Is Your Kid an Addict?
Addiction to drugs and booze are leading teenagers to the ER at a skyrocketing rate. How can you help them before they get there—and how much blame lies with the parents?
I know a 23-year-old NYU graduate—I'll call her Sophia—who had an arrangement with her dad when she was in high school: he would buy her booze if she would buy him pot. Since many folks don’t think either pot or alcohol are “hard” drugs, some adults—including Sophia's dad—don’t have a problem with such boundary-crossing bartering. For my friend, however, it created a number of conflicts: for one thing, it meant Sophia was dealing in illegal drugs, and exposing herself to prosecution for felony crimes. For another, it meant she got a clear message from her father that teenage drinking isn’t harmful.
So began Sophia’s drinking career as a young teenager. In high school she drank hard and hung out with likeminded kids. Her grades dropped, and her parents switched her school and put her in therapy—perhaps her father couldn’t imagine what might be leading his daughter to “act out.”
In college she continued to drink, picked up weed, popped Xanax and got wasted regularly. Finally she realized that if she were going to have any chance at a normal life, she’d have to get sober. So she did, at age 21, in the Manhattan 12-step community. To this day, her dad doesn’t get how much weight his lax attitude about drugs and alcohol carried.
This scenario is more common than you might think. “Sometimes we’ll see a situation where one parent smokes pot,” says Nicole Kurash, LSW, director of inpatient adolescent programs at Gateway Rehabilitation in Pittsburgh. “It hasn’t been a problem—they can hold a job, they’re successful, so they don’t think their kid smoking pot is a problem either. A lot of times what we see is, ‘If I let my kid drink at the house, it’s OK. At least it’s in my home.’”
“The substance becomes a remedy for normal emotional struggles,” one expert says. “How do you ask a girl to to dance? Is anybody going to like me? I feel my body going in a thousand different directions—all these things are managed by the substance. What you’ve learned is, ‘I don’t have to feel that.’"
Sophia’s situation might sound beyond the ordinary—her dad buying her booze if she buys him pot. But it’s how ordinary it came to seem to Sophia that’s so significant an illustrator of the teenage epidemic of drinking. “I was like, ‘Who am I trying to hide this from if it’s my dad who’s buying it for me?’” Sophia recalls. “My therapist told me I was totally crying out for rules.”
The federal Centers for Disease Control and Prevention (CDC) classify underage drinking as a public health crisis. Alcohol is the most commonly abused drug among America’s youth, more than nicotine and illegal drugs, and people aged 12 to 20 drink 11% of all the booze consumed in the US. Most of this alcohol—more than 90%, in fact—is consumed in binges. In 2008, underage drinkers made 190,000 emergency department visits for alcohol-related reasons.
“We see kids coming in on alcohol and marijuana, and also prescription opioids—first it’s Percocets and Vicodins, then Oxys, then heroin,” says Patricia Schram, MD, an instructor in pediatrics at Harvard Medical School and faculty at the Children’s Hospital Boston Center for Adolescent Substance Abuse Research.
“People are dying from this,” says Kurash. “It’s not this horrible homeless person living under a bridge using IV heroin—that’s not the total reality of who loses their lives. It is also the wealthy suburban kids who are mixing their prescription drugs. It’s the beautiful 19-year-old girl who goes off to college to be a teacher and gets pressured into drinking too much and overdoses and dies.”
Gateway’s adolescent program serves kids between 13 and 21, and most of the kids they see come from “privileged suburban neighborhoods,” not the inner city, says Kurash. “They have access and money, and sometimes they’re held less accountable. We always have kids who use alcohol and marijuana, and we’re seeing plenty of kids who are using prescription pills—opiates and benzos like Ativan and Xanax.”
“I’m seeing kids who get addicted on their first time” trying prescription drugs like oxycodone, Schram says. “Their prefrontal lobes are not fully developed, they don’t have brakes on their impulses. That’s why they engage in high-risk behaviors—not only drugs, but other high-risk behaviors.”
What happens in the brains of kids at risk for alcoholism and addiction? “We see that even prior to use themselves, they have some abnormalities in the cognitive control circuitry in the brain,” says Bonnie J. Nagel, PhD, who runs the developmental brain imaging lab at Oregon Health Sciences University in Portland. Nagel’s five-year, $1.6 million ongoing study underwritten by the National Institute on Alcohol Abuse and Alcoholism is looking at the effects of substances on adolescent brains. She enrolls kids ages 12 to 15 before they’ve started to drink or use and follows them throughout time.
“We know that family history of alcoholism increases one’s likelihood of going on to develop alcoholism,” Nagel says, “but we don’t understand the neurobiology of that. When we bring in kids and throw them in the scanner and say they have a predisposition to alcoholism, we don’t know how much is genetic and how much is environment.” But her initial findings suggest, she says, that “there are abnormalities in the circuitry of the brain during decision-making that would suggest atypical kind of control.” Which means that when kids are placed in a heated situation, unlike adults—whose wiring has had a chance to develop by years of experience making good decisions—kids’ fragile circuitry might break down.