Prevention Education: The Role of Parents

Introduction

The abuse of alcohol, tobacco, and illicit drugs are the leading cause of preventable, premature death and disability in the United States. Youth are among the most vulnerable in our population, vulnerable because they are at much higher risk for developing a substance use disorder later in life and because other adverse consequences are likely to affect them more significantly.  Research has shown that substance use by adolescents can often be prevented through interventions that respond to risk and protective factors that function at different stages of development. Individual, family, peer, school, community, and societal levels all matter. Can parents influence their children’s choices enough to make a difference? Parents play a major role in preventing substance abuse among youth and in helping them if they’ve initiated use. Talking with a child about the dangers of substance use and showing disapproval of such behavior are key to shaping children’s attitudes and behaviors. Staying involved in a child’s day-to-day activities is also critical. There are at least six steps that parents should take to help their children resist the pressure to use drugs, or to assist them if they have started to use drugs or progressed further along the path to addiction. In our modern era, when use of marijuana is increasing, when the risks to the adolescent brain are becoming increasingly apparent, every parent should become familiar with these six steps:

  1. Learn the major risk factors for drug use among children.
  2. Learn about drug use consequences and make clear statements that you disapprove of drug use.
  3. Be involved in your child’s life.
  4. Know your child’s friends.
  5. Minimize a child’s stress at home.
  6. Learn the signs of a child’s drug use and how to respond.

1. What Are Some Risk Factors for Youth Substance Use?

Many factors are associated with conferring a risk for drug use among children, including biological (genetic, psychiatric disorders), environmental (e.g., high or low socioeconomic status), or psychological (e.g., low self-esteem, aggressive behavior, poor self control). It is important for parents to learn the risks of using specific drugs and helping their children understand why use is unhealthy and risky. Among the major factors that can influence whether youth will use tobacco, alcohol, or illicit drugs is the extent to which they believe these substances might cause them harm. In a national survey on drug use and health (NSDUH, 2013), when young people (ages 12–17) were asked whether they thought they risked harming themselves if they used various substances, (“great risk,” “moderate risk,” “slight risk,” “no risk”), 65.7% perceived great risk in smoking one or more packs of tobacco cigarettes per day, 63.9% perceived great risk in having four or five alcoholic drinks nearly every day, and 39.7% perceived great risk in having five or more drinks once or twice a week. For marijuana, 43.6% perceived great risk in smoking marijuana once or twice a week, and 26.5% perceived great risk in smoking marijuana once a month. For other drugs, perceived risks were much higher (heroin, 80%; cocaine, 78.9%; LSD, 70.6%). Most importantly, use of these substances is much lower among youth who perceive them as conferring great risk than among those who don’t think they pose a great risk. Clearly parents can help by increasing their child’s awareness of potential harm of using substances.

Among other risk factors for using drugs that parents should be aware of are a diagnosis of attention deficit hyperactivity disorder (ADHD), personality disorders (e.g., oppositional defiant disorder), having first degree relatives (e.g., parents) with an alcohol or drug use disorder or using alcohol or drugs at home, poor grades at school, drug-using friends, and availability (e.g., being approached by someone selling drugs).

Countering these risk factors are protective factors, among which are religious involvement and beliefs, engagement in extracurricular activities, exposure to substance use prevention messages and programs, perceived parental disapproval of youth substance, and parental involvement.

2. How Can Drugs Affect Teenagers and What Clear Statements Can Parents Make?

Initiation of substance use in early adolescence is predictive of many negative outcomes in adulthood, compromising work, family roles, educational achievement, and ongoing drug involvement. It is critical to learn about drug facts (see, e.g., NIDA website https://teens.drugabuse.gov/parents) before engaging in crucial conversations with children. Most youths, about 90%, believe their parents would strongly disapprove of their using substances, including tobacco cigarettes, alcohol, or marijuana. Most importantly, youths aged 12 to 17 who believed their parents would strongly disapprove of their using specific substances were less likely to use these substances than those who believed their parents would somewhat disapprove or neither approve nor disapprove. Among youths who perceived their parents would disapprove of smoking one or more packs of tobacco cigarettes a day, 4.6% smoked in the past month. In sharp contrast, of youths who believed their parents were not strongly opposed, 31.9% smoked—a rate 7 times higher! The same differences were found for marijuana use. Among youth who perceived a strong level of disapproval of marijuana use, 4.3% used, but among those who thought their parents were not strongly opposed, 31% used!

3. How Can Parents Be Involved in a Child’s Life and Make a Difference?

Supportive parenting and monitoring of children’s behavior (parental involvement) is another critical factor associated with lower rates of drug use among youth. Most parents limit the amount of time that youth spend out with friends on school nights, always or sometimes check on homework, help with their homework, make children do chores around the house, tell children they had done a good job or were proud of them, and limit the time on television and on computers or cell phones for social media purposes. If parents frequently helped with homework, the illicit drug use by youth was 7.6%, but was 18.1% among youth who reported that their parents “seldom” or “never” helped. Current cigarette smoking and binge alcohol use in the past month also were lower among youths whose parents “always” or “sometimes” helped with homework (more than half the rates). Youth who spend a lot of time on social media websites are far more likely to use drugs.

4. Who Are Your Child’s Friends?

Friends and peer groups are important and consistently strong predictors of drug use. Adolescents whose friends use drugs are more likely to use themselves, and friends often provide the drugs. Friends also are role models for drug using behaviors, they help to shape beliefs and positive attributes to drugs and normalize drug use. Friends’ use of drugs predicts frequency of use and problematic outcomes. Early intervention with risk factors often has a greater impact than later intervention to change a child’s life path away from problems and influential peers, and toward positive behaviors. Parental monitoring and supervision of friendships are critical for drug abuse prevention: rule-setting for activities, monitoring friends and social engagements, limiting social networking, praise for appropriate behavior, and moderate, consistent discipline that enforces defined family rules all reduce children’s risks and protect against pathology and substance abuse.

5. How Can Parents Minimize a Child’s Stress at Home?

Many factors at home can influence a child’s attitudes and propensity to use drugs. Among the risk factors in the home environment are psychological, physical, or sexual abuse, living with parents who abuse alcohol and other drugs, witnessing fights at home, parental neglect, parental depression or psychopathology, providing mixed messages about drugs, especially if parents use, and permission for unlimited access to social networking. Each of these factors can be modified and improvements in the home environment can assist children avoid drug use.

6. What Are Signs of a Child’s Drug Use and How To Respond?

There are many signs that can alert parents to a child’s drug use. If a parent observes a child neglecting school work, their grades are declining, they are losing interest in extracurricular activities, they have changed friends, social groups, clothing, behavior, the child is at risk and it becomes important to find out the reasons. Sleep patterns can also change and are manifest by irregular, unusually short, or prolonged sleep. Worrisome health issues emerge and personal hygiene declines in some youthful drug users. Relationships with family members deteriorate, and a change in personality emerges. For example, a child can become less open, more secretive, lock his or her bedroom doors, and become less honest about his or her whereabouts or use of money. Or may even steal money. In the case of marijuana, telltale signs include red, bloodshot eyes; euphoria; unwarranted laughter; an increase in appetite, especially for sweets; difficulty paying attention or solving problems; memory loss; increased socializing; reduced inhibitions and poor judgment; dizziness; drowsiness; sedation; slow movement; and/or loss of ambition and motivation. Heavy consumption or high potency marijuana can result in hallucinations, paranoia, panic attacks, or delusions. If a person becomes addicted to marijuana or any drug, there will be persistent personality and behavior changes that can’t be related to other influences in life. Life goals and favorite activities may be dropped. The drug user may become withdrawn and secretive and may appear depressed.

At any stage along the spectrum of drug use, it is important to intervene and seek professional help. The earlier help is sought, before a substance use disorder emerges, the higher the probability your child can reverse course and fulfill a life of promise and potential. Speak to a primary care physician and seek his advice on the best possible care for your child. Early intervention may prevent a lifetime of unhappiness, derailed goals, unfulfilled dreams and compromised health.