The rise in drug-related deaths in Scotland has been relentless, with the number of deaths increasing almost every year since the 1990s earning Scotland the title of “drug death capital of the world”. Some 1,264 people died from drug-related causes in 2019—an all-time-high for Scotland, higher than any other European country, and nearly three times that of the UK as a whole. The majority of these deaths are in long term users, generally over the age of 35.
Other studies report that young people in Scotland drink more alcohol than their European counterparts. This elevated rate of consumption in Scotland will almost certainly have a negative effect on young people, their families, communities and future prospects.

When teenagers are struggling with emotional problems, they often turn to alcohol or drug use to help them manage painful or difficult feelings. Binge drinking, or discrete episodes of heavy drinking, is common among youthful populations. In this they are not different from adults. But because adolescent brains are still developing, the results of teenage “self-medication” can be more immediately problematic.
In the short term, substance use can help alleviate unwanted mental health symptoms like hopelessness, anxiety, irritability and negative thoughts. But in the longer term it exacerbates them and often ends in abuse or dependence. Substance use escalates from experimentation to a serious disorder much faster in adolescents than it does in adults, and that progression is more likely to happen in young people with mental health disorders than in other young people.

Some medical experts suggest that almost half of young people with mental health issues, if they’re not treated, will end up having a substance use disorder. Substance use also interferes with treatment for mental health disorders and worsens the long-term prognosis for a teenager struggling with one.

It’s common for children with mental health issues to develop self-esteem problems, a sense that there’s something wrong with them or that they’re flawed. When these children reach adolescence, with its focus on fitting in, they want to be normal but often they don’t feel normal. Drug use can become a way to fit in, to join a community and share something that only that group can provide.

Not only that, “self-medicating” with recreational drugs and alcohol works temporarily to alleviate symptoms of anxiety or depression because they affect the same brain regions that the disorders do. But the result is that young people, particularly teenagers, will experience a backlash from this kind of consumption. Substance use is a risk factor for suicide in young people with depression.
Another negative effect of substance use is that it undermines treatment. First, it diminishes a teenager’s engagement in therapy, and hence its effectiveness. Second, if they are taking prescription medication, it may lower the effectiveness of that medication. Drugs and the medications target the same areas of the brain. When medication has to compete with drugs or alcohol, they are less effective. Because of that we consider key to intervene from an early age providing healthy habits and a good support system.

The last thing to say from at the outset to a young person is, “Drugs are bad for you!” because the young person has heard that from teachers, parents, TV, everywhere. So instead, we should ask, “What is it doing for you?” “What are you getting out of it?” All behaviour serves a purpose, even if it’s self-injurious or risky behaviour. If we’re trying to divert young people from drug or alcohol misuse, you need to replace it with something positive and stimulating for them. So instead of just saying, “Don’t do that, it’s bad for you” we’re need to replace the need for substance with a coping strategy, with tools for coping without the substances and alternatives. Giving alternatives which improve physical well-being, offer positive engagement with peers, in safe environments, delivered by positive role models all contributes towards improving mental well-being.

At Achieve More Scotland we have being attempting to do this for the past 12 years, with significant positive effects. We don’t have all of the answers, but we know that we make a significant contribution.