Teens and Drug Use: Parents' Rx for Prevention
A Back-to-School Chat with Dr. Drew and the Nation's Drug Czar
On Wednesday, September 16, 2009, reporters and bloggers were invited to join a live chat with Office of National Drug Control Policy Director Kerlikowske and Dr. Drew Pinksy. The transcript follows.
Director Kerlikowske: Welcome, and thank you for joining us today. I am pleased to be joined by Dr. Drew to “chat” with bloggers and reporters whom we know parents rely on for important information.
Many of you submitted questions in advance, so we will do our best to answer those as well as questions that are submitted over the course of the chat. We will also share questions that are frequently posed to us on the topics of parenting and teen prescription drug abuse.
jwag: Which prescription drugs are the most commonly abused by teens?
Dr. Drew: There are three that you need to be aware of: opioid pain medication, benzodiazepines, and psychostimulants. The opioid pain medications include Vicodin and OxyContin. Benzodiazepines include Valium, Xanax, and sleeping medications. Psychostimulants are drugs such as Ritalin and Concerta. These are all medications that commonly get prescribed. Some of them you may find sitting in your medicine cabinet. Because these are such commonly used medications, teens tend not to have a sense that these medications are dangerous or addictive; 2,500 12- to 17-year-olds will use opioids and prescription medicines for the first time today, and every day.
Director Kerlikowske: Quite often we find that kids will look in their parents’ medicine cabinets and take a variety of pills, even if they’re not sure what the pills are. They think they’re safe because they are prescriptions, even though they may, in fact, be deadly.
stgeorged: Please talk about the connection, if any, between technology and prescription drug use among teens.
Dr. Drew: Well, there’s not a direct link other than to warn parents that the Internet is a dangerous place, and there is ample opportunity for people to access medications of various kinds. Most importantly, I would urge parents to use technology to monitor young people, know what technologies they’re using, have all their passwords, monitor their histories. Follow this downstream, and see what other kids are saying about yours. Don’t be afraid of the Internet, it can be a great tool.
shortpumppreppy: My kids want to help their friends who are doing drugs. They feel they can make a difference. I am afraid for their safety though. What is the best thing they can do for their friends?
Dr. Drew: You need to educate young people – your kids – that they cannot be responsible for someone else’s illness. While they can hopefully leverage, or keep the pressure on, motivating toward change and help, ultimately they can’t make someone better. After all, it takes me and a team of professionals many months. They should ultimately be prepared to leave that relationship, because loss is the only thing that catches their attention sometimes.
So, I would urge your young child to express to the person they’re concerned about, how much they care about them, but that they cannot be in their lives if they’re going to destroy their lives, that they will re-enter their lives once they're ready for change. www.TheAntiDrug.com has lots of parenting info, such as guidelines.
Jody: In regard to peer pressure, how do you teach your child to say NO!?
Director Kerlikowske: Some of the survey data is concerning because we know that young people who perceive drugs as risky or dangerous are less inclined to experiment or use those drugs. Helping teens to recognize, whether it’s a prescription or a drug that sold in a piece of tinfoil, these can all be very dangerous.
Dr. Drew: I concur that helping raise the levels of perceived risk is critical. More often than not, that is about how we live our lives. So treating medication casually, using alcohol and cigarettes without careful education and structure, is extremely problematic. We must walk the walk as well as talk the talk.
shortpumppreppy: There is so much public buzz in favor of the legalization of marijuana, how can I keep my teens from being swayed?
Director Kerlikowske: I think that the biggest influence on young people is often the parents or the caregiver in the house. If they stress the risks and dangers of drugs, regardless of what the discussion in the media might be about marijuana being legalized, they will have more influence than what happens on a news report that night. The marijuana today has a very high content of THC, which is the psychoactive component in marijuana, and it can have very serious effects on adolescents. The research on this is very clear.
Dr. Drew: Once again the Director and I agree. Not only that, but addiction to cannabis is probably the most common one I deal with today. Make no mistake about it. In addition, I would urge parents to ask their children to move away from the idea that there are “good” drugs and “bad” drugs; let the legal process do that. Stress that, particularly if you have any genetic predisposition to addiction in your family history.
NYdenise: Parents are now accustomed to having the “don't smoke pot” and “don’t drink” conversations. How do they broach the “don’t take pills” conversation?
Dr. Drew: First of all, get the pills out of your medicine cabinet. Make sure that substances such as pharmaceuticals are treated in your household with the care and safeguarding that reflects your understanding as a parent of just how dangerous these substances are. Include your children in the information on why you’re doing this. They shouldn’t be able to open the medicine cabinet and see Vicodin left over from your wisdom tooth extraction or sleeping pills from your airplane trip. The medicine should be under lock and key, or out of your house.
DRG: Where are kids getting all of these prescription drugs we keep hearing about? Most parents I know don't have a stash of OxyContin around.
Director Kerlikowske: So, there’s an awful lot of talk about drugs running across the border in the United States, but the prescription drug abuse problem we have is something that’s preventable and controllable. The pills come out of parents’ medicine cabinets. They may come from an extended care facility, or from the home of an elderly person who is being prescribed these drugs. That’s where we see a lot of the availability.
Dr. Drew: Also, if you look at the saturation of our country by medication, it’s easy to see that these things are everywhere, and kids get them from one another. They get them off the street and from the Internet and from parents’ medicine cabinets or bedsides. So vigilance is paramount.
PAZ-guest: Parenting seems to involve a lot of empty threats to try to keep teens from engaging in risky behaviors. How do parents make good on these threats without driving their kids away?
Dr. Drew: That is a frankly a bizarre fear. Kids want you to do your parenting. They may not like it, but they want it. There’s some sort of peculiar leftover from our own adolescence in history when there was much more of a need to cast off the yoke of a past generation. This generation tends to look to adults as more of an asset. It is a normal, elemental behavior to fiercely fight against the limits placed on them by parents and then deeply appreciate the parents’ efforts to not be afraid of doing the right thing. Do not be afraid of doing your job.
GeekNews: Teens always have their heads down in their computers and their ears pressed to their phones. How do parents get through?
Dr. Drew: There’s no magic potion for that one, except to say to spend time. Know where your opportunities lie. For instance, just before bedtime tends to be a quieter time of day, particularly for adolescent females, and they are more open to conversation. So merely going into a child’s room, late at night, and sitting down. Making sure you have at least one meal together. Make a point of seeking out your children. Driving in a car is a great opportunity – they can’t run away. Another opportunity, again, is when other kids are around. Don’t assume you have to retreat because their peers are in the vicinity.
Director Kerlikowske: Some parents have put the computer in a more visible place in the home rather than in the privacy of the child’s room. Parents have limited the time allowed online. Like us growing up, we had an allotted time to watch television. So there are systems in place to help limit these things.
Center Street: What about kids who have legitimate prescriptions for anti-depressants. How do parents know if they’re abusing those drugs?
Dr. Drew: Kids don’t abuse anti-depressants. They just don’t. Make sure you know what medication your children are on. Again, if they include benzodiazepines or psychostimulants, those have potential for abuse.
responsABILITY: How can parents use events like the death of DJ AM or Michael Jackson to talk their kids about the dangers?
Dr. Drew: I think these are wonderful opportunities. Try to look at the media for its potential in teaching. And particularly, DJ AM is an example of how cunning, treacherous, and deadly the disease of addiction is. The Michael Jackson story demonstrates how even the medical system and prescribed medications can be treacherous.
talktalk: What if parents find pills in their kids’ rooms or backpacks? How do they address the situation with their kids?
Director Kerlikowske: First, they need to confiscate the pills, if they’re not a prescription given to that child. I know that Dr. Drew has additional information to give you.
Dr. Drew: This is my opinion: I am of the opinion that if you are actually finding substances – illicit or prescription – on your child or their belongings, you have a very serious problem on your hands that needs professional intervention. It has been my experience that if the child is getting so casual with their substances that you are finding them, this is the tip of a very large iceberg. If you have no access to resources, a school will usually help and is equipped with professionals trained in dealing with your child. The school is your asset, not your enemy.
Director Kerlikowske: You can also go to the website we’ve both mentioned, TheAntiDrug.com for more information about the steps parents can take in situations like this.
ParentsConcerns: What can happen if a teen takes a painkiller or ADHD drug that is not prescribed for him or her?
Dr. Drew: Obviously, this can trigger the potential for addiction. One of the problems in teaching people about prescription medication is that they are safe, when taken occasionally, and teens are well aware some of their peers are on medication such as psychostimulants for long periods of time without ill effects. So, when you speak to a teen, you must always be honest and accurate. So here are the issues with medicines that you’re mentioning here: psychostimulants can cause addiction and psychiatric side effects such as paranoia, depression, mania, and even suicidality. Opioids cause intoxication, and poor judgments, and of course opioids are associated with the most severe forms of addiction.
abstract: When school starts up and teens’ cars are packed with friends, how can parents know if their teens are being safe?
Dr. Drew: In California, the State helps us; teens are not allowed to do that. I would have rules about packing teenagers in a car. I don’t think it’s a good idea.
Director Kerlikowske: There are a couple of things that parents can do. One is to know where their kids are going. They should also give their child the option that if they are with someone and they feel they are unsafe to do the driving or the atmosphere they’re in, that the child can have a backup plan that a parent or responsible adult can pick them up so they’ll be safe.
Dr. Drew: Perhaps I'm a little hardcore on this topic. I believe in being very strict. Each household establishes their own strict rules about hours of driving, who you’re driving with, etc.
Director Kerlikowske: I couldn’t agree more.
niall: What about “street drugs” like marijuana, cocaine, etc. Are these still popular - and accessible - for teens?
Director Kerlikowske: Yes, those drugs are popular. Marijuana, by far, causes the greatest number of calls to hotlines, people calling and asking for assistance with a problem. Cocaine use and availability in the country is down, but it is still available. Of course there is the problem of meth. This is in addition to all of our discussions about prescription drugs.
TINDAL: Parents say their kids spend all their time on Facebook and they’re not sure what really goes on there. What’s the best way for parents to share Facebook with their kids?
Dr. Drew: Get a Facebook account, insist if they have Facebook you have their password and they add you as a friend. Facebook can be your friend; you must know how these social media outlets work. You must be there and monitor your kids.
GovMA: There are varying parenting styles out there - what advice do you offer to those parents who want to be more hands-off with their teens?
Director Kerlikowske: Don’t be!
Dr. Drew: Here’s my one thought: If you don’t think you can be hands-on or want to be hands-off, at least be sure you’ve put some sort of boundaries in place, whether it be law enforcement, or school, or where the computer is; something that gives structure. Because structure and boundaries are the necessary elements for a healthy, productive adolescent so you end up with a healthy, productive adult.
McGuire Group: What are the pros and cons of families texting to communicate with each other?
Dr. Drew: The pros are, I think, the ability to remain connected. That you can, in a simple and rapid way, communicate with your children. The cons are, it’s easy to manipulate it to where you don’t know where they are or what they’re doing. By the same token, the parents can be perceived as nagging and intrusive. Since this is a medium that us old folks aren’t adept at, nothing replaces flesh encounters.
Director Kerlikowske: Remember in an earlier answer, where parents were suggested to have one meal a day with their child and to set aside time with their child every day in the flesh.
MomDierdre: Parents know their kids spend a ton of time on YouTube. Is there really anything to be scared of?
Director Kerlikowske: The answer would be not just about YouTube, but there are so many social media contacts and there is so much information available to kids through all types. So the more contact parents have, the more knowledgeable parents are about their kids, and I think the better protected kids will be from this onslaught of information they receive.
Dr. Drew: I would also add that we as parents have an obligation to become technologically savvy and to put in monitoring devices and parental controls where we can, and know what those things are. A parent can, for instance, go to YouTube and type in “marijuana” or “drugs” and see what their teen might be watching.
Luis Diego: How can parents best caution their kids about the photos they post on the Internet?
Director Kerlikowske: I think the most important thing that parents can do to help their children understand about posting photographs or explicit messages, is emphasize that these will then be available forever. A younger generation kept a diary, but it wasn't broadcast to the entire world. So, this is an entirely different system that once the information or photo is out, it can never be brought back home or kept secret or private.
Dr. Drew: Again, I agree. And remind them that this also includes texting and texting of pictures, which has become an increasingly common practice.
Sylvia: What do you think about the parents today that allow their teens to drink their homes as long as they take the keys away and no one drives home?
Dr. Drew: This is a horrible idea. I have seen it go bad more times than I can count. And it’s illegal. There’s a reason it’s illegal.
Director Kerlikowske: As a police chief for many years, and having had officers respond to these situations, where the parents thought they were helping their kids stay safe, there were so many awful instances of kids overdosing on alcohol or having alcohol poisoning, falling in swimming pools and drowning – just the most awful incidents under the very noses and eyes of the parents. And if that isn’t enough to frighten parents, they should just take a look at the number of lawsuits that have been filed against parents. If this is allowed, it can go badly.
Dr. Drew: If you know of parents that are allowing this, remind them of the liability that they are assuming. And a reminder to everyone: when you look at adolescents and unwanted sexual contact, rape, accidents, unintended pregnancies, and violence, you always find alcohol.
ILLFA: Your website suggests “monitoring” your teen - what does that mean?
Director Kerlikowske: I think that all of the things that both of us have been talking about: setting structure, knowing where your teens are, setting aside family time to be with your teen are the things that we mean.
Peers: What should parents do when they see their teens starting to hang out with a new, dangerous, crowd?
Dr. Drew: This is tough. It’s hard sometimes even to know when that’s happening or who a dangerous crowd is. Usually, I would tend to the mental health of that child. Often times, depression, low self-esteem, or substance abuse first emerges as a) a drop in grades or b) a change in their peer group. So, this should be carefully evaluated and paid attention to.
AnimeshD: Are schools doing anything to combat Rx abuse?
Director Kerlikowske: Many schools and principals are very knowledgeable about prescription drug abuse and have programs in place to educate the teachers, the PTAs, and the children themselves about the dangers of prescription drugs. When older children start school, they are usually given a set of rules and in almost all cases, those rules include drugs and prescriptions this child can have and what the policy of the school is. Because there are some children that have been prescribed a drug, the schools have policies and systems so that drug can be safeguarded.
Dr. Drew: The schools are definitely on the front line with us, not only the schools but the school nurses. The National Association of School Nurses has a Web site, NASN.org, where also a good source of material and resources in this battle can be found.
Director Kerlikowske: And the school counselors and school psychologists are also very knowledgeable about this problem.
Dr. Drew: The school is your friend. They are an asset. Use it.
pamena: Of course you’re both probably too young to have teens of your own, but how early should parents be starting to talk to their kids about drugs?
Dr. Drew: First of all, how dare you! The basic position is, it’s never too early. There’s some research that suggests 8-12 is a window in which to shape the behavior of the upcoming years.
Director Kerlikowske: Thank you for the compliment! I’ll tell that to my grandson.
Dr. Drew: I feel your pain, I have 17-year-old triplets.
envirodad: What happens when kids are popping pills and drinking at the same time?
Dr. Drew: This obviously enhances the potential for bad outcomes. The only combination that is specifically, synergistically, toxic is cocaine and alcohol, where a more toxic and more potent chemical is created.
JoseM: Are there any particular warning signs of prescription drug abuse that parents should look for?
Director Kerlikowske: I think the warning signs about a problem with a child that may involve drugs, are the ones that we have mentioned earlier – including a change in behavior. And remember not all of these are indicative of a problem, but these should be cause for parents to inquire further and to be more vigilant. So, aside from a change in behavior, a change in grades, a change where school may contact you, and hopefully parents are maintaining close contact with the teachers. Those are some ideas.
Dr. Drew: I concur and would include change in appearance, sleep patterns, peer group change, isolating, lying, disappearing for periods of time, outbursts of anger or irritability, hygiene changes. These are signs of global mental health problems; there are no specific signs for prescription drug use, per se, but a child manifesting these symptoms needs attention.
Director Kerlikowske: There is more information at the Web site TheAntiDrug.com.
sasha: If your child smokes cigarettes are they more likely to smoke pot and take drugs?
Dr. Drew: Yes. And if you smoke cigarettes, they’re more likely to do the same.
TennisMom: For parents who are working full time and don’t spend as much time with their teens as they’d like, how do they ensure they are steering clear of risky behaviors like prescription drugs?
Dr. Drew: It’s difficult. I sympathize with parents trying to raise a family in today’s economic time; it’s not easy. But we’ve given you lots of ideas about monitoring and employing school and community resources. Use what’s available. The care of your children has got to be a priority. If it is not, I would reconsider your priorities, and think very carefully about where you want to put your attention. In terms of what makes people happy, it’s usually family life or relationships – not that they should have spent more time at the office.
TheAntiDrug: Director Kerlikowske and Dr. Drew, we’re almost out of time for today’s chat. Do you have anything you'd like to add, before we have to close?
Director Kerlikowske: I'd like to thank all of the participants, and everyone involved for their hard work in helping us get the word out from the Office of National Drug Control Policy and the White House about the importance of prevention and treatment. And I want to thank Dr. Drew and the people at the Pasadena Recovery Center for making this possible today.
Dr. Drew: I want to thank Director Kerlikowske for the honor and privilege to participate with him and his staff this morning.
TheAntiDrug: Thank you for joining us for today’s chat with Director Kerlikowske and Dr. Drew. We are sorry we could not get to all of your questions. For more information on preventing teen drug abuse, please visit our Web site: www.TheAntiDrug.com.
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