Ask experts what parents do wrong when it comes to preventing children from using drugs and alcohol, and many share this image: A parent comes home from a tough day at work and announces he or she needs a drink. Or there's a promotion — great cause for celebration — and the wine bottle comes out.
Parents who use alcohol to celebrate, to wind down after a tough day or to rev up to socialize set children up to use alcohol and drugs. Few things have power to derail young lives as thoroughly as substance abuse, but parents are often oblivious to the signs — and to the messages they send their children that may encourage use, experts told the Deseret News.
The U.S. Department of Health and Human Services says that 23 million Americans need treatment related to drug and alcohol use, including minors. For some children, drinking starts as young as 8 or 9, drug use not much later.
"If you had a tough day, talk about it, verbalize it. Take a hot shower. Turn on music and relax a little," said Stephen Wallace, director of the Center for Adolescent Research and Education at Susquehanna University in Selinsgrove, Pennsylvania. "Do not model alcohol use as a way to self-medicate."
Parents have more power than they may recognize: They are the top reason that children make good choices, Wallace said.
Talk, talk, talk
Conversation is the "single most potent weapon" against drug and alcohol use, he said. "When parents take time to engage early and often in honest dialogue and express parental expectations, children are much less likely to use alcohol and drugs."
Wallace described a "big spike" in alcohol use starting between sixth and seventh grade, so addressing the topic around high school time may be years too late. At the least, children have seen others experimenting.
"Talk often and encourage them to come to you with concerns. And when they do, don't freak out," said Jesse Matthews, a licensed psychologist in Chester Springs, Pennsylvania. "Many parents encourage communication, but then discourage it by overreacting."
Talk about drugs and alcohol, "but don't demonize them. You want to instill good values in your children, but you cannot control them," he said. "Teenagers are often rebellious, so being too controlling will only encourage more of this."
The "big" talk about drugs and alcohol is probably less effective than snippets here and there. One of the best ways to have serious chats is walking or sitting in the car. It's less threatening and will probably not come across so much as a lecture, said Dr. Karen Khaleghi, co-founder of Creative Care, an addiction treatment facility in Malibu, California.
If a parent blows the conversation, her advice is revisit it directly. She's gone back to her son, she said, and admitted she didn't do a conversation justice because she was distracted.
Parents need to help kids plan for situations where they don't want to imbibe or do drugs, but they also don't want to appear uncool. Conversations can yield strategies.
A zero-tolerance policy works, too, Wallace said. Kids need to know expectations and consequences. "It needs to be a conversation, not an edict. When it comes to parenting style, the most effective is authoritative — high on both warmth and control."
David Gomel, senior vice president and COO of The Rosecrance Health Network in Rockford, Illinois, has important conversations about drugs and alcohol at work, but also at home, where he's dad to two teens and a preteen. "I am looking for opportunities, the teachable moments as they arrive, which is often in the car or as we watch TV or in a conversation about a friend who may be more progressive than my kids are."
Gomel criticizes parents who supply alcohol for kids and their friends on the theory that "they'd drink anyway but at least they're here and safe." He is blunt when talking to parents of his children's friends: "It is not OK for my kids to use alcohol, just so you know."
Khaleghi advocates parenting that is attentive and focused. Parents should look for the root of problem behavior and recognize that children who feel at ease in the world and can soothe themselves when they feel worried or challenged are less likely to use drugs or alcohol. Khaleghi said children with addictive, nervous traits need a strong support network so they won't fall prey to temptation or peer pressure.
"Addiction forms over time through a series of events. There are ways for parents to prevent and address addictive behavior," Khaleghi said. "Parents follow nutrition guidelines to create healthy eaters, read to kids to create lifelong learners and limit bad language around them to create respectful adults. Children take their cues and model behavior after what they witness at home."
Start early is the advice from Rina Das Eiden, developmental psychologist and senior research scientist at State University of New York at Buffalo. When a parent soothes a fussy baby, chooses not to use physical punishment and meets a child's need for interaction, that parent is helping prevent substance abuse later, she said. Parents should know what's normal or not at a given age and create time for shared meals, interactions and open communication.
Children at a young age are tiny mirrors who reflect back the behaviors they see far more than the words they hear, Eiden said. She recommends a Family Check Up, available online at www.drugabuse.gov/family-checkup.
Videos show good and poor communication with a teenager, as well as tips that help parents work through strategies. "I really think this kind of online help is helpful for parents," said Eiden. "Kids know how to push your buttons, and it's difficult to not let yourself get emotionally worked up. But you can't really learn to communicate with your child or how to set limits for them unless you're calm."
Dr. Melissa Deuter, a psychiatrist in San Antonio, treats adolescents and young adults. She likes peer mentors for older kids. It helps to have sounding boards like counselors or youth ministers — "somebody who is not a parent and can't administer consequences," but who can help sort through the issue and offer sage advice.
Stick with real science, not scare tactics. The truth is serious enough. Drugs and alcohol can damage the brain. When Deuter's young patients say marijuana is harmless, she points out that pro-marijuana websites leave out that studies show it increases risk of schizophrenia onset. The sites don't mention it can alter hormone levels, so young men who smoke it heavily may become impotent, she said.
"The pro-marijuana lobby has worked hard to create the perception it's not a big deal. That's the message kids are getting. It causes cognitive changes in kids, and adolescents don't always see the nuances," said Wallace, who believes legalizing marijuana has increased drug use.
On the plus side, it may prompt better research, Deuter said. That happened with alcohol.
Roots of addiction
Khaleghi knows genetics may play a role in addictions; she saw it in her own family. "It was not my personal issue, but one I had to learn to cope with and understand," she said.
One in four people has someone in their lives who struggles with addiction, she said. Some don't recognize it. While society tries to figure out how to address addictions, a great deal is known about how addiction works and the brain chemistry behind it.
Khaleghi thinks people who use have higher levels of anxiety and when that becomes unmanageable, they use alcohol and drugs. The solution to addiction is discovering what one's self-medication issue is, she said. Effective treatments connect emotion and behavior.
Genetics is just one puzzle piece. Khaleghi proposes an experiment: Watch TV with a child and see how many times problems are solved with a pill or a drink — for headache, for indigestion, for sexual dysfunction. Or how often a parent, on screen, drinks — to celebrate, to cope, or just because. Her count shocked her.
Warning signs of substance abuse include suddenly having new friends or losing old ones, skipped classes, falling grades, wanting to be left alone at home or loss of interest in formerly favorite activities, among others.
Those can happen without drugs. But a cluster may indicate use, Eiden said.
Khaleghi said most of her patients started with alcohol or prescription medications. "It's an issue of availability."
Parents often have no idea what's going on in their communities and even in their homes. Deuter described parties where kids bring whatever prescription drugs they can find. They are pooled together and kids take them by the handful, unsure and uncaring what they are and what the effect will be.
If a child is already drinking or using, Eiden said it's crucial to figure out the extent of the problem. Consult someone who knows a lot about drugs and alcohol. Severity, frequency, type of drug, context for use, abuse, dependence and other issues need to be part of the evaluation, she said.
An in-patient program may not be required. But if children are addicted or using at a level that could result in addiction, Deuter said they probably need to go into a program where use "forcibly stops. If it has its hooks in, you can't reason them out of it. It's like being taken hostage. At that point, it's too big" without professional help.
People need to seek help from those who regularly treat others with the same issue, Deuter said. Especially since brains are still forming up to about age 25, it's a mistake to go to someone who might with best intentions but little experience provide the wrong treatment, including medication dose.
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