There is a common misconception that abuse, such as the abuse of substances is synonymous with addiction. While abuse often leads to addiction, it is important to distinguish between the two. Abuse indicates that the action is inappropriate either socially, legally or physiologically in a way that puts the individual or those around them at risk. The rebellious nature of teens coupled with peer pressure often results in teens overestimating their tolerance to abuse of substances or activities. This makes teenagers more susceptible the development of an addiction.There are many forms of addiction, but the most common in teenagers would be substance addiction.

Some substances such as heroin or crystal meth are more addictive than others and have more rapidly deteriorating effects on the physical and psychosocial elements of the teenager. The physical addiction results in the teen’s body either becoming reliant on the substance or building a tolerance to the substance that more is required to achieve the same desired effects. The latter usually goes hand-in-hand with psychological addiction. This is when the teen feels overcome with the desire to experience a certain effect elicited by the substance of choice. The teen loses self-control and is overpowered by the need to abuse the substance.

There is a higher risk of substance abuse and addiction in teens who:

• Have family history of substance abuse
• Have a poor sense of identity and self esteem
• Lack drive and motivation to achieve specific goals for the future
• Live in difficult socio-economic circumstances
• Engage with negative social circles

It is important to be aware of the signs of addiction in order to identify the teen with an addiction early. Signs that you or someone you know may have a substance addiction include:

• withdrawal or keeping secrets from family and friends
• loss of interest in activities that used to be important
• problems with schoolwork, such as slipping grades or absences
• changes in friendships, such as hanging out only with friends who use drugs
• stealing or selling belongings to be able to afford drugs
• failed attempts to stop taking drugs or drinking
• anxiety, anger, or depression
• mood swings
• changes in sleeping habits
• feeling shaky or sick when trying to stop
• changes in eating habits, including weight loss or gain

Finally, it is also important to acknowledge the important role technology plays in the lives of today’s teenagers. While substance abuse remain the most common form of addiction, it is crucial to recognise the growing trend among the new generation of teens to become addicted to some form of technology such as texting or social networking. The same rules of addiction apply, but the difficulty with preventing or remedying technological addiction is that technology has become pervasive in all areas of life.

This is particularly common in teenagers who lack the resources gained through life experience to overcome difficult life situations. Teens who reach this point feel that they lack the resources to cope with their problems and try to communicate feelings of hopelessness and the expression of insurmountable stress through suicide. While some teenagers attempt suicide as a desperate act to get help from others without the intention of ending life, there are those who have lost all hope that help is obtainable that the goal to end their life becomes a reality.

Suicide prevention is best achieved by anticipating the precipitating factors for suicidal ideation and being aware of the warning signs of suicidal intent. Even if the teen denies suicidal intent, behavioural clues and thinking patterns can indicate the teenager’s level of suicidality. Depression, hopelessness and anxiety are found to be important factors in suicidal ideation and behaviour. This is often accompanied by feelings of isolation and perceived loss of control over their environment. All-or-nothing thinking emerges in which no options for coping or overcoming problems seem possible.

Suicidal intent refers to how committed the teen is to dying. Suicidal lethality refers to the dangerousness of the teen’s intended method of dying. Warning signs that a teenager is thinking about suicide include:

• Lack of hope for the future: the teen feels that there is no hope for the future, and things will never improve
• Preoccupation with death and dying: the teen imagines the world without their existence, or frequently talks about death or dying. For example they might say things like, “I wish I’d never been born”
• Feelings of worthlessness: the teen expresses self-hatred and self-loathing and perceives him- or her-self as a burden.
• Social withdrawal: withdrawing from family and friends and isolating self from social interaction.
• Self-destructive or self-harming behaviour: purposely taking unnecessary risks and risk-taking behaviour such as drug and alcohol abuse, or engaging in self-injury such as cutting.
• Saying good-bye: unexpected visits to family and friends and talking as though they will never see them again.
• Getting affairs in order: the person appears to be making preparations for after their death such as suddenly giving away prized possessions or making arrangements for pets and family members.
• Seeking out suicide implements: the person has a sudden interest in obtaining lethal objects such as pills, guns, knives, etc.

Sudden sense of calm: this is often the most surprising warning sign as many people remark that the person who committed suicide appeared very happy before the suicide. If there is a sudden change from being depressed and experiencing feelings of hopelessness to displaying a sense of resolve, this could indicate that the teen has made peace with the decision to end their life.