Should I Shame My Teen Into Stopping Her Drug Use?

No!

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

WARNING: THIS ARGUMENT IS A SLEIGHT OF HAND TRICK
 

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.

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 Drugfree.org 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!

Stimulant Medications: Friend or Foe?

Parents of teenagers with Attention Deficit Disorder (ADD) were likely terrified by the recent NYT article (http://www.nytimes.com/2013/02/03/us/concerns-about-adhd-practices-and-amphetamine-addiction.html?pagewanted=all)  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!

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.

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.

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 http://www.monitoringthefuture.org 

Should My Teenager Be Drug-Tested?

If you suspect (or know) that your teenager is using drugs, then the short and rather obvious answer is "Yes!" But the details here are important: you need to be careful about who is doing the drug testing, what drugs are being tested for, what is done with the results, and how long the testing should go on for. A professional should guide you through all of this. I usually counsel against parents testing their own teenagers, because the parents are so easily fooled, and a positive result usually ends up with anger and recrimination, rather than the more clinical response of a therapist, who will help the teenager access treatment. (I am not saying that I or any other therapist cannot be fooled on a drug test, only that we are much more likely to do the test correctly, and find out what is really going on.) Also, it is important to test teenagers, even if they are actually telling you what drugs they are using. I am often confronted with a urine toxicology which is positive for cocaine or opioids, when the teenager professes to be "only" using marijuana. Oftentimes the teenager is in denial, or simply lying. But sometimes the teenager may be unaware of other substances being sprinkled on a joint.....
I usually agree with the teenager that I will give him or her the results of the weekly drug test, but not pass that information on to the parents. The teenager can then give the parents the drug test results or not, but not giving the results to one's parents of course sends the message that it was positive.  However, if a drug test (or anything else) tells me that the teenager is in immediate danger, I will call the parents. I would call the family of any patient whose life is in immediate danger!

How Do I Talk to my Teenager About Drugs and Alcohol?

The short answer is....any way you can. You should start the conversation as soon as you possibly can. When your fifth grader mentions learning about the dangers of smoking, or your third grader sees Lindsey Lohan on the cover of People magazine, you have a golden opportunity. Rather than delivering a monologue on the dangers of drug use, ask your child what he or she thinks about the subject at hand. Does she know anybody who smokes? Has he heard kids talk about drugs? You want to have an ongoing conversation

about this issue as your child grows, is exposed to drugs and alcohol, and as his views change about drugs and alcohol. You cannot really expect your teenager to hold the same perspective he did in 3rd grade, and the reality is that drugs and alcohol will be readily available in the High School years, at the latest. Even if he does not try addictive substances, he will have plenty of friends who have. I don't mean to say that your teenager should not have to hear your warnings, and your set of values. In fact, I think he will be much more likely to follow your lead if you give him the respect of hearing him out. You may have to listen to your teenager tell you that marijuana is "natural" and therefore safe, that laws against teenage drinking are unfair and anachronistic, or that plenty of kids use cocaine without any discernible problems. Engage your teenager in that conversation, and do not hesitate to give your own viewpoint. If you have nuanced views about drugs and alcohol - and most adults do - don't hesitate to tell  your teenager about those views. But also, don't hesitate to absolutely forbid some behaviors: your teenager will benefit from knowing exactly where you stand...... 

What if Your Teenager is Abusing You?

 I usually counsel families not to shut out their drug or alcohol using teenager, in the service of staying ready and willing to help the young person back to sobriety. I worry about families who use Tough Love as an excuse to abandon a young person who is essentially helpless to control his or her behavior. All the lying and cheating that addicted kids do can (quite understandably!) lead parents to eject the teenager from the family home, with the admonition to "get yourself together or don't come back!" Generally speaking this is unfair, in the same way it would be unfair to demand that a  person bleeding in the street get himself together and stop bleeding. He'd like to! However, there is one circumstance that absolutely necessitates that the teenager be cut off from his family, for the good of both the family and the teenager. That circumstance is when the teenager is abusing the family, or any members of the family. Although the most obvious issue would be physical abuse, I do include emotional and financial abuse. Are you afraid of physical harm from your teenager? Does your teenager browbeat you verbally? Demand and receive money from you? Steal money or goods from your home? If any of that is happening, your home is not a safe or sobriety-promoting place for your teenager, and he or she needs to be out. I say this not only for your own protection as parents, but for the well being of your drug or alcohol using teenager. The world simply does not work that way - outside of your house, offering physical violence or stealing things will get your teenager arrested, beaten up, or worse. And the abuse dynamic set up in your home makes it certain that your teenager will not get help for the drug or alcohol use, and you will be helping no one. Although an abusive teenager cannot stay in your house, you can still offer help by arranging for treatment elsewhere or  setting up insurance benefits. Aside from physical abuse, the definition of what constitutes abuse, emotional, financial, or otherwise, can be a bit subjective. But if you feel afraid in your own home, or you worry about not being able to reason with your teenager, you are probably being abused and you need to separate from your teenager for his benefit and yours!

"Dad, Did You Smoke Pot In College?"

That question can be the feared moment-of-truth for parents who don't want their kids to use drugs. Although you are under no obligation to tell you children everything about yourself, be glad you are getting this question! Frankly, unless your teenager is brain-dead, he already knows that the statistical liklihood that you at least tried marijuana is very high. The question is an opportunity to talk about drugs with your teenager, and an opening for you to get your opinion out there at a time when your teenager is actually listening to you. Before you answer, start a conversation - why is he asking, now, about what you did in college? Do a lot of kids smoke marijuana at school? Does your teenager smoke? How often? What's it like? The understanding you have gained over the years, including the change of perspective we all experience when we become parents, are perfectly reasonable ideas for you to promote here. Here are some responses parents I know have used when asked "Did You Do It?"

1. "I did, and I didn't like it very much."
2. " I tried it a few times, but it made me so groggy I just couldn't function."
3. "I did, and I really got into trouble with it. Made me miss classes, hang out with the druggies all the time..."
4. "Yes, and it really didn't do me much harm. But I had a friend who dropped out of school because of marijuana."
5. "Yes, but the marijuana around now is much more potent. You could really hurt yourself with it."

       Remember, the fact that you did or did not do something in college hardly proves that it is OK for your teenager to do that same thing. Make that logical point but, more importantly, use the "Question" as an opening to talk with your teenager about his drug or alcohol use in an open and honest way. If you listen respectfully to what they have to say, they will take your opinion with them, whether they admit it or not.

Celebrity Addiction

Amy Winehouse's death provoked much speculation about her drug and alcohol use, the cause of her death, and her hit song "Rehab." But regardless of what actually happened to Amy and other celebrities whose personal pain is so often covered in the media, the stories do offer you a starting point for talking with your teenager about drugs and alcohol. For instance, you could ask your daughter if she knows about Lindsey Lohan's court appearances. What does she think of the drug-using behavior? Are celebrities protected from the consequences of their actions? Does an artist need to use consciousness-changing substances? Your first instinct may be to turn off the news reports about celebrities and their public struggles with addiction. Don't! Use the situation to talk to your teenager!

When is it Time For Inpatient Treatment?

Your teenager needs inpatient treatment for his addiction if his use is life-threatening, or if he is suicidal or has a serious mental illness, or if he just can't stop without going to an inpatient facility. Inpatient facilities -where the patients stay 24 hours a day, 7 days a week - are naturally more intensive, and can monitor your teenager in a way no clinic can possibly match. "Life-threatening" is of course sometimes a subjective term, but if your teenager cannot stop using cocaine, that would be a good time to consider inpatient treatment, given the lethality of that drug. And if your teenager hints at or even acts out at being suicidal, an inpatient stay will probably necessary to secure his safety. Also, if your teenager just can't stop using his drug of choice, even if it is marijuana, then an inpatient stay will likely be necessary. Teenagers often say that they don't want to go to inpatient treatment, since nothing external will change when they return home. That is true: the pressures of school, drug-and-alcohol using friends, and the vagaries of adolescent  adjustments will not have changed. But your teenager will have changed, gaining new strategies for refusing and moving ahead with a drug and alcohol- free life. Inpatient isn't perfect, nor is it usually curative of addiction. But it can safeguard your teenager's well being and start him on the road to sobriety!

Synthetic Marijuana and Your Teenager

Your teenager may come across a variety of substances known as "synthetic Marijuana," the most common being Salvia and K2. Marketed to teens on the Internet, in head shops, and gasoline stations, these substances look and act like marijuana, but (some) are technically legal. Some of the substances are packaged like marijuana, and some are powders that can be smoked on a cigarette. Recently, the DEA banned the most common 5 drugs in this category, but others will likely take their place. Since these   drugs are so different from each other, their effects are quite different, but you should look for hallucinations, "out-of-body" experiences, dizziness, slurred speech, and paranoia. If your teenager displays these symptoms, you should get help from an addictions specialist immediately. The argument that the substances are technically legal is just plain silly: the legality or illegality of a particular substance has no bearing on the danger it poses to your teenager.

Cigarettes and Your Teenager

Cigarettes kill more Americans every year than alcohol, heroin, and cocaine, put together. This is why it is vitally important for you to help your teenager kick cigarettes, even though they are not as immediately lethal as cocaine,or heroin, for instance. But studies have shown - in adults, at least - that there is no harm in stopping cigarette use at the same time the addicted person is stopping alcohol or other drugs. That is, there is no truth to the idea that stressing the person by stopping cigarettes will prevent achieving abstinence from other drugs. If your teenager smokes, you must yourself stop, and get help if you cannot stop on your own. Your teenager can attend groups therapies, like Smokenders and Smokestoppers, run by local Lung Associations and other groups. There are numerous complementary treatments available, like hypnosis, acupuncture, and mediation which have some effect in helping smokers stop.Finally, medications like Chantix, Zyban, and Nicorrette Gum can also help. But whatever you do, make sure your teenager tries, and keeps trying to stop smoking. It's important.

Sexual Addiction and Teenagers

With all the recent news about celebrities engaging in "sexting," extramarital affairs, and prostitution, one wonders about the sexual behavior of teenagers. How does a parent know when his teenager's behavior is dangerous or addictive in nature? While it is certainly normal for teenagers to experiment with sexuality, sexual behavior which is compulsive and/or destructive is certainly a problem, and should be addressed that way. I am not talking about whether or not your teenagers engages in sexual behavior, and at  what age,  or how many partners she has, or even what gender she is attracted to. You may have family values which necessitate rules about all these sorts of behavior, but they are not addiction. (Good luck enforcing those rules, by the way.) Sexual addiction, by contrast, is compulsive sexual behavior which is destructive to your teenagers and/or others.  For instance, posting pornographic images on oneself on the Internet is both illegal and can  be very harmful to one's future educational and job prospects. Trading sexual favors for money, drugs, or anything of value similarly suggests a dangerous precedent. Having multiple sexual partners, putting oneself in danger of becoming pregnant or contracting a sexually transmitted disease, or being raped, all constitute thoughtless and compulsive behavior, at the least. If yo see any of this, you will need to get your teenager to a therapist knowledgeable about teenagers and their sexual behavior, to sort out teenage experimentation from addictive behavior. No parent can handle this one alone.

What's So Bad About Marijuana?

Marijuana use has been increasing amongst teenagers for the past two years: 38% of High School Seniors acknowledged having used marijuana over the past year, according to the annual Monitoring the Future Study, conducted by researchers at the University of Michigan. What exactly does this mean for your teenager? First, marijuana use is not so harmless as teenagers would have you believe. The profound effects on motivation, social relatedness, memory, and decision-making ability are unquestioned. And your teenager's brain is still developing, making him or her even more vulnerable to the noxious effects of marijuana and other drugs, including alcohol. So, when your teenager says that the marijuana use if "just for fun,:" and "natural," you need to refute the idea that the drug is harmless. But you will also temper your assessment with a real risk assessment: how is your teenager functioning in school? In relationships? Health?Given the understanding that marijuana remains illegal, how much legal jeopardy is he or she in? You will need to fashion a plan for helping your teenager move forward in life: for some teenagers addicted to marijuana, a stay at an inpatient treatment center is necessary. (And yes, you can get addicted to marijuana!) For other marijuana users, however, meeting with an addiction-knowledgeable therapist suffices. The most important thing is to find  out what exactly is happening with your marijuana-using teenager, and then respond to that, rather than the mere fact of marijuana use!

"Bath Salts" and Your Teenager

"Bath Salts" are packaged drugs sold under  innocent sounding names like "Ivory Wave," "Purple Wave," Hurri9cane Charley," and "Aura." Although some of these packages have been found to contain mephedrone, a central nervous system stimulant, since there is so little oversight, the packages could in fact contain amphetamine, or sugar. (Or cyanide, for that matter.) These misleadingly labeled substances are sold in head shops, gas stations, and over the Internet.Stimulants can cause euphoria, high blood pressure, strove, and heart attack, and the DEA has named these substances "Drugs of Concern" in a prelude to making them illegal. ( http://www.cbsnews.com/stories/2011/02/01/earlyshow/health/main7305536.shtml )Don't assume your teenager is treating herself to a bubblebath if you see these packages in your house!

Heroin and Teenagers

Over the last 10 years, the US  have been flooded with cheap, high quality heroin. The wide availability of this highly addictive drug has caused some teenagers to become addicted in numbers which would have been unthinkable a generation ago. Teenagers who see party drugs as marijuana, Ecstasy and alcohol, sometimes try heroin with the same casual attitude, not realizing its' highly addictive nature. Since the heroin available is so pure, teenagers can snort the drug, rather than having to inject it into their bodies with a needle, thereby lowering the bar to use. Some, but not all, teenagers progress to actually injecting the drug. Signs of heroin use include profound sedation( to the point of falling "asleep" into a plate of food), as well as pinpoint pupils and an overall silly mood.Overdose from heroin includes an unconsciousness from which you cannot arouse the person, can progress to death from paralysis of the breathing muscles, and necessitates an immediate call to 911. Withdrawal from heroin consists of a runny nose and eyes, goosebumps, muscle cramps, and diarrhea, and is the most common reason for return to heroin use. If your teenager is using or addicted to heroin, don't despair. Excellent treatments are available, and like all drug problems, your teenager can return to a healthy, gratifying life without substances. But you will have to help by getting him or her to professional help as soon as possible!.

Steroids and Teenagers

In our performance - obsessed culture, the use of performance enhancing drugs like Anabolic Androgenic Steroids (steroids) is all too common, among adults as well as teenagers. Teenagers most often get mixed up with steroids after reading about them on the Internet or taking advice from a "trainer" who foists these illegal and dangerous drugs on naive gym-goers. (No legitimate athletic trainer would recommend anything of the sort.) Many teenagers use steroids for bulking up and looking good for girls, rather than  for pure athletic performance. And teenagers often believe that if the dose they read about on the Internet is good, then double, or triple, that dose must be even better. If you see your teenager rapidly gaining weight or muscle, showing newfound aggression, or receiving packaged substances in the mail, you should take action by confronting him! The profoundly damaging effects of long-term steroid use on the adolescent body make it an absolute necessity for your teenager to avoid steroid use. However, DO NOT let your teenager stop these substances without guidance from a physician who can help - withdrawal can provoke or worsen suicidal thoughts. Bottom line, if you suspect your teenager is using steroids, get professional guidance immediately.