Cravings and Teen Co-Occurring Disorders

We all have cravings. They are not just desires that we want to fill, but cravings tend to be an urge for something that we know is bad for us. And to make matters worse, we will even go to great lengths to get quench those cravings.

Cravings might become the center of our lives to the point that they are surrounded by the need to tell lies. You find yourself lying to family, friends, and co-workers. You are also lying to yourself. You continue to tell yourself that you have it all under control and that you do not have a problem. Besides, meeting your craving brings you great pleasure, and what is wrong with that?

And we can have a craving for anything. It can be for shopping, for sex, for money as in the need to gamble, or for a substance such as alcohol, caffeine, or nicotine. The mental health field and the American Psychological Association (APA) acknowledge that there is a cycle of addiction that occurs in the brain with both drugs and compulsive behavior, such as gambling. With the fulfillment of that craving comes a rush in the brain. For this reason, the APA now recognizes almost any behavior that becomes compulsive and that initiates the cycle of addiction can be diagnosed as an addiction. According to the APA, certain behaviors, such as gambling and shopping, can produce the same high, or rush in the brain, which is similar to the use of drugs. In that way, addictions can resemble the physiological symptoms that the use of drugs and alcohol might create.

However, there are a variety of reasons why teens might have certain cravings. Some teens might experiment with the use of alcohol or other drugs and discover the euphoric feelings it brings. It might bring them a high and an escape from the frustrations in their life. Furthermore, it might give an adolescent a feeling of being able to control his or her emotions. Some teens might use drugs to quell symptoms of a mental illness, which might be stimulating the craving in the first place. For instance, when you’re not feeling well emotionally one morning, you might crave some caffeine because you know it will change your mood and give you energy to face the day. Or you might crave marijuana to help relax the over thinking that goes on in your mind. Teens who use drugs or alcohol to cope with intense emotions and strong inner experiences or to function better in their lives are known to be self-medicating.

Having both an addiction and a mental illness is known as a teen co-occurring disorder or having a dual diagnosis. Approximately, 60-75% of teens who abuse drugs or alcohol also have a mental illness. Research indicates that of those teens use drugs for the first time, a majority of them are those who have experienced a major depressive episode. In addition to depression, other mental illnesses that co-exist with substance use are Oppositional Defiant Disorder (ODD), Attention-Deficit/Hyperactivity Disorder (ADHD), Anxiety, Major Depression, Bipolar Disorder, and Post Traumatic Stress Disorder (PTSD).

Although the mental illness might be the cause for the use of drugs and a developing addiction, it’s often difficult to determine which came first:  the substance use or the mental illness. Nonetheless, treatment must thoroughly address the addiction, the mental illness, as well as any underlying issues that might also be contributing to substance use. Sadly, many teens who are diagnosed with an addiction might be sent to a rehabilitation treatment center that does not also address the psychological factors of the mental illnesses. This usually leads to teen chronic relapse because the primary cause for the addiction was not addressed.

Typically, treatment would include individual and family psychotherapy, medication, support groups, and strong communication among the psychiatrist, psychologist, family members, social workers, teachers, and other professionals in the teen’s life. Ideally, there would be an integration of services between the psychiatric and the drug counseling fields in order to best treat a teen with a co-occurring disorder.


ASAM Board of Directors. “Definition of Addiction.” American Society of Addiction Medicine. American Society of Addiction Medicine, 19 Apr. 2011. Web. 05 Mar. 2014.