Saturday, December 12, 2009

Talking to Kids about Substance Use and Abuse: Who and When

After mentioning some very disturbing statistics a couple posts ago, I would like to address ways that discussion might go and when it might be a good time to have it. Contrary to comments on that post, I am not suggesting you have it with the infants. But depending on various risk factors, I would suggest that it is hard to start too early. I have discussed this before and will probably do so again. The big difference between the last time I discussed this and now, is not the content of the discussion but that I now have evidence to support assertions I will make. I am only going to start this now, because I would like to post the paper I just wrote before I go into too much depth and I am waiting until I know it was graded to do that.

I think the first and most important issue to discuss, is that of what it is appropriate to talk about, with whom and when. I will start with who.

There are a remarkable number of parents out there who believe that they don't need to have this discussion with their child, because their child would never dream of using drugs. I am not engaging in hyperbole when I suggest that there are a lot of parents out there who have buried children they thought would never use drugs. While there are factors that elevate the risk that specific children are more likely to engage in substance use at a rather young age, that doesn't mean children who do not have those risk factors are immune. More importantly, there are risk factors you may not be aware your child has.

There are a lot of neurological issues that come up, that you may not be aware your child has. Your child may have friends who use drugs that you aren't aware of - your child might not even be aware of yet. A particular substance may be making the rounds at you child's school - this happens from time to time. A drug becomes particularly prevalent and is available at a very low price. It is there and because so many kids are using it, it becomes vogue to do so. It is also quite possible that your child is not nearly as open with you as you think s/he is. Your child may be something of a social outcast and you don't even know it - and that is a significant risk factor.

More importantly, as I mentioned in my last drug use post, there are substances that transcend normative risk factors. Pharmaceuticals are huge these days and kids don't necessarily have to raid the medicine cabinet at home. With a lot of children on psych meds (most commonly abused, more than a percentage point or two over pain killers) they can just quit taking their pills, save them up and trade some with another kid who has done the same and take some of both - or more, if they let another kids or so join the fun. I will grant that they usually get a little older before they add alcohol to the mix, but this is behavior that more than 5% of children age 12-13 have at least tried. At least 3% of kids in that age range are abusing pharmaceuticals. What the National Survey on Drug use and Health doesn't say, is that a significant percentage of 9-10 year olds are also trying this. By the time they are old enough that they are more likely to use alcohol, the percentage of kids playing with pharmaceuticals is above the 40% mark.

To be totally clear and rather harsh about it, it is critically important that you discuss pharmaceuticals with your kids. The wrong combination can cause serious problems, even death. Throw some alcohol into the mix and there is an even stronger likelihood that you will go to wake up your child, only to find them stiff and cold and very, very dead. I doubt the thought that this child was a very good kid is going to be much comfort at that point. And no, the fact that your child might well engage in really stupid drug use doesn't make them any less a good kid. It just might make them dead though...

The next question, now that I hope we are clear that all kids should have this conversation with their parents, is when. My own attitude is to start young and never stop. Latch onto opportunities as they present themselves. Don't be preachy and don't be too intense or regular with it. When they are very small, just use their own insatiable curiosity. If you are a drinker, tell them about what you are doing. See something on tee vee, use that as a starting point. As they get a little older, make a point of sitting down with them once in a while, specifically to talk about drugs and drug use. When they get towards 11, 12, 13 - ask them about it. Let them guide the conversation. Talk about it a little bit more often, but not too often.

Most importantly, make sure they know that they can ask you anything they want to know about. Make it clear to them that you would be happy to honestly and openly discuss topics that are important to them - sex, drugs, relationships. Encourage them to develop a habit of talking to you about things that are bothering them when they are young, because that will make it infinitely more likely that when they are confronted with choices like using drugs, they will be inclined to talk to you about it. Also keep in mind that the best time to talk about drugs initially, is before they ever start. Don't assume that they will wait to talk to you - make it clear that there are dangers and that they need to understand those dangers. Also, accept that they may come to you and tell you someone offered them something or another - you can ask, but don't push them for a name. Yes, it would be ideal to know - but they aren't going to tell you if they aren't going to tell you and pushing them will be a detriment to the development of that trust.

As they become teens, make sure you have laid the groundwork already. If you have done your part early on, trust them to come to you with questions. Make sure that you have discussed the specifics - the dangers of various substances and the like - I am going to write another post about how those discussions might sound. If they seem to be depressed, ask them how they are feeling - is there anything wrong that they might want to talk about. If not with you, then with someone else that you trust and they trust. It may well be that they aren't going to be as interested or comfortable talking to you at that point - let it go and encourage them to talk to someone who is trustworthy. About the best you can do is to make it clear you are available and open to them.

Whatever you do, do not lie - we will go into this more tomorrow, but this one is important. Never. Never ever lie to them. If they ask you something about your past that you aren't comfortable talking about (assuming it is age appropriate), my first suggestion would be to get over it and just tell them what they want to know. But shy of that, if you aren't willing to answer, then honestly tell them that. Don't tell them you never did something you did - just tell them that you aren't comfortable talking about that.

Unless of course you have or have had a substance use disorder. At that point all bets are off. Your child has a major risk factor and you absolutely have to make that clear to them. Forget about your pride and all that bullshit. Suck it up and spill it, because your child absolutely must know that you have a problem and that because of that, they are far more likely to have similar problems if they engage in drug use. The thing is, you have an almost magical power at your disposal, one that makes it exponentially less likely your child will have this problem. You tell them they have an elevated risk and you tell them why. Do that and it is exponentially less likely that your child will initiate drug use. This applies to most risk factors, but is considerably more poignant when it comes to owning up to your own issues with substance use.

I am not just pushing shit in your general direction, that I am afraid to do myself. I have had myriad substance abuse problems and will be dealing with them until the day I die. My oldest son has a lot of very significant risk factors besides the substance abuse issues of his dad. My youngest will probably not be too far off his brother's risk factors. We have talked about it before and we will continue to talk about it, my soon to be eight year old son and I.

No, it isn't easy. It is just critically necessary, because I love my boys.

1 comment:

abnrml said...

i love this article. i wish it would get distributed everywhere and everyone would heed the advice. my mom and dad smokes cigarettes, my dad and grandfather are alcoholics and i remember going over to my aunt and uncle's house when i was about 6ish and asking my uncle, 'what are you doing?' he said, 'making a cigarette' but then i said as i pointed, 'there's your pack of cigarettes right there'. and around the age of 13, all my mother ever said was, 'don't you EVER do drugs.' that was my drug talk. and by that time i was smoking pot and had tried lsd. i've never had an abuse problem, thank god. but that's not to say i haven't tried MANY things. my sister ended up with a heavy addicition to opiates. she's stopped that, thank god, but she started drinking very heavily and is now having to deal with pancreas problems. she's getting better, though. but the thing i originally wanted to say, maybe into an addition to your article, that i plan on doing with my children if i have any is to give them information about specific drugs. so there's another conversation to have with them. say, 'you may know someone doing or seen -insert drug here- this is what it is and this is what it does. (of course get some info off of the internet so they don't get the chance to say 'how do you know what it does? you did it so it's okay for me.' but at the same time incorporate any experience you may have with a certail chemical, but 'it's off the internet') and just inform them about the crazy things these substances do. but what scares me is that the kids these days can just (for an extreme example) go pick some poison sumac, look on the internet for ways to cook it/ burn it/ etc... and are told "it'll make you feel so good"). it just seems that the craziest things, new 'drug'-wise are things that A LOT of older people have no idea about. i found something on youtube with these (mostly) teenagers were smoking something they bought over the internet and hallucinating. HEAVILY! and it only lasted about 10-15 seconds. and it just blew my mind. that was the first i had ever seen anything like it. so after seeing that, i had to see what it was all about. well, it's a legal plant they buy over the internet. (salvia divinorum) -sp?- i'm not sure if you've heard of it or not but it got me thinking about all of the other stuff i have no idea about. so i figure if i tell them what i know, at least they'll have a start. but i'm not sure if you've seen some of these videos on youtube. these kids are filming themselves doing EVERYTHING!!! it's definately worth checking out if you haven't already because a lot of kids use that site, and maybe they think that their parent wouldn't go there for any reason. and hey, it just gives parents that much more information. and it baffles me that kids see these videos, see how stupid these people are acting and still think, 'i want to try that!' i'm sorry if this is too long or i rambled. this is the first thing like this i have ever seen and commented on. and thank you one again for your article. blog? (first timer) and thank you for taking your time to read this. i have to go so i can't proofread it. if you find some parts helpful, feel free to cut them out of here so you can make them sound better than i ever could and put them on your page.