[COLUMNIST] The silent epidemic of substance abuse among teenagers

WITHIN the complexity of society, the issue of substance abuse among teenagers arises as a pressing concern, entwining its influence throughout communities worldwide.

Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol, tobacco, nicotine, and illicit drugs. This behaviour may stem from various factors, such as the fear of missing out (FOMO), curiosity and societal influence, among others.

In severe instances, persistent substance abuse in teenagers can eventually lead to addiction - a more serious and clinically diagnosed condition marked by compulsive drug, alcohol or tobacco seeking, continued use despite adverse consequences, and enduring alterations in the brain.

According to the World Health Organization (WHO), globally, approximately 155 million teenagers, or more than 25% of the population between the ages of 15 and 19, currently use alcohol.

In the local context, the National Health and Morbidity Survey (NHMS 2022) survey conducted by the Ministry of Health (MoH), it was revealed that among Malaysian teenagers aged 13 to 17 who have ever used drugs, three in four (75 per cent) initiated drug use before the age of 14. While 18.6% of Malaysian teenagers reported having used alcohol at some point in their lives, 64.6% of them did so before turning 14.

It was also revealed that in 2023, over 137,000 people were reported to be battling drug addiction; whereby youths and teenagers made up (73,769) 65% of the total.

As we delve into the complexities of this issue, it becomes apparent that the spectre of substance abuse not only jeopardises the physical and mental health of our teenagers but casts a shadow on their educational pursuits, familial bonds, and overall societal contributions.

Teenage substance abuse often extends beyond experimental or occasional use to a detrimental pattern of misuse that disrupts normal daily functioning, relationships, and personal development.

The issue at hand transcends mere data and statistics, unfolding into a compelling narrative about the obstacles young people face while navigating a world full of influences that might jeopardise their bright futures.

The Battle Against Easy Access and Availability to Substance Abuse

Based on a local media report from 2017, students could obtain ice and methamphetamine (meth) for as little as RM10. Considering the continuous influx of drugs in Malaysia over the years, this cost may have further decreased.

A teenager's likelihood of substance abuse is significantly influenced by their surroundings. Teenagers with readily available access to drugs, tobacco and alcohol face an increased susceptibility to developing addiction.

The recent actions of the current administration, providing unrestricted access to tobacco products while dropping the generational end-game (GEG) provision under the anti-smoking Bill, have made it easier for teenagers to access these products. This raises critical concerns regarding both availability and affordability, creating an environment where children can easily obtain these products.

Moreover, teenagers, particularly those living in high-risk areas with drug users, are more vulnerable to the effects and risks of substance use.

For instance, as highlighted in the 2023 Synthetic Drugs in East and Southeast Asia report by the United Nations Office on Drugs and Crime (UNODC), the Golok river that borders Kelantan and Narathiwat has been heavily exploited by organised crime groups to transport large quantities of crystal methamphetamine, as evidenced by many cases reported in 2022 and early 2023.

As reported by the National Anti-Drugs Agency (NADA), there is a concurrent concern with synthetic drugs, particularly prevalent in states like Kedah, Kelantan, Terengganu, and Perlis. The geographical location of these states, bordering Thailand, makes them susceptible to the influence of the illicit drug trade, establishing Thailand as a primary source and distributor.

Moreover, these states have high rates of unemployment and poverty. Due to the huge demand in Malaysia and the low cost of supply from foreign illicit substance manufacturers, the local community and teenagers in particular are easily persuaded, which can result in drug mules as well as consumption for extra pocket money, for instance.

Substance abuse in context of family environment and structure

The development of substance abuse issues in teenagers is a complex interplay of various factors, with family dynamics playing a pivotal role.

As the primary social unit, the family significantly shapes a teenager's attitudes, behaviours, and overall well-being. Four key factors—unhealthy family dynamics, parental substance abuse, lack of parental supervision, and inconsistent discipline—contribute to the vulnerability of teenagers to substance abuse.

In contrast to the past, where parents maintained strict rules against substance use, contemporary parenting has evolved towards a more lenient approach (less responsible). Some parents now accept their children's actions, even if they are misguided. A recent incident exemplified this shift when local media reported a father openly supporting his son caught smoking on school premises during the SPM examination.

Rarely discussed, socioeconomic inequalities in teenagers pose a significant risk for substance misuse, with studies suggesting that children from socioeconomically disadvantaged households are more likely to have poorer mental health than their more affluent counterparts.

According to the research by Jane et.al (2022), the prevalence of current cigarette smokers in rural schools was almost twice as much compared to the prevalence in urban schools

Furthermore, parental substance abuse is a potent predictor of a teenager's susceptibility to similar behaviours. Children of parents who misuse substances face an elevated risk of developing substance abuse issues themselves.

A cross-sectional study by Machado et. al (2019) involving 6,254 teenagers aged 14-19 years old found that teenagers with at least one or both parents smoking had a greater risk of smoking than those with neither parent smoking.

The normalisation of substance use within the family might contribute to the notion that it is acceptable, if not expected, impacting the teenager's views towards substances.

The intricate effects of substance abuse on the physical and mental health of teenagers

Peer pressure, academic stress, and identity formation are some of the variables that can lead to mental health issues throughout adolescence, which is a susceptible developmental stage — a crucial time for cognitive, emotional, and physical growth.

For instance, as a coping mechanism with mental health challenges, some teenagers may resort to substances, finding momentary relief from anxiety, depression, or trauma. Research conducted by Boys et. al among 2,458 teenagers aged 13-15 years found that those suffering from a depressive disorder were over five times more likely to be smokers.

Furthermore, the stigma associated with mental health issues may discourage some teenagers from seeking professional assistance, which might result in their self-medicating instead and continuing the cycle of substance misuse. Co-occurring disorders, in which drug abuse and mental health concerns coexist, pose specific challenges for diagnosis and treatment.

Teenagers engaging in substance abuse face a myriad of physical consequences that extend beyond the immediate effects of intoxication.

Substances use, including alcohol, tobacco, and illicit drugs, can impose significant strain on the physical health of teenagers. From disrupted sleep patterns to compromised nutritional habits, the physical toll is substantial.

Apart from reinforcing the GEG provision under the anti-smoking bill, EMIR Research recommends:

● Extend the reach of AntiDrugs Skuad initiatives administered by NADA by directing concerted efforts towards rural areas identified as high-risk, intensifying the impact on substance abuse prevention and intervention.

● Conduct comprehensive rehabilitation initiatives among teenagers and youths, encompassing accessible mental health interventions, aiming to address both aspects holistically (e.g. nicotine replacement therapy administered in Hong Kong). By addressing both aspects holistically, we can promote healthier coping mechanisms, reduce stigma, and foster environments that support the overall well-being of teenagers.

● Call to maximise the taxation for alcohol, drugs, tobacco, and similar products under the same category. Higher taxes can lead to price increases, which might discourage young people from starting or continuing to consume alcohol and cigarettes, as young people are especially susceptible to price fluctuations.

● Simultaneously, stakeholders should be prepared to implement blockchain technology to reduce the prevalence of smuggling. This aims to create transparent and tamper-resistant records of transactions, making it more challenging for smugglers or even civil servants to manipulate documentation.

● Reinforce border security, particularly in high-risk areas such as Sungai Golok, Kelantan and Bukit Kayu Hitam, Kedah, for instance, through modernising border infrastructure to optimise legal trade processes and robustly monitor and thwart illicit activities. In addition, mechanisms for anonymous reporting of smuggling activities with appropriate protection for whistleblowers, as oftentimes smuggling also involves some civil servants.

The urgency of addressing substance abuse among teenagers lies not only in mitigating its immediate consequences but also in fostering a generation free from the chains of addiction, allowing them to realise their fullest potential.

---

Jachintha Joyce is Research Assistant at EMIR Research, an independent think tank focused on strategic policy recommendations based on rigorous research.

** The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the position of Astro AWANI.