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Prescription Drugs
Presentation
by Douglas Davies, M.D.
Nicotine
Dependence
Presentation
by Douglas Davies, M.D.
Psychiatric
Comorbidity
Presentation
by Douglas Davies, M.D.
Why
Do Sally and Johnny Do Drugs?
by Alan
I. Leshner, Ph.D.
Right
at the top of virtually every parent's concerns is the fear that
their children might become involved with drugs. And they are right
to be concerned. Whether in cities, suburbia or rural communities,
whether in wealthy or poor neighborhoods, drugs are now readily
available to all young people. And even the seemingly nerdiest kids
can speak with apparent fluency and familiarity about marijuana,
cocaine, heroin, and such strange-sounding things as blunts, ecstasy,
roofies, Special K, and crystal meth. Drugs are an equal opportunity
destroyer. Fifty percent of young people have used an illegal drug
by the time they leave high school. What's a parent to do? How can
you predict if your children are going to use drugs? What can you
do to prevent it? How can you help them once they've started using?
The
first step is to understand why Sally or Johnny might be
using drugs. Researchers have identified over 50 factors that might
put someone at risk for drug use. These risk factors can be found
at the individual, the family, peer groups, and broader community
levels. They include things like having too much free time, weak
family structures, peer group, social pressures, and the glorification
of drug use by some in the popular media. But those risk factors
really only talk about overall probabilities of whether young people
with certain characteristics might be more or less prone to using
drugs. Knowing about these risk factors can help keep a parent alert,
but no set of risk factors determines that a particular child will
use drugs, and many kids who have many of those risk ractors don't
even try drugs. So parents really have to deal with the individual
child's situation and state of mind.
Two
Paths to Drug Use
Research on the pathways to drug use and addiction suggests the
immediate decision to use drugs is driven, basically, by one of
two types of reasons. One group of young people seems to use drugs
simply to feel good. They are seeking novelty or excitement, to
have a good time. I include in this group those who say they use
drugs just because all their friends are doing it; they just want
to join in common fun or to be "cool." These kids are the ones most
likely to be responsive to prevention programming that educates
about the harmful effects of drugs on their bodies, and are most
influenced by the powerful protective factor of having strong and
loving parents interested and involved in all aspects of their lives.
These kids also seem to have the best chances of being successfully
taught to seek alternative ways of having fun and to resist the
temptation to seek novelty in drugs and other harmful ways.
But
there is also a second, very different group of young people who
are using drugs for quite different, actually more intractable reasons.
These are kids who in some way or another are suffering and use
drugs to try to make themselves feel better, or even normal. This
group often includes people stuck in very difficult life situations
- poverty or abusive families, for example. It also includes kids
suffering from a variety of untreated mental disorders, like clinical
depression, manic depressive illness, panic disorders, schizophrenia.
Estimates are that as many as 10 million children and adolescents
may suffer from emotional and psychiatric problems of such magnitude
that their ability to function is compromised, and the majority
of those kids are at extremely high risk of becoming addicted to
drugs.
These
young people are not using drugs just to feel good. These children
are actually trying to medicate themselves with drugs. they use
drugs becase they think they will make them feel better, or normal,
in the same way that other people might be given anti-depressants
or anti-anxiety medications. The problem, of course, is that using
illicit drugs is not an effective treatment. In addition to other,
perhaps more obvious problems - like that their use interferes with
normal functioning - this kind of drug use actually will ultimately
make them feel worse, not better. Medical research has shown clearly
that this kind of drug use only exacerbates underlying psychological
problems.
Treatment
Different For "Self Medicators"
Both
the preventive and the treatment approaches for these "self-medicating"
young people need to be quite different from the approaches one
would use with novelty seekers or social users. For example, it
can't be very meaningful to warn people who feel terrible today
that using drugs may alter their brains a month from now. Their
problem is getting through today. And encouragement to seek alternative
sources of fun or to seek nicer friends doesn't seem very meaningful
for them either. Again, they are trying to get through today's issues.
Even
the otherwise powerful protective factor of loving, supportive family
involvement in the life of the child is not very effective in these
areas. Those young peopie who are trying to self-medicate must have
help with their underlying problems. They need professional treatment.
Whatever
the reasons, how do you know if your children are using drugs and
what do you do if they are? Telltale signs include recent mood and
energy level changes, changes in eating habits, specific signs like
redness around the eyes, and changes in social and educational performance.
Listen carefully to what your children are telling you about their
lives and how they feel. And watch how they behave. It may seem
natural for an adolescent to be a bit surly, but most adolescents
are not actually sullen, withdrawn, apathetic and lethargic. You
should talk to your child about any of these symptoms. You do need
to know.
What
Can Parents Do?
What, if the answer is "yes," your child is using drugs? What do
you do? In a small percentage of cases, parents can work with their
own kids to get them to stop using drugs. This might be easiest
when the young person is just using drugs occasionally to have a
good time. And, of course, the earlier you start talking to your
children about drugs, the better the chances are they won't become
involved with them. If a child reaches the age of 20 without using
alcohol, tobacco or marijuana, the probability is almost zero he
or she will ever develop a serious drug problem.
But
if you suspect your child is really trying to self-medicate, or
if you suspect your child is using regularly or even is addicted,
you need to get help right away from the professionals. These are
not problems the typical parents can handle alone. And help is available.
There are many professional social workers, nurses, drug counselors,
psychologists and psychiatrists well trained to deal with both mental
disorders and drug use problems. Your child's school, your family
doctor, or community health center can help get you a referral.
Do not assume Sally or Johnny's drug use is just a passing phase
or something every kid must go through. It isn't. It may well be
the beginning of a lifetime of problems that could be prevented
with early intervention.
Alan
Leshner is Director of the National Institute of Drug Abuse.
Alan
I. Leshner, Ph.D.
Director
National Institute of Drug Abuse, National Institutes of Health
6001 Executive Boulevard, Room 5213
Bethesda, MD 20892
Phone: (301) 443-1124
www.drugabuse.gov
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