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By "Today" contributor
updated 4/22/2006 5:22:30 PM ET 2006-04-22T21:22:30

In the latest installment from "Today" show contributor Dr. Ruth Peters' book, “Laying Down the Law: The 25 Laws of Parenting to Keep Your Kids on Track, Out of Trouble, and (Pretty Much) Under Control,” she shares advice on keeping kids substance-free. Here's an excerpt:

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Law # 8:
Have Zero Tolerance for Substance Use
Any substance use (drugs and/or alcohol) is substance abuse. No ifs, ands, or buts about it. It’s illegal, dangerous, addictive, and has absolutely no place in your family. Learn the signs and symptoms of use and how to keep your children substance free. If you don’t take a stand, how can they?

***

Notice that the title of this law is “have zero tolerance for substance use,” not abuse. What’s up with this? Well, after years of working with kids who get involved in smoking, swallowing, huffing, injecting, and snorting anything that they can get into, I’ve come to the conclusion that kid substance use is synonymous with kid substance abuse. Even though they may try to convince you otherwise, these young critters just don’t know when to call it quits, before it’s too late. I know, I know, when we were kids and could get our hands on some beer to drink or cigarettes to smoke, many of us indulged. But it just seemed different back then, and not only because it was our generation doing it. It really was different. Yes, cigarettes were easy to obtain — you could often buy them from a vending machine when an adult wasn’t looking. And sure, a dedicated lush could scrounge up a six pack in high school or a keg in college, but that took some planning, money, and plenty of moxie. Today, the drugs that our kids are exposed to are more toxic and addictive. Kids tell me about alcohol and drugs brought to school, stashed in book bags, pockets, or sneakers. I have several clients who smoke marijuana on an almost daily basis — they go to school stoned, sleep through many of their classes, and do a crash and burn in the afternoon, telling Mom that they’re tired from classes and need to take a nap.

And then there are the even scarier risk seekers, those who are looking for the latest in designer drugs — mostly pills, but also inhalants and liquids. These kids, knowingly or unintentionally, are risking brain damage through organic toxicity as well as disruption to their daily routines, schools, safety, and families.

Substance abuse counselors often view drug or alcohol dependency as falling within four progressive stages of development or severity.

1. Initial usage involves a minimal number of episodes (about five or less) and the usage hasn’t yet interfered significantly with daily functioning. The child still attends and participates in classes, is engaged in regular extracurricular activities, friendships, and family relationships. The tween or teen may view the substance as a way to gain acceptance into a social group, to alter feelings, or to deal with discomfort.

2. Problem usage involves using the substance on a more frequent basis. In addition, the child’s thought process moves from perceiving substance use as “a possible way of” to “the best way of” altering negative feelings or being accepted by others.

3. Psychological addiction is stage three. At this level the youngster is often very open about his drug usage and quite defiant about others’ attempts to help or to stop it. Kids begin to look forward to binges, to depend upon the “good” (although temporary) feelings associated with substance use, and often show an increased tolerance for their drug or alcohol of choice.

4. The most severe stage, that of physiological addiction, contains all of the symptoms and signs of stage three but the body chemistry has adapted to the drugs taken. Therefore, detoxification procedures must be cautiously implemented if physiological withdrawal is to occur.

What’s out there to worry about
Liquor
is often the substance of choice for many of our young people. Although illegal to sell to anyone under the age of 21, a determined teen can usually find a way to secure some booze. Kids raid their parents’ liquor cabinets (lock ’em up, folks!), pay an adult to buy it from the local convenience or liquor store, or use false identification to buy from a store themselves. Beer, wine, and hard liquor can become addictive, and alcoholism is one of the top health as well as mental health problems in our culture. Alcohol addiction often leads to loss of motivation, DUIs, and other illegal involvement. Safety can be compromised, as are judgment and self-control. The disinhibiting effect of alcohol may feel good, but the behaviors and consequences that follow are a large price to pay for continued usage. Psychological and physiological dependency follow, and detoxification procedures may be necessary.

In addition to liquor and marijuana, it’s important for parents to become aware of other drugs of choice of our kids. The following is a primer of some of the more common substances used.

  • Ecstasy (MDMA). This is a widely available drug (in pill form) often known as the “happy pill” as it makes people excited and euphoric. However, ecstasy may cause permanent brain damage by killing cells that release the neurotransmitter substance serotonin. Side effects can include increased heart rate, possible stroke or heart attack, seizure, or dehydration.
  • Nitrous oxide (whipits). This is a favorite of the middle school set — mainly because it is easily obtained and “legal.” Nitrous oxide is a gas that is used in some aerosol sprays, such as cans of whipped cream and other foodstuffs. Dealers also sell it in balloons. The effects that it can have on the user are very similar to alcohol intoxication. Seizures or permanent brain damage can be caused by the depletion of oxygen to the brain.
  • Dextromethorphan (DXM). Another favorite of the younger group as it is legally and readily available. This liquid is taken orally and is found in many cough suppressants, such as Robitussin. If taken in high doses, it can be a hallucinogen and cause coma or suppress breathing.
  • Crystal methamphetamine (crank). This stimulant can be smoked, eaten, snorted up the nose, or injected in a vein. It causes the user to feel happy, increases energy, and can result in psychotic behavior.
  • Heroin. This narcotic is highly addictive. Heroin is a relaxant and can cause a dangerously slow rate of breathing. This substance is used by injection, snorting, or smoking.

With all of the drugs available and their potential side effects, you would think that parents are on top of their child’s substance use. Sadly, though, many are not. Kids can be so sneaky that often substance use has to become a distinct problem before parents notice. Consider Chas, for instance. This kid was 14 years old, a decent student and part-time athlete. On paper he looked good — went to school most days, although he rarely seemed to have homework to do, was present and accounted for at the dinner table, and dressed in a preppy manner. The bad news was that Chas was a pothead. The kid could smoke two to three joints a day, every day, and still function, although at a decreased level. His grades had dropped since beginning high school, and his hustle at football was marginal. Chas just seemed mellow — not argumentative as his folks Charles and Nancy thought a druggie would be. You can imagine how surprised they were when their kid’s urine screen for his high school physical came back positive for cannabis (marijuana) as well as nicotine. The boy had been smoking dope and cigarettes for over 4 months without his parents suspecting anything.

Well, once Chas was nailed, his folks brought him to my office at his pediatrician’s suggestion. He knew that the gig was up, and although he personally saw nothing wrong with smoking dope on a daily basis, he did admit that it probably was not such a hot idea since it freaked out his parents. He also acknowledged that his motivation for academics and athletics had decreased over the months and that he had to make some changes if he wanted to go to college.

Since he was already in such hot water, Chas told me of his frequent alcohol use — mostly beer when he could get it. He noted that he preferred marijuana to liquor — it was easier to get and more difficult for his parents to detect. In order to work on Chas’s addictions, he needed to stop using, and to do so immediately. I told the family that no substance use should be tolerated — I don’t believe in “social” or “recreational” use of substances for kids. You either say “no” to all drugs and alcohol or run the risk of the recreational user becoming a frequent flyer.

Because he had been dishonest and sneaky (swiping liquor from his folks’ cabinet, smoking a joint on the walk to school), I instructed the family to avoid trust situations for the present. That meant that they were not to take Chas’s word that he was abstinent — he had too great a history of lying and sneaking, and most likely would revert to that if given the chance. We had to go in for the kill to help motivate him to stop using, and I suggested employing regular urine drug screens as well as alcohol tests. The drug screens were given at the pediatrician’s lab, and Chas went every 2 to 3 weeks. His parents bought an Alco-Screen product from the local pharmacy to keep his drinking behavior in check.

Almost immediately these measures were successful. Once Chas knew for sure that his folks would be administering these screening devices, he was smart enough to knock off the drug and alcohol usage. His parents also paid closer attention to his whereabouts and the people that he was hanging out with, and his free time was initially restricted to supervised activities. Because Chas knew that he would be caught red-handed, he stopped using. The screening measures gave him the motivation to no longer use substances as well as a convenient excuse to use with his friends when they tried to pressure him into partying.

Well, I’ve worked with Chas for over 2 years now, and he continues to stay clean and sober. I have little doubt, though, that had we screened for only a few months, Chas would have returned to his druggie behavior and usage. That stuff is so addictive that it not only becomes a psychological habit but can also result in physiological addiction. The most important motivator was his fear of getting caught using, with the consequence being sent to a drug rehabilitation center. This reaction to drug and alcohol screens is not unusual for tweens and teens. Most will stop using substances if they believe two things: That their folks will really pay for, and take the time to arrange for, the drug screens, and that if the reading comes out positive, then a tour of duty at a drug rehab is in order.

A couple of years ago I was involved as an expert on The Oprah Winfrey Show on a program entitled “I Was a Parent in Denial.” It was a great hour, but the most important point, in my opinion, was that every one of the teens on the show admitted that had their folks employed drug screens, especially early in their substance abuse careers, they would have stopped using out of fear of getting caught and the consequences they would have had to face. Pretty powerful stuff those screening devices, and I highly recommend them to parents who have reason to believe that their child is using. Now, I wouldn’t drag every kid into the laboratory and have them pee in a bottle just because the technique works — only kids who have “drawn first blood.” That is, they have shown signs and symptoms of substance use, and you are suspicious of what they are into. It’s insulting for a straight kid to be accused of using, so please be fair in your assessment and your behavior.

Living the Law

Talk to your kids about substance use and abuse. Studies have shown that parents who hold conversations (notice the plural, not just one quick lecture on the way to the ballpark) about the pitfalls of drug and alcohol use help to prevent addiction in their children. In your own discussions with the kids, give examples of people they know who have faced difficult consequences because of substances, such as dropping out of school, poor health, divorce, loss of job, and family upheaval.

Discuss media and peer pressure. Your children are besieged with images, both visual and auditory, about how cool it may be to use drugs, alcohol, or cigarettes. To combat this, supervise their TV viewing and music choices, and discuss how peers may pressure your children to engage in substance use. Promote a home environment that allows for and invites communication on this topic.

Be a good role model. Don’t do drugs yourself. I don’t care that it’s “only marijuana” — it’s illegal, addictive, and a lousy way to bring up your kids. If you drink alcohol, do so responsibly. Never, ever drink and go near the wheel of a car. Never, ever. Be sure your kids know this is your policy and how serious you are about drinking and driving. Consider abstaining from alcohol yourself — you may be surprised at how nice life is when you are consistently sober.

Make it a point to let your children hear you when you politely turn down drinks, especially when you’re driving. This will clearly show them how easy it is to say “no” and still have a good time without alcohol.

Make substance abstinence for your kids, and perhaps for yourself, part of your family code of values. This is one of the biggies, folks, right up there with building honesty, responsibility, and self-discipline. Set up a rule banning all kid substance use (including cigarettes) and stick to it. If you need to employ alcohol or drug screens to get their attention and motivation, do it. Don’t back down on this one!

Rodale Books

From “Laying Down the Law: The 25 Laws of Parenting to Keep Your Kids on Track, Out of Trouble, and (Pretty Much) Under Control,” by Dr. Ruth Peters. Copyright ©2002 by Dr. Ruth Peters. Excerpted by permission of Rodale. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

Dr. Peters is a clinical psychologist and regular contributor to “Today.” For more information you can visit her Web site at www.ruthpeters.com. Copyright ©2006 by Ruth A. Peters, Ph.D. All rights reserved.

PLEASE NOTE: The information in this column should not be construed as providing specific psychological or medical advice, but rather to offer readers information to better understand the lives and health of themselves and their children. It is not intended to provide an alternative to professional treatment or to replace the services of a physician, psychiatrist or psychotherapist.

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