This is such an important issue and just about guaranteed to get you eye rolls and ridicule from your teens. There's not much to say - "Don't do it." "No duh," as my sister always says. Yeah, I wish it was that easy. If your family is open and easy with each other and has healthy relationships all around, it probably isn't that big of a deal.
But so many of us come from dysfunctional nuclear families, currently have dysfunctional families or are rescuing a child from a dysfunctional family. Anyone who has been there knows - substance abuse is just the tip of the iceberg. What underlies addictive and high-risk behavior is often a huge undersea mountain of pain.
I ask all of the teenagers who come in for check-ups whether they think drugs are a problem in their high school. They almost ALL say yes - these are generally the kids who aren't participating in drug use, though some of the participating kids talk to me, too. And now middle school may be dealing with this issue, too. So, IF we make assumptions about what's happening with our kids and what they face at school AND those assumptions don't include drugs or alcohol, then we are hiding our heads in the sand.
There is the drinking-at-camp phenomenon. Kids observe the climate of alcohol making inhibitions lighter and fun more exuberant. We teach our kids to drink by drinking. The way to raise kids who enjoy life without the aid of alcohol is to have fun with your kids without alcohol in the picture.
There is the marijuana-might-be-the-lesser-of-evils phenomenon. Medical marijuana is everywhere now, making it so much easier for teens to obtain. A lot of people think, "what's the harm? It's a lot better than alcohol or other drugs." To that, I say, "not when you're dealing with developing brains." Marijuana affects motivation, desire and ambition. Do we really want our kids so mellow that they never move out? Do we want our kids so mellow that they could care less about getting a job or applying for college or GOING to college or vocational school? There's a recent nugget of scientific knowledge showing that people who have a genetic susceptibility may develop schizophrenia as a result of marijuana use. I'm a pediatrician. I'm not discussing the use of marijuana in adults. But for our youth, I continue to say, "steer clear."
There is the U.P. wide prescription-narcotics-and-stimulants-addiction issue. If your child has an injury, take care to watch the narcotic use, to back off when it's no longer needed, to look for alternatives to control the pain as soon as is feasible and to beware of prolonged use. A common precursor to prescription narcotic addiction is an injury treated with narcotics that were continued too long. 4 weeks is a general rule of thumb for narcotic use associated with acute severe injuries. Don't be offended if your doctor tries to keep close tabs on this but, rather, view it as an attempt to keep your child healthy.
Stimulant medications are controlled substances. The long-acting stimulants typically used to treat ADD or ADHD are theoretically not abuse-able but they may be used by narcotics addicts to counteract the narcotic effects in the morning and they are sold on the street. Anyone who knows your child takes a stimulant might break into your home to steal these meds. Be cautious. Get a lockbox. Supervise the use of these meds.
There are multiple psychological problems that are self-treated by people of all ages with stimulants, narcotics, alcohol and marijuana. If your child is starting to show signs of using drugs or alcohol, look for any underlying depression or anxiety. Ask about suicidal thoughts. Make it OK to talk about feelings. A person can have chronic pain that is unbearable in the face of severe depression or a mood disorder but becomes tolerable or even unnoticeable when the psychological illness is addressed and treated.
My personal view is that drugs, alcohol and family dysfunction are all symptoms of overwhelming emotional pain. I think a lot of people assume that living in the U.P. with all of its natural beauty somehow protects its inhabitants from emotional pain and "toxic stress." A lot of people think that these things only happen to other families or to other kids. Well, I'm here to say it doesn't. A common denominator with all of these issues is shame and a strong tendency to hide. There are strong motivations to "hide the pain." Please stop hiding. We need to bring these things out into the open, not to attack each other but to listen and to help each other. The issues are societal. Having meth labs in our towns, seeing staggering numbers of children for behavior issues, finding out about domestic violence and sexual molestation and drug addiction - these things are all scary and they are all here. Children act out the symptoms of a society that is ill. We need to act together to probe the wound, let it drain, give it some air and let our society heal. We need to do whatever it takes to protect our children and to break any cycles that are in our families.
Editor's note: Sharon Gilliland is a pediatrician at BCMH.