Talking with Young People About Teenage Substance Use and Abuse
Public education campaigns directed at both teens and adults have raised awareness of the risks associated with teenage substance abuse and are in part responsible for the decrease in teen use over recent years. According to Leslie Kimball, executive director of Responsibility.org, adults who care about keeping children safe have been more willing to talk directly with teens in recent years: “Conversations between parents and kids have increased by over 30% over the past 20 years and in that same period, underage drinking declined by over 50%.” The best way to reduce a young person’s lifetime risk is to delay the onset of alcohol and drug use as long as possible, giving the brain time to mature while the individual learns self-regulation and other critical life skills.
Parents and educators, therefore, should not minimize the importance of offering young teens information about the impact of substances on the developing brain and about how to make informed decisions. Open discussions about the risks of substance use in safe, non-judgmental home and school settings are the necessary first steps of both prevention and intervention efforts.
Likewise, parents should not wait until a problem is suspected to have these discussions with children – by then it may be too late. They can begin by helping youngsters understand that taking medications, even vitamins, is serious business that should be done thoughtfully and precisely. Family medications should be locked up and out of reach, and parents should model a careful approach. In the same way that parents warn kids not to take candy or gifts from strangers they should teach that it is also not safe to use another person’s medicine or accept any kind of pill or substance offered, even by friends or classmates.
Parents can take advantage of common daily occurrences to teach children – when watching a TV show or movie where alcohol or drug use is displayed, when a child asks why he can’t taste a parent’s alcoholic drink, when song lyrics reference substance use. As children reach middle school it is advisable to regularly ask whether they see peers using substances or if they have been offered anything, and what their thoughts and feelings are about it.
Conversations related to substance use (or any risky behavior for that matter) will be more successful, of course, if parents follow some basic guidelines:
- It is important to talk with young people about all aspects of their lives, not just to grill them about teenage substance abuse or other areas of concern.
- Pay attention to when your teen is more open to talking – it may be late at night, or on car rides, etc. – and maximize those opportunities.
- Practice active listening. Don’t interrupt except to ask clarifying questions.
- Stay open, curious, and calm – even if you start to get anxious or alarmed by what you are hearing, encourage your child to talk while holding back your own reactions.
- Ask open-ended questions, that is, questions that cannot be answered with a simple “yes” or “no”. “Tell me about the party last night”. “Tell me about your new group of friends”. “What are your teachers talking about in health class lately?”.
- Make sure to recognize the good choices they make, their willingness to talk, their thoughtfulness about the issues being discussed.
- Don’t give up when they or you feel uncomfortable – the more conversations you have the easier it will get to discuss tough topics.
- Present information about both the short and long-term risks of nicotine, alcohol, and drugs and make it clear that you do not want them to use substances. Explain to your child that experimenting with drugs or alcohol during adolescence is risky for still developing brains.
- Explain that contrary to the common belief that “everybody’s doing it”, most of their peers are NOT using drugs.
- Clearly articulate that even just “one time” drug use can be dangerous given the contamination of the drug supply with substances like fentanyl that pose a high risk of death.
- It is also important to emphasize to young people that although marijuana is now legal in many states, and that along with psychedelics it is increasingly being used as an alternative treatment for both physical and mental health problems, these drugs are not “safe”.
Current Approaches to Drug Awareness Education and Treatment
For many years the prevailing “best practice” for substance abuse recovery was based on the abstinence model that stressed the importance of total sobriety, that is, the need for people in recovery to refrain from all types of substances regardless of one’s “drug of choice” or specific addiction. As recently reported in a New York Times article, however, “Notions of what constitutes sobriety and problematic substance use have grown more flexible in recent years as younger Americans have shunned alcohol in increasing numbers while embracing cannabis and psychedelics — a phenomenon that alarms some addiction experts.”
At the same time, growing numbers of practitioners have espoused the “moderation-harm reduction” approach to treatment in order to reach greater numbers of people, many of whom have outright rejected or cannot sustain abstinence as a goal. As the name suggests, this model aims at changing behavior to reduce usage and to decrease the risks associated with drug use, a model born out of the AIDS crisis that prioritizes bodily autonomy and meeting people where they are without judgment.
Although this newer approach is not universally accepted, evidence is growing that it can protect youth from accidental overdoses and from other substance-related risks. As reported by the American Psychological Association (APA), data has shown that “Just Say No” campaigns have not worked since they only emphasized the risks without acknowledging the real or perceived benefits of using substances (e.g., relaxation, distancing from painful emotions/memories, etc.). All-or-none approaches discourage conversations with teens about how to mitigate risk and about how to make better choices. Modern prevention and treatment methods, on the other hand, focus on empowering youth, in age-appropriate ways, to consider the consequences of their actions and to take steps to increase safety while offering healthy ways to address the reasons for using drugs in the first place (e.g., to gain friends, to cope with emotional problems). They offer education and provide opportunities to practice skills, such as how to decline an offer to use drugs and how to approach caring adults for help when needed. They typically incorporate both prevention and harm-reduction elements to maximize the protection of young people.
What to Know About Available Treatment
As with treatment for adults struggling with substance use disorders, there are various levels of effective treatment for teens as well. Depending on the level of severity and risk, the appropriate level of care for any given youngster might be an outpatient clinic or practitioner that offers individual, family and group therapies; a 12-step program; an inpatient detoxification or rehabilitation program; a partial hospital or intensive outpatient program that offers multiple visits per week; and longer-term residential treatment facilities. Families should be encouraged to seek evaluations through community treatment programs and/or school-based mental health or student assistance programs where available, as well as from their teen’s pediatrician.
Some important resources to know about:
The Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 offers information on support and treatment facilities in your area.
Individuals with suicidal thoughts can dial or text 988 to connect with a trained counselor at the 988 Suicide & Crisis Lifeline. If you or a loved one is in immediate danger, call 911.
Resources:
https://www.verywellhealth.com/teenage-drug-addiction-5213002
https://www.huffpost.com/entry/underage-drinking-survey-trends_l_657c7201e4b08e9b410a1b37
Connecting with Your Teenager – Partnership to End Addiction (drugfree.org)
Redefining Sobriety: Shaking Up the Field of Addiction Medicine – The New York Times (nytimes.com)
