A recent edition of the American Journal of Drug and Alcohol Abuse reports that of the 1,300+ children, aged 9 to 13, surveyed, 9% more tested positive using hair testing for substance use than the 10% who self-reported use. Wait, now…
The report indicates that 5% of 8th graders — children aged 13-14 — are reporting cannabis use in the past year. That statistic, which may be underreported per NIDA, which reports 8.3% (NIDA), is horrifying to me, and I hope others feel the same despite various opinions about cannabis use for adults. But that’s just cannabis; 26% of those same children admit using alcohol in the past year, and 23% admit to smoking nicotine during that same timeframe (Medical).
What the American Journal article is saying is, basically, that testing works. Sure, there are other nuances, but the bottom line is that nearly twice as many 8th graders who report using substances are actually using substances. And we wouldn’t know this without direct biomarker testing. Self-reports are inaccurate. They may be inaccurate for a number of reasons, but the end result is that they are, indeed, inaccurate.
So addiction is a disease. Preaddiction is a concern, per a JAMA report in June 2022. It states, “We suggest the DSM-5 diagnostic categories mild to moderate SUD as a starting operational definition for the term preaddiction, a commonly understood, motivating term that could engender broader clinical efforts to effect that strategy” (JAMA). The rationale is that more people would seek treatment if they knew they suffered from preaddiction. I believe more people would seek treatment if they knew they were sick, which is why I have such a problem with the whitewashing of our language. If we tell someone that ze has a “substance use disorder,” even a severe one, what does that even mean?
The solution, therefore, is direct biomarker testing. How do we know what is wrong with any person with a disease? We test for it, or we test about it. Some diseases don’t have a test to determine the actual disease, but there are tests to see if someone has characteristics of it. Addiction — or even severe substance use disorder — is the same. We don’t have a blood test that shows positive for addiction, but direct biomarker tests may be the next best thing…especially when we really need to know.
And when we really need to know is when someone is significantly misusing substances. It could be a young person experimenting or it could be someone deep in the throes of addiction. Again, self-reports are inaccurate. Self-reports are self-fulfilling, and that’s AFTER we muster up the courage to ask the question in the first place. If we have the intestinal fortitude to ask our loved one if ze has the disease of addiction or to point out our concerns, we are generally overjoyed when that person allays our fears. We don’t want to be the bearer of bad news, and we don’t want it confirmed, so we are part of the conspiracy of silence.
But addiction is a disease, and the end result of a disease that remains untreated is death. What if we did just a little bit better identifying the disease? Maybe THAT could engender broader efforts to effect treatment. It’s certainly worth a try since what we’ve done thus far hasn’t worked.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2793694
https://medicalxpress.com/news/2023-03-hair-analysis-child-drug-high.html
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