Adolescent Substance Use, Risky Behavior, and STDs

Risk-taking is one of the primary characteristics of adolescence. We’ve discussed this phenomenon in detail in our article Understanding Adolescent Development. The short explanation of why adolescents take more risks than adults has to with brain development: the amygdala, the part of the brain responsible for emotions, develops ahead of the frontal cortex, the part of the brain responsible for rational decision making. To use an analogy from computer science, this means teenagers have all the hardware they need to produce strong emotions, but they lack the hardware to regulate those emotions and make accurate predictions about potential outcomes of their emotion-driven impulses. This trait is not unique to humans: research in behavioral neuroscience shows that in many mammals – particularly rodents and non-human primates – the adolescent or pubescent period is characterized by similar, risk-taking behavior.

In behavioral neuroscience, though, this behavior is typically referred to as novelty-seeking. At the most basic level, this squares with what most of us humans (also mammals) know through direct experience or through parenting teens. Here’s an oversimplified version of how it works:

1. Adolescent sees something new.
2. Adolescent is insatiably curious about that new thing.
3. The emotional part of the adolescent brain says, “Go check that out – now!”
4. The under-developed, rational decision-making part of the adolescent brain responds, “I can’t see any good reason not to go check that out. Great idea – let’s go!”
5. Adolescent goes and checks it out.

The problem with human adolescents is that seeking the novelty in question often involves risky behavior, i.e. actions that can cause short- or long-term physical or emotional damage. When an adolescent engages in a risky behavior without any immediate consequences, the behavior is reinforced, which can set the predicate for transforming one-off behaviors into lifelong habits.

Alcohol, Drugs, Teens, and Sex

A report published this week by the California Department of Public Health (CDPH) foregrounds the intersection of the adolescent propensity for risk taking and a very real health risk: sexually transmitted diseases (STDs). One risky, novelty-seeking behavior common in adolescence is sexual experimentation. Another risky, novelty seeking behavior common in adolescence is experimentation with drugs and alcohol. When the former and the latter combine and are considered in light of the new STD report by the CDPH, the potentially negative consequences of adolescent risk-taking and novelty seeking compound.

Let’s back up and look at Centers for Disease Control (CDC) data regarding the relationship between alcohol, drugs, and the sexual behavior of adolescents. Research shows that when adolescents use alcohol and/or drugs, chances of the following behaviors increase:

• Having sex at all
• Having multiple sex partners
• Not using condoms

CDC data further indicates that as substance use increases for an adolescent, the likelihood of both having sex and having multiple sex partners also increases. Risky sexual behavior is elevated for teens who use alcohol, but is highest in teens who also use:

• Marijuana
• Cocaine
• Prescriptions drugs such as:
  • Sedatives
  • Opioid pain relievers
  • Stimulants
• Any other illicit drugs

Data on adolescent sexual activity in general, as reported by the 2015 National Risk Behavior Survey (YRBS), indicates that:

• 41% of high school students have had sex
• 30% of high school students are sexually active
• 21% of high school students drank alcohol or used drugs before having sex

Now let’s look at the new STD data from the CDPH. Their report, published on May 14^th, 2018, contains several alarming facts about the rise in cases of chlamydia, gonorrhea, and syphilis between 1990 and 2017.

1990-2017: STD Rates In California

• For of all three diseases, rates increased 45% between 2014-2017.
• Rates of chlamydia have doubled since 1990. They increased by 9% from 2016-2017.
  • Rates for females were 60% more than for males
  • 54% of cases were in individuals under age 25
• For gonorrhea, rates decreased between 1990 and 2010, but rose steadily from 2011-2017.
  • Rates increased 16% from 2016-2017.
  • Gonorrhea rates are the highest they’ve been since 1998.
  • Rates are double for males.
  • 33% of cases were in individuals under age 25.
• For syphilis, rates decreased between 1990 and 2000, but have risen steadily since 2001.
  • Rates increased 20% from 2016-2017.
  • They’re the highest they’ve been since 1987.
  • Rates for females are seven times greater than they were in 2012,

[Please note that syphilis is a more complex disease than chlamydia and gonorrhea. The CDPH data includes information on primary, secondary, and congenital syphilis, but this article only includes the data on early syphilis. Also note that untreated syphilis can lead to serious health issues including brain damage, and increases transmission and acquisition of HIV]

Parents: What This Means for You and Your Teenager

The takeaway from this article is very simple: if you haven’t had the safe sex talk, have it now. Especially if you suspect, or know for sure, that your teen is experimenting with alcohol and drugs. Talk to your teenager about the risks of STDs in general, the new STD data just published by the CPDH, and the risks of teen pregnancy. If you’re unsure of how to start the conversation, have a look at our article How to Talk to an Internet Obsessed Teen About Sex. Even if your teen is not internet obsessed, the article makes three important points:

1. Communication is everything. It’s never too late to have the talk.
2. The more real facts teenagers have about sex, the less likely they are to engage in risky sexual behavior.
3. Teenagers want your guidance about sex, despite the fact that the conversations will probably be uncomfortable for everyone involved.

Every family has their own idea of when it’s appropriate for sexual activity to begin, ranging from ultra-progressive to ultra-conservative. In light of the latest data released by the CDPH, it’s easy to frame this conversation in terms of health consequences, which can help avoid the inevitable awkwardness of The Big Talk. Finally, we’ll reiterate what we want your main takeaway from this article to be:

If you haven’t had the safe sex talk, have it now: your teenager’s health depends on having accurate knowledge at the appropriate time.