Background: When a family encounters the problem of adolescent substance misuse, the burden of managing it often falls primarily on the mother. Objective and methods: This research was conducted in two phases to explore the experiences of mothers of adolescents who misuse substances. Phase one was a systematic qualitative evidence synthesis of qualitative studies on the experiences of mothers of adolescents who misused substances. In this phase, conventional content analysis was used to create a narrative synthesis of themes and categories. Phase two was a qualitative study using thematic analysis to describe mothers’ experiences of parenting an adolescent who misused drugs. Findings: Eleven qualitative studies were included in the literature review. New categories regarding mothers’ experiences emerged from the review and synthesis: 1) I love you and we can talk no matter what; 2) So this is really happening . . . My kid’s on drugs; 3) What have I done?; 4) My family is shattered: a) I can’t believe what you’re doing, b) I can’t face this, c) I’ve lost my baby; and 5) It’s not my addiction. Four mothers were interviewed for the qualitative study. Mothers described their realities and the challenges they faced parenting an adolescent who misused drugs. Their experiences were represented in the following categories:1) recognition, 2) punishment/surveillance, 3) negative emotions, 4) relationships, 5) escalating effects, 6) strategies, and 7) home–a safe place. Conclusions: The findings from this research contribute to our understanding of the everyday lives and struggles that mothers face with their adolescents’ substances misuse. Nurses, by implementing early targeted interventions, will meet the needs of these mothers and assist themselves and ultimately their adolescents to attain optimal wellbeing.

Adolescence is a time of experimentation and exploration. For many young people, a feature of this developmental period is the initiation of substance use. Whilst the majority of young people do not go on to develop substance use problems, any substance use has potential for danger. The current body of literature on the prevention of substance use problems suggests that in order to advance understanding, researchers must adopt a risk-focused approach. There is a wide range of indices that have been cited as risk factors for the development of substance use disorders. Chapter 2 explores some of the aetiological models and literature on risk factors with specific reference to psychological wellbeing, studies highlighting comorbid relationships between adolescent mental health and substance use problems, and the functional value of substances in relation to well-being. Although attention to psychological risk factors has received increased press in the literature, the number of controlled, longitudinal studies is relatively small. A review of recent studies (Chapter 3) indicates that the presence of anxiety, depression, low self-esteem or behavioural problems such as delinquency represent psychological risk factors for the development of later substance use problems, however findings are inconsistent and many studies do not examine differential predictive utility by substance or gender. Thus, Study 1 of this research aimed to add to this body of work by exploring the prediction of alcohol, cannabis and other illicit substance use at age fifteen from key indicators of psychological well-being taken at age thirteen. The data from a normative sample of high school students indicated subtle differences in trajectory for young males and females and effects specific to different drug categories. Delinquency emerged as the most consistent predictor in both males and females. Low self-esteem was also an important indicator for future female marijuana use and marijuana intoxication and both male and female other illicit substance use. The findings highlighted the need for a greater contextual understanding of the relationship between delinquency, self-esteem and substance use. The second study sought to provide a deeper understanding of these issues by examining the perceived functional value of substances in relation to psychological wellbeing, by means of a qualitative study of a group of young people who had experienced problems with their substance use. Chapter 4 explores the limited phenomenological research in this area, with a focus on studies which have used methods of measurement that highlight the perspective of young people. Using a Consensual Qualitative Research approach, Study 2 builds on the drug type and gender contrasts noted in Study 1, and explores the interface between substance use and psychological well-being in depth using a clinical population. A number of key functions are identified by young people, with evidence of both convergence and divergence across drug categories (alcohol, cannabis, other illicit substances). Interviewees reported six functions common to all substances; social connectedness, improve affect, positive self-transformation, better coping with problems, fun and laughter, and feeling intoxicated. Nine additional functions were identified in relation to cannabis and other illicit substances. Several gender differences were also noted, with males tending to report more positive reinforcement from alcohol and cannabis, and young females more frequently describing benefits related to use of other illicit substances. The concluding chapter (Chapter 5) reviews the main findings across both studies and their implications for theory, practice, and future research. Overall, the findings of the research provide support for both problem behaviour and adaptive models of adolescent substance use, and indicate that young people are capable of reflecting on their substance use experiences. Incorporating the wisdom of young people into risk frameworks may enhance prevention, education and intervention efforts.

Adolescence is a time of experimentation and exploration. For many young people, a feature of this developmental period is the initiation of substance use. Whilst the majority of young people do not go on to develop substance use problems, any substance use has potential for danger. The current body of literature on the prevention of substance use problems suggests that in order to advance understanding, researchers must adopt a risk-focused approach. There is a wide range of indices that have been cited as risk factors for the development of substance use disorders. Chapter 2 explores some of the aetiological models and literature on risk factors with specific reference to psychological wellbeing, studies highlighting comorbid relationships between adolescent mental health and substance use problems, and the functional value of substances in relation to well-being. Although attention to psychological risk factors has received increased press in the literature, the number of controlled, longitudinal studies is relatively small. A review of recent studies (Chapter 3) indicates that the presence of anxiety, depression, low self-esteem or behavioural problems such as delinquency represent psychological risk factors for the development of later substance use problems, however findings are inconsistent and many studies do not examine differential predictive utility by substance or gender. Thus, Study 1 of this research aimed to add to this body of work by exploring the prediction of alcohol, cannabis and other illicit substance use at age fifteen from key indicators of psychological well-being taken at age thirteen. The data from a normative sample of high school students indicated subtle differences in trajectory for young males and females and effects specific to different drug categories. Delinquency emerged as the most consistent predictor in both males and females. Low self-esteem was also an important indicator for future female marijuana use and marijuana intoxication and both male and female other illicit substance use. The findings highlighted the need for a greater contextual understanding of the relationship between delinquency, self-esteem and substance use. The second study sought to provide a deeper understanding of these issues by examining the perceived functional value of substances in relation to psychological wellbeing, by means of a qualitative study of a group of young people who had experienced problems with their substance use. Chapter 4 explores the limited phenomenological research in this area, with a focus on studies which have used methods of measurement that highlight the perspective of young people. Using a Consensual Qualitative Research approach, Study 2 builds on the drug type and gender contrasts noted in Study 1, and explores the interface between substance use and psychological well-being in depth using a clinical population. A number of key functions are identified by young people, with evidence of both convergence and divergence across drug categories (alcohol, cannabis, other illicit substances). Interviewees reported six functions common to all substances; social connectedness, improve affect, positive self-transformation, better coping with problems, fun and laughter, and feeling intoxicated. Nine additional functions were identified in relation to cannabis and other illicit substances. Several gender differences were also noted, with males tending to report more positive reinforcement from alcohol and cannabis, and young females more frequently describing benefits related to use of other illicit substances. The concluding chapter (Chapter 5) reviews the main findings across both studies and their implications for theory, practice, and future research. Overall, the findings of the research provide support for both problem behaviour and adaptive models of adolescent substance use, and indicate that young people are capable of reflecting on their substance use experiences. Incorporating the wisdom of young people into risk frameworks may enhance prevention, education and intervention efforts.

Adolescence is a time of experimentation and exploration. For many young people, a feature of this developmental period is the initiation of substance use. Whilst the majority of young people do not go on to develop substance use problems, any substance use has potential for danger. The current body of literature on the prevention of substance use problems suggests that in order to advance understanding, researchers must adopt a risk-focused approach. There is a wide range of indices that have been cited as risk factors for the development of substance use disorders. Chapter 2 explores some of the aetiological models and literature on risk factors with specific reference to psychological wellbeing, studies highlighting comorbid relationships between adolescent mental health and substance use problems, and the functional value of substances in relation to well-being. Although attention to psychological risk factors has received increased press in the literature, the number of controlled, longitudinal studies is relatively small. A review of recent studies (Chapter 3) indicates that the presence of anxiety, depression, low self-esteem or behavioural problems such as delinquency represent psychological risk factors for the development of later substance use problems, however findings are inconsistent and many studies do not examine differential predictive utility by substance or gender. Thus, Study 1 of this research aimed to add to this body of work by exploring the prediction of alcohol, cannabis and other illicit substance use at age fifteen from key indicators of psychological well-being taken at age thirteen. The data from a normative sample of high school students indicated subtle differences in trajectory for young males and females and effects specific to different drug categories. Delinquency emerged as the most consistent predictor in both males and females. Low self-esteem was also an important indicator for future female marijuana use and marijuana intoxication and both male and female other illicit substance use. The findings highlighted the need for a greater contextual understanding of the relationship between delinquency, self-esteem and substance use. The second study sought to provide a deeper understanding of these issues by examining the perceived functional value of substances in relation to psychological wellbeing, by means of a qualitative study of a group of young people who had experienced problems with their substance use. Chapter 4 explores the limited phenomenological research in this area, with a focus on studies which have used methods of measurement that highlight the perspective of young people. Using a Consensual Qualitative Research approach, Study 2 builds on the drug type and gender contrasts noted in Study 1, and explores the interface between substance use and psychological well-being in depth using a clinical population. A number of key functions are identified by young people, with evidence of both convergence and divergence across drug categories (alcohol, cannabis, other illicit substances). Interviewees reported six functions common to all substances; social connectedness, improve affect, positive self-transformation, better coping with problems, fun and laughter, and feeling intoxicated. Nine additional functions were identified in relation to cannabis and other illicit substances. Several gender differences were also noted, with males tending to report more positive reinforcement from alcohol and cannabis, and young females more frequently describing benefits related to use of other illicit substances. The concluding chapter (Chapter 5) reviews the main findings across both studies and their implications for theory, practice, and future research. Overall, the findings of the research provide support for both problem behaviour and adaptive models of adolescent substance use, and indicate that young people are capable of reflecting on their substance use experiences. Incorporating the wisdom of young people into risk frameworks may enhance prevention, education and intervention efforts.

Adolescence is a time of experimentation and exploration. For many young people, a feature of this developmental period is the initiation of substance use. Whilst the majority of young people do not go on to develop substance use problems, any substance use has potential for danger. The current body of literature on the prevention of substance use problems suggests that in order to advance understanding, researchers must adopt a risk-focused approach. There is a wide range of indices that have been cited as risk factors for the development of substance use disorders. Chapter 2 explores some of the aetiological models and literature on risk factors with specific reference to psychological wellbeing, studies highlighting comorbid relationships between adolescent mental health and substance use problems, and the functional value of substances in relation to well-being. Although attention to psychological risk factors has received increased press in the literature, the number of controlled, longitudinal studies is relatively small. A review of recent studies (Chapter 3) indicates that the presence of anxiety, depression, low self-esteem or behavioural problems such as delinquency represent psychological risk factors for the development of later substance use problems, however findings are inconsistent and many studies do not examine differential predictive utility by substance or gender. Thus, Study 1 of this research aimed to add to this body of work by exploring the prediction of alcohol, cannabis and other illicit substance use at age fifteen from key indicators of psychological well-being taken at age thirteen. The data from a normative sample of high school students indicated subtle differences in trajectory for young males and females and effects specific to different drug categories. Delinquency emerged as the most consistent predictor in both males and females. Low self-esteem was also an important indicator for future female marijuana use and marijuana intoxication and both male and female other illicit substance use. The findings highlighted the need for a greater contextual understanding of the relationship between delinquency, self-esteem and substance use. The second study sought to provide a deeper understanding of these issues by examining the perceived functional value of substances in relation to psychological wellbeing, by means of a qualitative study of a group of young people who had experienced problems with their substance use. Chapter 4 explores the limited phenomenological research in this area, with a focus on studies which have used methods of measurement that highlight the perspective of young people. Using a Consensual Qualitative Research approach, Study 2 builds on the drug type and gender contrasts noted in Study 1, and explores the interface between substance use and psychological well-being in depth using a clinical population. A number of key functions are identified by young people, with evidence of both convergence and divergence across drug categories (alcohol, cannabis, other illicit substances). Interviewees reported six functions common to all substances; social connectedness, improve affect, positive self-transformation, better coping with problems, fun and laughter, and feeling intoxicated. Nine additional functions were identified in relation to cannabis and other illicit substances. Several gender differences were also noted, with males tending to report more positive reinforcement from alcohol and cannabis, and young females more frequently describing benefits related to use of other illicit substances. The concluding chapter (Chapter 5) reviews the main findings across both studies and their implications for theory, practice, and future research. Overall, the findings of the research provide support for both problem behaviour and adaptive models of adolescent substance use, and indicate that young people are capable of reflecting on their substance use experiences. Incorporating the wisdom of young people into risk frameworks may enhance prevention, education and intervention efforts.

Adolescence is a time of experimentation and exploration. For many young people, a feature of this developmental period is the initiation of substance use. Whilst the majority of young people do not go on to develop substance use problems, any substance use has potential for danger. The current body of literature on the prevention of substance use problems suggests that in order to advance understanding, researchers must adopt a risk-focused approach. There is a wide range of indices that have been cited as risk factors for the development of substance use disorders. Chapter 2 explores some of the aetiological models and literature on risk factors with specific reference to psychological wellbeing, studies highlighting comorbid relationships between adolescent mental health and substance use problems, and the functional value of substances in relation to well-being. Although attention to psychological risk factors has received increased press in the literature, the number of controlled, longitudinal studies is relatively small. A review of recent studies (Chapter 3) indicates that the presence of anxiety, depression, low self-esteem or behavioural problems such as delinquency represent psychological risk factors for the development of later substance use problems, however findings are inconsistent and many studies do not examine differential predictive utility by substance or gender. Thus, Study 1 of this research aimed to add to this body of work by exploring the prediction of alcohol, cannabis and other illicit substance use at age fifteen from key indicators of psychological well-being taken at age thirteen. The data from a normative sample of high school students indicated subtle differences in trajectory for young males and females and effects specific to different drug categories. Delinquency emerged as the most consistent predictor in both males and females. Low self-esteem was also an important indicator for future female marijuana use and marijuana intoxication and both male and female other illicit substance use. The findings highlighted the need for a greater contextual understanding of the relationship between delinquency, self-esteem and substance use. The second study sought to provide a deeper understanding of these issues by examining the perceived functional value of substances in relation to psychological wellbeing, by means of a qualitative study of a group of young people who had experienced problems with their substance use. Chapter 4 explores the limited phenomenological research in this area, with a focus on studies which have used methods of measurement that highlight the perspective of young people. Using a Consensual Qualitative Research approach, Study 2 builds on the drug type and gender contrasts noted in Study 1, and explores the interface between substance use and psychological well-being in depth using a clinical population. A number of key functions are identified by young people, with evidence of both convergence and divergence across drug categories (alcohol, cannabis, other illicit substances). Interviewees reported six functions common to all substances; social connectedness, improve affect, positive self-transformation, better coping with problems, fun and laughter, and feeling intoxicated. Nine additional functions were identified in relation to cannabis and other illicit substances. Several gender differences were also noted, with males tending to report more positive reinforcement from alcohol and cannabis, and young females more frequently describing benefits related to use of other illicit substances. The concluding chapter (Chapter 5) reviews the main findings across both studies and their implications for theory, practice, and future research. Overall, the findings of the research provide support for both problem behaviour and adaptive models of adolescent substance use, and indicate that young people are capable of reflecting on their substance use experiences. Incorporating the wisdom of young people into risk frameworks may enhance prevention, education and intervention efforts.