Drugs and Children, the Conversation that Never Ends

Abel Pharmboy has a great post up, about the dangers of prescription and even some over the counter medications, that kids use to get high.

Related to the DrugMonkey post, PharmGirl just tipped me off to this Benadryl nightmare at the Sweet Hill (OR) High School. Students have turned up in local emergency rooms after having taken 20 to 30 of the tablets, each containing 25 mg of diphenhydramine.

At high doses, diphenhydramine's central antimuscarinic effects become apparent as hallucinations but this is a terribly risky approach. Suppression of parasympathetic drive to the heart can cause tachycardia and lead to fatal cardiac arrhythmias. The story is deeply concerning...

He then goes on to describe the problems with a couple other commonly abused medications, well worth reading the entire post and comments. Towards the end of the post, he poses a very important question;

But it's stepping over the line to tell them if they're going to choose any illicit behavior, there are far safer alternatives.

How do other parents ethically approach this conundrum?

First I would like to comment on the very notion that it's stepping over the line, to tell children there are far safer alternatives.

One of our very important responsibilities as a parent, is to do everything that we can, to ensure they survive childhood. The point that we decide that something this important is off the table, is the point where we really start to gamble with the lives of our children. Kids are all individual, different beasts. They each have unique needs, what works for one child, won't work for another. Thus it is important to recognize that one needs to tailor this discussion, to the needs of their child – also realizing that the approach you take with one of your kids, may not work for the next one that comes along.

This is much akin to the discussion of sex. It's a hotbutton issue, with no easy answer. But just as we gamble with the life and well being of our children, if we refuse to teach them about making sex safer, we also gamble with their lives, if we just say no. It is not telling your child it's ok, to make them aware of ways to keep themselves safer. But we owe it to our children, to give them information that can and probably will, keep them alive and safe.

While every kid is different, there are some very standard, near universal steps one should take, when making their child aware of the dangers of drugs. Most of this also applies to every single hotbutton issue we should discuss with our kids.

Honesty – Always

This cannot be emphasized enough. There is nothing more important, than always being honest, when talking to our kids about sex, drugs, dangerous activities or any hotbutton issue. Never, ever lie about anything. Never even exaggerate anything with them. Always be honest with your child. If they ask a question your not comfortable answering, at the very least tell them your not comfortable talking about that. The best policy is to be open with them, occasionally telling them you will be happy to discuss it when they are a little older, if it really isn't age appropriate. But if you just can't bring yourself to respond, then have the courage to tell them that.

The point that we start to lie or overstate the case for something, is the point that we lose all credibility about that issue. Do it enough and we lose credibility all together. For a good many kids, the credibility we are talking about, is a lot easier to lose, than it is to ever regain it, should it be lost. If the goal is to have a child that is confident and comfortable with bringing up any and every topic they wish, then this credibility is essential. We throw that away at our own peril. More importantly, we throw that away at our child's peril.

Get Your Facts Straight

Do not approach the topic of drugs, without doing your homework. If, like me, you have personal experience to draw from, by all means use it. Even if your experience is limited to only small aspects of the discussion, they are far more valuable than anything else you will bring to the table. First, this is establishing credibility. They know you're being honest, when you discuss your own failings, or even less dire experiences, with licit or illicit drugs. Too, they place a lot more value on your actual experiences in life, than they usually let on.

For those with less experience, or even those with a lot of them, read and question people who've been there. Don't depend on sites the government provides. Read a wide range of information, from different perspectives. Call organizations such as narcotics anonymous and even alcoholics anon. Tell them you are interested in finding someone who can talk to you and your kids about substance abuse. I can virtually guarantee that they can and will be very keen on helping you. The perspectives of people who have lived the worse of drug use, are extremely valuable.

But the most important aspect of this, is to never overplay the very worse of consequences. Talk to your kids realistically. Taking alcohol as an example; Focus the majority of your attention, on the potential consequences to their bodies development, especially the brain. Make it clear that in their early to mid twenties, the consequences of having a drink, are far less dire. The brain is pretty well developed, having a drink or smoking a little pot, is going to do far less damage. While the brain is still developing, THC or alcohol (not to mention a whole lot of different drugs) will inhibit proper neurological development. It may not translate to significant loss, but there is no getting around it, they will impair neurological development.

Use Realistic Risk Assessments

Yes, you are right in sensing a theme here. But it is critical that we make sure we use the best possible information. Risk assessment, is where a lot of drug campaigns really falter. They want to scare kids out of using drugs, so the focus is on the very worse potential consequences, consequences that are the least likely to be observed by the child. Meanwhile, the milder, but far more common consequences are virtually ignored.

The thing is, most kids, unless they are sheltered to an extremely unhealthy degree, are going to observe the milder, more common consequences of various sorts of drug use. The more dire consequences are less likely to ever be observed. Focusing more on the realistic, provides another source for the credibility that is so important.

To take an honest risk assessment approach, means that you will be telling your children that there are safer, albeit still dangerous alternatives out there. Such as, you will be telling them that smoking pot isn't nearly so dangerous as huffing canned air or gasoline. You will be telling them that freebasing cocaine (crack) is more addictive and dangerous than snorting a line of cocaine. You will be saying that it is far safer to only drink where it is safe and stay there, if they decide to drink, instead of following their parent's advice. Because always, above all else, we have to focus on safety first.

Do Not be Afraid to Tell Kids How to be Safe

We can be clear that something is a bad idea, while maintaining that there are things that can make certain activities far more dangerous than they inherently are. To tell a kid to use a condom if they are going to have sex, does not have to mean we condone them having sex. Likewise, telling a child the difference between smoking crack and smoking a joint, is not telling them they should go smoke pot. What we are doing, is refusing to gamble with our children's lives.

The consequences of having unsafe sex, can be as bad as death, or at least a horrible, ravaging disease. The consequences of using various substances to get high, can also be as bad as death. There are all sorts of potentially dire consequences, to all sorts of activities. There are also ways of reducing the potential for the very worse consequences, for any number of activities. Some people, in the name of ideological or dogmatic purity, feel the need to take an abstinence only approach to all of these topics. They want to make it as simply black and white. Then they trust that there kids will just do as they are told and abstain.

This is nothing less than gambling with your child's life. You are doing nothing less than throwing your child to the wolves, without the least bit of protection. You make them vulnerable to perfectly natural impulses they may be unable to control. If they are going to break down and have the sex, they're going to do it. Statistically, it is far more likely they're going to than they're not – no matter what try to teach them. Likewise, it is entirely likely that they are going to use some sort of inebriant, some time in their youth. The only question becomes; What sort of risk assessment are they going to use? Because if one's just as “bad” as the rest, one of the easiest ways to get high, is using highly toxic, very dangerous inhalants. They are bar none, the easiest to get their hands on.

Build Confidence

The more confident the kids, the less likely they will fall prey to peer pressure. Peer pressure is a huge part of using various substances. Most dangerous, it takes the control out of the hands of our kids, and gives it to their compatriots. By themselves, our kids are probably in pretty good shape for staying safe and listening to us parents. It's when they feel it's more important to fit in, than to be safe (or safer), that they really can get into the worse trouble.

Start Early

It is never too early to talk about the hard stuff. Make it a habit from the git go. We first discussed drugs with our son, when he was three. He saw a friend of ours rather drunk and the conversation began. A few months later, we saw someone smoking crack in the streets. When he was five, he actually had quite the q&a with a guy he saw hitting a crack pipe. He has also talked with a friend of mine, who has been dealing with some serious substance abuse issues for much of his life. We started with very general, very basic ideas and haven't progressed far beyond them. But we have begun the habit of talking about drugs and inebriation. Likewise, we have done the same with topics such as sex, bigotry, hatred, environmental issues, social issues. It doesn't take much, but with even the tiniest foundation, you pave the way for talking about it when these issues become very relevant to your child.

Showing them you have the courage to talk about difficult issues, also makes it more likely they will want to involve you in their decision making process. As much as I would love to see my children retain their virginity until they are secure, mature adults, I would settle for them being comfortable asking my advice, when they decide they are going to do it anyways. Likewise, I would love to see my boys forgo smoking pot or drinking, until they are much older, if ever. But I will settle for them talking to me about it, before they decide to do those sorts of activities. Remember, if they don't feel they can trust you, they aren't going to talk about it. They will however, likely make decisions you aren't going to like anyways – you just won't know what it is.

This means biting your tongue. It also means standing your ground and making it clear what the consequences are likely to be. It means knowing your child well enough to know when they are likely to do something dangerous and when you just have to bite it and do what you can to keep them safe while they do it. Because it may be the difference that prevents them from transmitting HIV, or means they have a beer instead of dying with a can of air freshener in their mouth. Most importantly, it means making sure that they never have to question your love for them, no matter what they choose to do. Let them know when you are disappointed, but never let them question your love. Like your credibility, if they question the love, you've lost important and hard to restore ground.

There is plenty more involved with this topic. I would love to go on about it far more than I have here and may well do so, but these are what I consider the most important keys to keeping one's children safe. For certain, they are pretty universal.

I am also going to just have to admit that it is unlikely I will get to a lot of things any time soon. We just have a lot on our plates and things aren't slowing down anytime soon. I will keep up posting as much as I can, but please bare with me, it will be slow.