents and teachers have duty to identify these risky traits as early as possible. This identification and talent based differential reinforcement help child to turn as pro social being . Following school centered social work interventions are the need for hour.
1. Life skill training
2. Awareness creation
3. Training for parents on parenting skills
4. Alternative pleasure activities e.g. Pleasure trips, games
5. Pro social group activities
6. Anti drug campaign for ban and policies
Temperamental traits have to be considered while training children at school or home. World famous swimming star had Attention deficit and hyperactive problem in childhood. His father identified this problem and diverted him to swimming pool. That helped him to become unbeaten sports man with number of world records in swimming. Careful assessment of child’s nature and talents and appropriate reinforcement strategies would prevent drug use among children.
Sojan Antony *Ph.D Scholar in Psychiatric Social Work department and Psychiatric social worker of De-addiction Centre, NIMHANS, Bangalore, sojan47@gmail.com.