Executive Function and Substance Use

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By: JoAnn Kukulus, MS Clinical Psychology; MFT Intern
ACS Outpatient Counseling Services

I went to the gym, got the kids off to school, walked the dog, and am now ready to head to work on time. As I’m reaching into the refrigerator to grab my lunch I receive a phone call from the dentist who wants to reschedule next week’s appointment. I check my calendar, find a new time that works for both of us, run back to the refrigerator for my almost forgotten lunch and am finally backing out the driveway, still only 10 minutes behind schedule. I’m preparing to make the left turn onto my office’s street when another driver zooms in front of me, cutting me off and causing me to miss the light; he has the nerve to shrug and wave at me but I refrain from making any hand gestures as I step on the brake in anger. While I wait for the next green light I take a deep breath and let it all go.

We all may have mornings like this occasionally, or even frequently, and think nothing of it, but that we are able to accomplish all these tasks/goals is due to our brain’s skill at executive functioning! The prefrontal cortex (aka frontal lobes) portion of our brains is responsible for successfully integrating the mental processes that include working memory; organization, time management, and planning skills; self-control; and emotional regulation. By the time an individual is in her/his mid-to-late twenties this executive functioning is well-established, and contributes to one’s ability to plan for the future, engage in goal-directed behavior, and use good judgment.

Adolescence is usually when parents are ready for their teenagers to be practicing many or all of the executive functioning skills that encompass behavior control, problem solving, and wise or informed decision making. What science has demonstrated recently about the teen-aged brain is that it is still in the early stages of development toward its ultimate adult maturity. Research has shown that the adolescent brain is predominantly under the influence of a more primitive part of the brain, the amygdala, which is responsible for automatic responses like fear and aggression. For this reason, teens may be more likely to act impulsively, misunderstand social cues and emotions, have any variety of accidents, fight, and engage in risky or dangerous behavior.

Due to the biological limitations on their ability to engage and integrate executive functioning, teens are highly susceptible to the unhealthy consequences of using tobacco, alcohol, and other drugs. Compared to adults, alcohol causes a greater impact on teen and young adult brains in the areas of working memory and learning; adolescents who use alcohol before age 15 have an increased chance of becoming alcohol-dependent than individuals who wait until age 21; and teen/young adult brains show less sensitivity to alcohol’s sedative effects, leading them to consume greater quantities that result in higher blood alcohol levels.

Early nicotine use results in memory bank damage and increases the frequency of depressive episodes and heart irregularities; teens have a greater tendency toward long-term nicotine dependence. Other drugs, such as stimulants, marijuana, and opiates, target the dopamine receptors in the brain and can cause life-long damage to the development of impulse control and the capacity to experience reward. Substance abuse contributes to delays in executive function skills and immature or under-controlled emotional responses.

Current research indicates that teens who exhibit an ability to focus on tasks and ignore distractions are less likely to develop substance abuse issues after early experimentation. Strategies for increasing and improving executive functioning abilities include: creating structure such as writing down assignments, following daily routines, and developing a reminder system; practicing impulse control and emotional self-regulation by becoming aware of triggers and learning to avoid them, as well as accessing positive emotions to cope with and manage negative ones by learning self-soothing techniques. Methods for refilling the “executive function fuel tank” include taking breaks from challenging tasks, engaging in relaxing and soothing activities, and getting exercise.

Greater understanding of teen brain development will contribute to strengthened relationships between teens and those who care about them.

Sources:

The Special Edge, volume 27, No. 3
Johns Hopkins University, Center for Adolescent Health: “The Teen Years Explained”Nauert, R (2014) Strong Attention Skills Can Help Some Teens Avoid Substance Use Problems Psych Central
American Academy of Child & Adolescent Psychiatry, Facts for Families No. 95: “The Teen Brain: Behavior, Problem Solving, and Decision Making”