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.