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Acknowledging that ongoing brain development during adolescence is linked to self-regulation is an important perspective for youth-serving professionals and parents as they address teenage substance use/dependence – including prescription drug diversion.

Most brain material is in place at the start of adolescence. In most cases, the size of the brain is also established by the teen years. Yet, MRI studies and other techniques tell us that several important developmental processes in the brain continue throughout adolescence. Frequently, the result is a teenager whose body may be nearly fully developed, but not his or her brain. 

As this essential “hard wiring” matures, what we as parents and others experience is a kid who may be moody; many times reckless and impulsive; increasingly secretive; more prone to be influenced by friends; and when it comes to making decisions, more prone to focus on rewards that may result from acting in a certain way – and less interested in thinking through negative consequences.

Parents and treatment providers cannot stop brain maturation, but we can shape it. One path may be to teach important self-regulation skills that are related to decision making. This way we help strengthen what may be a “weakness” for the adolescent brain.
 
The Substance Abuse and Mental Health Services Administration’s National Registry of Evidence-based Programs and Practices identifies these skills as impulse control, “second” thought processes; social decision-making, dealing with risk situations and taking healthy risks.
 
Bottom line: just telling the teenager about the rules and expectations is not enough. Helping guide a teenager as to how he or she might handle a challenging situation is better for self-regulation. Some examples:

“Call home and we will come and get you, rather than you getting a ride home with a drunk friend.”

“Let’s review how you’re going to say ‘no’ when you’re faced with pressure from your friends to do something you know is wrong.”
  
“Don’t just act on an impulse. Pause and think of options, then act.”

Parents, doctors, treatment providers and educators are crucial to influencing teenagers’ decisions for or against drinking or drug taking. Teaching developmentally appropriate self-regulation skills may make better sense than asking something of a young person whose brain isn’t (yet) fully capable of delivering the action requested. Certainly, exercising developmentally appropriate influence to account for those times is a role for all of us.  

Ken C. Winters, PhD is Associate Director of the Parents Translational Research Center at the Treatment Research Institute in Philadelphia. He is also Professor, Department of Psychiatry and Director, Center for Adolescent Substance Abuse Research, at the University of Minnesota. 


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