Mental health and the broader consequences of illicit substance abuse beginning in adolescence

Purpose
Adolescent drug abuse is a growing global public health concern, with early onset linked to a variety of harmful effects. This study examines the long-term mental, physical, social, and legal implications of adolescents’ illicit drug usage, with an emphasis on psychiatric illnesses and risks associated with demographic factors such as cultural background and socioeconomic status.

Material and methods
A retrospective descriptive study was conducted at the “Ali Mihali” Psychiatric Hospital in Vlora, Albania, using clinical data spanning 10 years (2014-2024). The study comprised 312 individuals with a history substance use that began during adolescence (12-18 years). Patients were assessed using structured psychiatric interviews and standardized evaluation tools, including the Hamilton Depression Rating Scale (HAM-D), Beck Depression Inventory (BDI-II), and Young Mania Rating Scale (YMRS). Data on mental, medical, and legal histories were obtained from the hospital.

Results
The study found a significant rise in early-onset substance use, with cannabis being most commonly used, followed by cocaine and heroin. The average age at the initiation of use ranged from 12 to 18 years, with 34.5% starting at 18. Psychiatric problems, including psychotic disorders (56.4%), bipolar disorder (21.8%), and personality disorders (17.9%) were observed. Physical health concerns were present in 39.7% of patients, including liver disease, respiratory issues, and infectious diseases (hepatitis, HIV). Moreover, 14.4% of patients had experienced legal issues, including drug trafficking and domestic violence.

Conclusions
Early drug misuse has long-lasting impacts on mental health, physical health, and social integration, according to this study. It highlights the necessity of all-encompassing, multisectoral approaches to prevention, early intervention, and rehabilitation.