Talking to your Teenager about Substance Use

Parents must discuss substance use with their adolescent.

Posted Apr 19, 2009

Although I do not provide counseling for substance use problems, I do talk both with adolescents and parents about it, where appropriate. So, in no particular order, here are a few talking points that may help parents start to figure out how they want to address this troublesome issue with their teenager. To say nothing is irresponsible parenting. What they need to have is not a one-time discussion, but an ongoing dialogue.

To begin, accept that we live in a drug-filled world. From "natural" remedies, to herbal supplements, to over the counter medications, to prescription drugs, to those that are illicitly grown, to those that are illicitly manufactured, we ingest a huge variety of chemicals for their supposed medical, health, performance, or recreational benefits. In the United States, drugs are increasingly the universal fix for whatever ails the human condition.

Explain what a drug is. A drug is just a potion with a purpose. Although we take it for its beneficial influence, there is always a risk of harmful side effects. As the song says, "You can't have one without the other." Despite what we are told by whoever is selling, prescribing, or offering it to us, there is no guaranteed "safe" drug of any kind. Partly this is due to unintended effects of the drug itself, and partly it is due to the highly individual human system of the person taking it. After all, a drug is not precise like a rifle bullet; it has a scattered spread of effect like a shotgun.

And there are two problems of tolerance that go with every drug we take. First, some of us simply can't tolerate a given drug. You may get an aversive or allergic reaction to some medication that many other people do not. In terms of recreational use, one young person can get a mellow high on marijuana while another can take off on a bad trip. This is why taking any drug is a gamble. You hope the reward is worth the risk.The more often you use, the more risks you take, and often the more unmindful of these risks you tend to become.

Second, sometimes the more we take a drug, the greater the tolerance for it that we develop, the more we may self-administer to get the desired affect. So when your high school buddy boasts about how much alcohol he can tolerate ("a six-pack of beer doesn't affect me at all") he does so to prove how immune he is to its intoxicating effects. However, what that statement really shows is the size of the dose to which his body has adjusted and how much he now needs to get the psychoactive benefit he is after. ("It takes a lot to get me drunk.")

Psychoactive drugs are taken because they have a mood or mind altering effect. When parents worry about adolescent drug use, these are the ones of concern, and today there is more variety of psychoactive substances available to people, young and old, than at any time in human history. The big three, at least through high school, are nicotine ("I take it to relax"), marijuana ("I like to mellow out"), and alcohol ("I enjoy getting a buzz on.") By the end of high school, the majority of students have tried one or more of these.

Certainly explain how underage alcohol use and illicit drug use are against the law. Describe common costs for getting caught: a court appearance, legal expenses, monetary fine, court-ordered instruction and community service, and an offense that adds to or begins a juvenile record (that can effect your employability.)

The rule for psychoactive drugs is that you can't alter the mood, without impacting the mind, and that includes one's capacity to make decisions. Psychoactive drugs not only affect how you feel, they affect your judgment, perception, sensitivity, inhibition, coordination, and reactivity. It's the first of these capacities - judgment - that betrays users because by becoming altered it causes them to become poor judges of their own use. "I'm fine, I can drive okay, give me the wheel!"

Abstinence is another problem. How can abstinence be a substance use problem when by definition no use is involved?  Because not using substances carries some degree of danger. Consider the difference between ignorant abstinence and informed abstinence.  Having your teenager not use alcohol or drugs in adolescence is well and good, but what happens after high school when he or she, off in an apartment or at college, enters the period of maximum substance use?  Ignorance is no good protection should the young person now choose to use.  At worst, suppose parents send an ignorant, abstinent adolescent off to college to join a sorority or fraternity, organizations with well-deserved reputations for heavy social drinking?  Suppose you've never done your preparatory job of instructing the young person about strategies for safe drinking should he or she ever choose to use?

Informed abstinence means that parents, in addition to cautioning against use and appreciating the teenager's desire to remain substance-free, have also been informing their child's understanding about substance risks, safe and responsible use, in family discussions since early adolescence (around ages 9 -13) when peer interest to experiment usually begins.

Some teenager's believe they are abstinent, when they are not. When prescribed psychoactive medication for anxiety, despondency, mood swings, or impulse control, for example, they have become prescription psychoactive substance users. This means that any additional use of recreational substances is not a good idea because it may adversely interact with, or reduce the helping power, of medication being taken.  Whoever prescribes this medication needs to make very clear to the adolescent what risks are associated with other substance use. 

One question about abstinence parents commonly ask is, "Is it okay for my abstinent child to be a "designated driver?" I don't believe so.  A "designated driver" is responsible for driving "designated drinkers." It's not safe drinking and driving.  It's not safe being driven by a drinking driver.  And it's not safe driving around drinking (particularly drunken) friends.  Nor should your child have to assume responsibility for the behavior of intoxicated peers.

As for telling an adolescent that when it comes to drug use, "Just say no," that is not enough instruction. Parents need to discuss how to say "no" when refusing is socially hard for the young person to do. Consider three alternatives. Play for delay. Say "Not now, later." And if peers keep pushing use, say, "I didn't say I didn't want to do it. I said I'd do it when I feel like it. And I don't appreciate being pushed around about it!" Peers can often respect not wanting to be pushed around. Or take a break. Say, "I need to go to the bathroom." A lot of times a short break in the bathroom gives you time to think, and by the time you get back with your friends, group inclination may have changed in another direction. Or lie. Say, "If I did that I'd be grounded forever. My parents drug test me, and I'd get caught. So it's not worth it." This is all a fiction. But if the lie allows the young person to get out of using when he or she doesn't want to, for most parents this lying is okay. So tell your teenager, "play for delay, take a break, or even lie when you can't socially afford to say ‘no'."

Frequently parents wonder, what they should answer when the adolescent asks them: "Well, did you ever do alcohol or drugs when you were growing up?" The temptation is to dodge the question out of the fear that if you say you did, that example will the give the teenager permission to do so too. "Well if you did it growing up then so can I!" In my experience, this fear is ill founded. Although parents can't actually control adolescent choice, they can definitely inform that choice, and one of the most powerful ways of doing so is through sharing their own experience. Parents can be very credible informants. By sharing some of their painful lessons from early substance use ("I never would have had sex that night if I hadn't been drinking") they can allow their son or daughter to profit from what they learned the hard way.

So what I suggest to parents is to make an "equal disclosure contract" with the teenager. "I will be glad to answer any questions about substance use in my growing up, about what I saw and did and learned. What I would ask is in return for you to agree to share with me what you hear about, see, and experience so we can make substance use an open topic for discussion between us. Although you do not have my blessing to use, should you choose to do so, since any use is risky I would like to add the benefit of what I know to help you learn what you can from this experience."

In addition, parents should share any history of substance problems in the extended family because there may be informative cautionary stories to be told in the lives of people the teenager knows and loves. Of course, parents need to declare their willingness to respond to any of the teenager's concerns or questions about their current use of alcohol or other drugs.

In regulating risk of use, the toxicology statement is helpful to remember, "the poison is in the dose." For example, there are often traces of arsenic in drinking water, but the amount is so small there is virtually no harm. Increase the dose, however, and the amount becomes lethal. So one guideline for alcohol and other psychoactive drug use is: "start low and go slow."

Psychoactive substances work. For example, that's why alcohol is the "get to know you" drug. A young person who feels shy, inhibited, or self-conscious at a party drinks some alcohol to relax social discomfort in the situation. Alcohol loosens them up, just like cigarettes give them something to do with nervous hands. In the extreme, someone can drink so much they "feel no pain." The problem is, the more one drinks, the more likely normal boundaries of caring will be violated and what they say or do, on sober reflection later, is inappropriate, unwise, injurious, or wrong. As police will testify, most of the fights, domestic violence, and reckless driving they deal with is drug or alcohol effected.

What parents need to explain to their teenager is how psychoactive substance use affects normal caring. Depending on the substance and dose, it takes a person from a normal caring to a less caring to a non-caring frame of psychological reference. For example, the drunken person feels "care-free" because sober cautions, considerations, and restraints have been entirely broken. Thus one parental guideline for using is simply this: don't use to the point that you are at risk of violating standards of behavior that you normally care about."

Statements of regret are reliable indicators of problematic substance use. For example:
"I wish I hadn't done (or said) what I did."
"I wish I hadn't accepted that dare."
"I wish I had been paying more attention."
"I wish I hadn't started that fight."
"I wish I hadn't broken the law."
"I wish I hadn't had sex."
"I wish I hadn't stopped studying."
"I wish I hadn't given up what I cared about."
"I wish I hadn't gone along with I didn't agree with."
The clarifying question to ask when a young person has done something they regret when under the influence, is "would you have made the same choice if you had not been using substances at the time?" If substance use is linked to making decisions one regrets, there may be a problem to address.

Freedom is the adolescent drug of choice - freedom from and freedom for. Adolescents want freedom from childhood restraints and for adult behaviors. Substance use is one way to achieve a state of freedom where "nothing is forbidden and everything is permitted." Drugs are not just physically intoxicating; they are psychologically intoxicating. They create an in-the-moment sense of limitless possibility for young people when throwing off and expanding limits is what the adolescent most wants to do.

Depending on the dose, one can liberate ones self a little or a lot. Understanding this, parents can explain about two ways to get freedom. One way is through gathering responsibility, using effort and accountability to earn freedom of independent choice. Another way is through experiencing intoxication, depending on chemicals as a way to experience momentary freedom. Say to your adolescent, "lasting freedom is more valuable and less destructive than the momentary kind."

For sure, discuss with your teenager the difference between friends who use and using-friends. Friends who use do so for their own enjoyment. Using-friends exploit friendship to socially and financially support their use. Don't use with using-friends. And if you find yourself explaining your own use to parents by saying everyone you know uses, then consider expanding your circle of friends so you can learn to socialize with people who can have fun without choosing to use.

Finally, do warn your teenage son or daughter about the 4 D's - the four Don'ts for alcohol or other drug use. DON'T drink or drug when you Drive because that raises the risk of accidents. DON'T drink or drug when you Date because that raises the risk of sexual involvement. DON'T drink or drug when you Debate because that raises the risk that disagreement (argument) can turn violent. And DON'T drink or drug when you Dare because that raises the risk of accidental harm.

For more about parenting adolescents, see my book, "SURVIVING YOUR CHILD'S ADOLESCENCE" (Wiley, 2013.) Information at:
Next week's entry:

FLUNKING OUT OF COLLEGE: The lack of readiness responsibility.