American Academy of Pediatrics

Substance Abuse Prevention


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The use of tobacco, alcohol, and other drugs is one of the biggest temptations facing young people today. As a parent, you are your child's best protection against drug use. You can start by telling your children that you expect them not to use drugs and become informed yourself about drug use. This publication was written by the American Academy of Pediatrics to help you identify the warning signs of drug use and provides tips on how to help your child (especially during the preteen and teen years) say no to drugs.

Stages of drug use

Both casual drug use and addiction impact health, but it is important for parents to know the difference. The same pattern of use and abuse exists for alcohol as with other drugs, such as marijuana or cocaine. The following is how experts explain the stages of alcohol or drug use:

Stage Description
Abstinence No use.
Experimentation The first 1or 2 times your child drinks alcohol or uses drugs. Children at this stage are curious about what it feels like to be drunk or high.
Non-problematic use Repeated drug use in social situations without associated problems. Children at this stage are using in order to have fun with friends.
Problem use Drug use for purposes other than recreation or drug use associated with a single problem, such as to deal with tension with parents or a school suspension. Children at this stage have begun to use in order to help them manage their emotions.
Abuse Drug use that has a negative impact on daily functioning or that is associated with recurrent and significant risks and problems. Children at this stage have experienced problems because of their drug use but continue to use anyway.
Dependence Loss of control over use. Children at this stage have developed a compulsion to use and no longer can simply decide to "just say no" or "stop using any time they wish."

How can I tell if my child or teen is using drugs?

Certain symptoms and behaviors are warning signs for drug use. But keep in mind they may also indicate other problems, such as depression. Look for

  • Alcohol, smoke, or other chemical odors on your child's or their friends' breath or clothing

  • Obvious intoxication, dizziness, or bizarre behavior

  • Changes in dress and grooming

  • Changes in choice of friends

  • Frequent arguments, sudden mood changes, and unexplained violent actions

  • Changes in eating and sleeping patterns

  • Sudden weight gain or loss

  • Loss of interest in usual activities or hobbies

  • School problems like declining or failing grades, poor attendance, and recent discipline problems

  • Trauma or frequent injuries

  • Runaway and delinquent behavior

  • Depressed mood or talk about depression or suicide; suicide attempts

Teens will try to hide, disguise, or downplay alcohol or other drug use, so you must learn to recognize the signs of abuse and stay on top of things. Also, trust your instincts. If you suspect a problem, talk with your teen, ask questions, and speak with a health professional about your concerns.

Remember that your child's doctor has the knowledge and experience to help you find out if your child has a drug or alcohol problem and how to help your child.

About teen confidentiality

All teens should be screened for alcohol and other drug use as part of routine medical care. Your child's doctor will want to ask questions about alcohol in private in order to get honest answers. If your child does report alcohol use, the doctor will determine whether your child needs very brief advice, a return visit, or a referral to a specialist. Every doctor will have his or her own policy about what information must be shared with a parent and what will stay confidential (meaning stay between the patient and the doctor), but most doctors will protect a teen's confidentiality if they believe that the teen's drug use is not an immediate safety risk to the child or others. It is important for you to respect the doctor's decisions about confidentiality in order to encourage your child to have an open and honest discussion with the doctor.

What you can do

The following is what you can do to help your child say no to drugs:

  • Talk with your children about drugs. Young people who do not know the facts about drugs may try them just to see what they are like. After you become informed, talk with your children about drugs and their harmful effects. Use current magazine articles or news reports, as well as TV or movie scenes, to bring up the topic and make a quick point. Try to get your children to share any questions and concerns they have. Be sure to really listen; do not lecture or do all the talking. Ask your children what they think about drug use and its consequences.

  • Help your children handle peer pressure. Peers and friends can strongly influence teens to try drugs. As a parent, your influence can be just as strong in helping them be independent and resist unhealthy peer pressure. Tell them that it is OK to say no and mean it. They can try saying, "I need all the brain cells I have to make it through this school year," or "I would get in a lot of trouble if my parents ever found out," or they can try saying, "No, that's not for me," and leave to do something else. Practice these and other responses with your children. If a friend is offering drugs, it may be harder to say no. Encourage your child to suggest other things to do with that friend. This shows that they are rejecting the drug, not the friend.

  • Help your children deal with emotions. During the teen years, many young people face strong emotions for the first time. These new feelings can be hard to cope with, and your child may sometimes get depressed or anxious and possibly turn to drugs to try to escape such feelings and forget problems. It is important to talk with your children about any concerns and problems they are facing. Explain that everyone has these feelings at times. Everyone must learn how to cope with feelings and face their stressors in ways that are healthy and help them get through their problems. Assure them that everything has an upside, and things often do not stay "bad" for very long. Point out that even after using drugs, the same problems and hassles are still going to be there.

  • Boost their self-confidence. It is often overlooked how important it is to notice and frequently praise others' positive qualities. Encourage your child to set goals, make personal decisions to achieve them, and actively work toward these goals. With each success, your children will gain more confidence. Applaud effort as well as success. As your children become more responsible, you should still provide guidance, emotional support, and security when needed. Becoming responsible also means facing the results of one's actions—good or bad. Making mistakes is a normal part of growing up, so try not to be too critical when your child makes a mistake.

  • Instill strong values in your children. Teach your children the values that are important to your family. Also teach them to think of these values when deciding what is right and wrong. Explain that these are the standards your family lives by, despite what other people are doing.

  • Be a good role model. As a parent, your actions often speak louder than words. You should use alcohol only in moderation and avoid using tobacco and drugs. You should not drink and drive or ride with a driver who has been drinking. Have a safety plan to pick up a teen in an unsafe situation, like if they end up at a party where drugs are being used. Make a stand against drug issues—your children will listen. You are the best role model for your family, so show them how to have fun without using drugs.

  • Encourage healthy ways to have fun. Young people are always looking for ways to have fun. They can also get bored easily. Drugs offer what seems to be a carefree high with little or no effort or consequences. Help your child understand this myth. Encourage interests in different hobbies, clubs, sports, or other activities. Look for healthy ways to reduce boredom and too much free time. Take an active interest in what is important to your children. Plan interesting activities together as a family, and have fun!

Copyright © 2009 American Academy of Pediatrics

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