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Child's Drug Use Can Go Way Beyond 'Recreational'

November 09, 1998|ALAN I. LESHNER | Leshner is director of the National Institute on Drug Abuse at the National Institutes of Health

Now that their children have returned to school, 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.

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 more than 50 factors that might put someone at risk for drug use. These risk factors can be found at the individual, the family, peer group 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 factors don't even try drugs. So parents really have to deal with the individual child's situation and state of mind.

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 want to join in common fun or to be "cool."

These kids are the ones most likely to be responsive to prevention programs that educate about the harmful effects of drugs on their bodies. They are also the ones more likely to be 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.

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But a second, very different group of young people use drugs for quite different and more intractable reasons. These kids are usually suffering in some way 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 disorder or schizophrenia. It is estimated 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 because they think they will make them feel better, or normal, in the same way that other people might be given antidepressants 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--these drugs will ultimately make them feel worse, not better. Medical research has shown clearly that this kind of drug use only exacerbates underlying psychological problems.

Prevention and treatment for these "self-medicating" young people needs to be quite different from the approaches used for novelty seekers or social users. If someone feels terrible today, it might not be effective to warn them that using drugs may alter their brains a month from now. Their problem is getting through today. Encouraging them to seek alternative sources of fun or nicer friends probably won't work either.

Even the otherwise powerful protective factor of loving, supportive family involvement in the life of the child is not very effective in these cases. Those young people 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?

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