How the Family can Help or Hurt part 1: Teen Substance Abuse-Prevention & Treatment Options
How The Family Can Hurt or Help: Teen Substance Abuse-Prevention & Treatment Options.
Part 1 By Elisabeth Escobar & Kathryn Staron
A family component to substance abuse treatment is imperative. While certain aspects of the disease of addiction are still unexplained, there are multiple treatment options (12 steps, abstinence based vs. harm reduction and faith-based programs, to name a few). However, there are enough evidenced based practices that suggest that certain treatment approaches are more effective than others.
Family participation is one of those approaches and indicates that having “the talk” with your teenager is an important step for parents to take.
Parents, who talk in a productive way with their child, often have kids who may still “experiment” with alcohol or other mind-altering chemicals, but those children are less likely to develop a pathological relationship with substances. A productive talk with teenagers means that you do not give a “lecture” or go into long diatribes about the ills of using. It is also ineffective to discuss the far off future (immediate future is more acceptable to teens) or threaten to ground the teenager for life! Rather, the dialog would go something like this:
“Paula, I would like to talk to you about alcohol and other drug use because I know this will, if it has not already, come up for you now that you are becoming more independent. You will be making more of your own decisions as you get older and I am just hoping that if you are offered alcohol, weed, pills or any substance, that you will really think long and hard about whether or not you are going to try it. I am really hoping that you don’t. You have your whole life to drink alcohol once you are an adult and I would be really scared and disappointed if you started now, or if you developed a problem with it.
I never told you this but my sister got a DUI when she was young and your dad’s father abused alcohol, which caused a lot of problems in his family.
I trust you to make the right decision. Also, I want you to know, that if you do decide to use, there will be consequences, such as loss of privileges (cell phones, car, curfew) but I am confident we will not get to that point, because I know that you have a good head on your shoulders. Do you have anything you want to say about this…..?”
As you can see, this dialog lets teens know that you are aware of what they are facing, and that you can’t control their every move. It also lets them know that you see their new found independence. It is important that you share with them how you would feel if they choose to use mind-altering chemicals at a young age and what the consequences would be. You also need to inform the teen that the decision will untimely be up to them as you cannot be there to police your child every minute. This gives the teens the confidence to say to themselves, “I don’t want to let my parents down” or, “I know I have to make this decision and today I am deciding not to do this”.
A recent study, best explained by Shankar Vedantam in his podcast, “The Hidden Brain” showed that kids who were concerned about being popular were more likely to succumb to peer pressure.
Kids who were not overly concerned about popularity, do not feel the peer pressure as intensely. Kids who are popularity driven are often suffering from low self-esteem, which can lead to trying substances.
Consequently, associating substance use with fun, peer interaction or as a way to cope with stress may perpetuate the teen’s use. What we are proposing with the dialog above, will allow the teen to develop the necessary maturity to lead a happy, successful and functional life. (Many successful people suffer from a Substance Abuse Disorder and they may be successful but not happy).
It is essential that parents, helping professionals and educators know how to talk to teens about this topic. Healthy conversations regarding substance use can aid in a teen’s understanding that they do not need to use at this point in their life in order to be accepted. The longer a person waits to try alcohol, the less likely they are to become addicted (Note: this may not be true for highly addictive substance such as benzodiazepines). The developing brain is at risk for kids who use at young ages and/or who use habitually. Binge use or using in isolation are two red flags for developing a more serious problem with alcohol and/or other drugs.
Often we hear parents say, “Well, I would rather my kid use at home so I know what they are doing” or, “I used when I was a kid and I turned out ok”, or, “Better to not have it be a taboo so they feel it is no big deal”.
These rationalizations can be dangerous because often kids who use at home ALSO use outside of the home. Perhaps, you, as a parent, personally did not have a problem, that does not guarantee your teen will not develop a Substance Abuse Disorder.
In countries where the legal age to consume alcohol is 16, we find that some youth go on to develop a Substance Abuse Disorder and many are more likely to try other drugs, such as marijuana. Cultural influences do affect teen’s decision to use, but teen substance abuse is also about the effects on the brain, no matter the cultural norms or legalities.
The research is clear that tobacco, alcohol and marijuana are Gateway Drugs. By this, we mean that while a majority of kids who use one of these 3 substances will not go on to use “harder drugs’, it is common to find that the majority of heroin users report that their use began with one of these 3 substances. To reiterate, tobacco, alcohol or other drugs are not healthy for a developing brain.
Parents, therapist and educators need to help our young people understand why they are taking the risk. We often ask parents, “Would you let your child be in a car and not wear a seat belt?” Because this is an expectation of parents for their kids, which is usually non-negotiable, we encourage parents to think about it the same way when talking about substance use.
It is crucial that we do not forget the importance of Parental Role Modeling. If you are using tobacco or coping with stress by drinking alcohol, using some other mind-altering chemical, or demonstrating to your children that the only way to have fun is to use a substance, then it is time to get the support for yourself to change your own behavior.
One standard of practice is that individuals in treatment are strongly encouraged, if not required, to be involved in the 12 step fellowship. Though meetings are not treatment, they are a most useful support for the addict and his/her family members. The family members may be encouraged (or required as part of their treatment plan) to attend Al-anon meetings. Other 12-Step meetings may be helpful to the family such as Over Eaters Anonymous for a family member with food issues or weight gain, Co-Dependents Anonymous for family members who are constantly trying to fix or control things, or Narcotics Anonymous, especially if prescription drugs are part of a parent’s life.