Sunday, August 11, 2013

Marijuana is Legal - So I Should be Allowed to Use it!

Your teenager is trying to use a public policy argument  about marijuana to deflect attention from the harm it is causing him, or likely will cause him. He may try  to convince you that since marijuana is legal for medical and even recreational use in some states, he should be able to use the drug. A recent CNN article  and show (Sanjay Gupta Article)made the case that a knee-jerk rejection of marijuana for medical use is irresponsible and thoughtless. This is probably true, as is the contention that marijuana is less addictive than cocaine, alcohol and nicotine. The idiocy of  Federal Drug Scheduling, which makes marijuana as dangerous as heroin, is self evident. But by the time your teenager comes to clinical attention for marijuana use, it is most likely affecting his schoolwork or relationships or motivation. And no responsible person says that adolescents should be allowed to use marijuana, because their brains are highly susceptible to the particular damage caused by Cannabis. No, you're not on a "Reefer Madness" kick. You are simply trying to help your teenager avoid a harmful substance.

Monday, March 4, 2013

Preventing Teen Drug Use

As a parent, you can do absolutely everything possible to prevent your child from having a problem with drugs or alcohol, but you do not have absolute control. You are not omnipotent. But most (well, all) parents want to do everything humanly possible to help their child avoid entanglement with addiction. The Partnership at has a listing of six research-verified ways that parents can reduce if not eliminate their child's vulnerability to addiction. These directives are simply common-sense, but they have substantial backing in the field as bulwarks against addiction. These recommendations are expanded upon at 6 Parenting Practices/Help Reduce the Chances Your Child Will Develop a Drug or Alcohol Problem
In summary, here they are;
1. Build a warm and supportive relationship with your child
2. Be a good role model when it comes to drinking, taking medicine, and handling stress
3. Know your child's risk level
4. Know your child's friends
5. Monitor, supervise, and set boundaries
6. Have ongoing conversations and provide information about drugs and alcohol.

I think it is enormously important for children and teenagers to have good examples of how one handles life's vagaries, including any use of intoxicants. If your child has an example of safe alcohol use, he or she will at least have a paradigm for how adults can use alcohol without coming to any harm. But if  you drink or drug to excess, not only will it be difficult to have the necessary conversation with your teenagers, but their model will already be hard-wired. And if you have an addiction problem yourself, you want your teenager to know that getting help has allowed you to lead a full and gratifying life!

Tuesday, February 26, 2013

Stimulant Medications: Friend or Foe?

Parents of teenagers with Attention Deficit Disorder (ADD) were likely terrified by the recent NYT article (  about Richard Fee, a 24-year-old who became addicted to the stimulant medication which eventually contributed to his death by suicide. Although he was prescribed the medication by licensed professionals, Fee took the medications in a self-destructive way, and misled those who were attempting to treat him. And the psychiatric evaluation he received appears to have been inadequate and unlikely to pick up his addictive response to the medication.
To my mind, the stimulant medications for ADD - most commonly Adderall and Ritalin - are both under-prescribed and over-prescribed. That is, some people who desperately need treatment for their ADD never even receive an evaluation because of poverty, ignorance, or both. But others are haphazardly prescribed these potentially dangerous medications by physicians trying to satisfy parents, or teachers, or a demanding patient.
So what should you look for if your child is being evaluated for ADD and the potential prescription of a stimulant medication?
First, look for a physician or psychologist who is trained and experienced in the evaluation of ADD. Ask for credentials! Legitimate practitioners will be delighted to give you their curriculum vitae. Second, make sure that your child has a full evaluation including family informants (you!), teachers, and anyone who is a close observer of your child. Third, make sure that the physician or psychologist at least considers non-stimulant treatments for ADD: organizing strategies, cognitive-behavioral psychotherapy, and non-stimulant medications like Wellbutrin or Strattera. Finally, make sure that you and your child know the potential benefits of any prescribed medication, as well as the potential side effects and risks. With this knowledge  you can make the best decision possible about the these  effective but potentially dangerous medications. Also, you will recognize any side effects long before they become harmful!

Sunday, February 24, 2013

Steroids: Is My Teenager Using Them?

Anabolic Androgenic Steroids (AAS), when combined with exercise, build muscle mass. Bodybuilders, athletes, and teenagers who are trying to look "buff" have relatively easy access to these drugs. The AAS are not the corticosteroids, which in creme form can be used for skin problems, or injected into joint spaces to treat inflammation. Common  names for the AAS are Winstrol, Stanazolol, Dianabol or "T" for testosterone.  These drugs can be taken orally or injected, and cause muscle growth and may speed injury healing. Unless provided by prescription by a licensed physician, they are illegal, and the AAS are banned by all amateur and professional sports leagues, including High School and College leagues. Side effects of AAS use - which you may notice - are increased acne, muscle injuries, shrinkage of the testicles, breast growth in boys, and the profound irritability called "Roid Rage," Girls can show the growth of facial hair, development of a masculine bone structure, and the cessation of their menstrual periods. But the most common thing to notice, in both boys and girls, is the rapid and uncharacteristic muscle growth. If you notice this in your teenager, start asking questions. Is he/she taking any supplements? Getting anything from guys at the gym? Buying anything over the internet? If you know or suspect that your teenager is using AAS, get him or her a a consultation with a physician who is knowledgeable about AAS as quickly as humanly possible. DO NOT have your teenager abruptly stop the AAS, as the reduction in AAS use must be medically managed.

Wednesday, January 30, 2013

Should my Pastor Counsel my Drug-Using Teenager?

Some clergy are well-trained in counseling addicted people, and some are not. If your clergy person has training and experience in helping teenagers with drug or alcohol issues, he or she  should would be a great place to start! The advantages that clergy have is that they 1)share a set of faith-beliefs with the members of their Church/Synagogue/Mosque, and 2 have an initial trust relationship with those who come in to see them. (Therapists can't be expected to have either!)
So,if you are worried about your own behavior with drugs/alcohol, or the behavior of a loved one, your clergy person would be an ideal first consultation. If you need formal treatment, your clergy person will likely be able to find a treatment facility which has a philosophy consistent with your own beliefs and worldview.Of course, some clergy have received advanced training in counseling or psychology, and might be perfectly capable of treating an addicted person. As always, when you are looking for a clinician, you should ask about the person's experience and training in treating addiction, and make sure that you are comfortable with his or her treatment philosophy and demeanor.

Monday, January 21, 2013

How Much Marijuana is Too Much?

In an ideal world, the answer to that question would of course be none: teenagers should use no illicit drugs of any sort. But here on planet earth, 36% of 2012 High School Seniors had used marijuana over the past year, and 6.5% used the drug on a daily basis*. So, how should you distinguish between harmless marijuana use, worrisome marijuana use, and harmful marijuana use? First, any use of marijuana puts the teenager in some amount of legal jeopardy, and entails at least the risk of thinking problems like memory loss, poor motivation, and lethargy. And some teenagers have their lives destroyed by marijuana, although that is rare. To my mind, then, there is no use of marijuana by a teenager that is harmless. But many, if not most, teenagers marijuana users take the drug with little evidence of problems in school, relationships, or physical or mental health. I would characterize this use as "worrisome," in that it might lead to serious problems, even if it hasn't yet. Harmful, marijuana use, by contrast, has the obvious pattern of social isolation, paranoia, school absences, etc. Teenagers who have been addicted to marijuana or anything else, or have a mental illness, put themselves at grave risk if they use the drug.  I never give permission for teenagers to use marijuana, and neither should parents. But I don't call 911 either, because we all must distinguish between behaviors which are immediately life-threatening and those which are potentially harmful, and manage them accordingly. The good news here is that if you are addressing "How much marijuana is too much" with your teenager, you have a dialog going. Use it! Without lecturing, ask your teenager how marijuana affects her. Talk about your concerns. Ask her what, if anything, concerns her about marijuana. In the absence of any signs of harmful marijuana use, you are better off registering your concerns and keeping the subject open, rather than declaring an emergency where none exists.

*Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (December 19, 2012). "The rise in teen marijuana use stalls, synthetic marijuana use levels, and use of 'bath salts' is very low." University of Michigan News Service: Ann Arbor, MI. Retrieved 01/21/2013 from