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Substance Abuse in Children and Adolescents: Information for Parents and Educators

By Stephen N. Campbell, PhD
Nova Southeastern University

Substance abuse among American youth is a widespread problem. Despite indicators that use of illicit drugs and alcohol has declined over the past decade, a U.S. Department of Health and Human Services survey in 2002 (Johnston, O’Malley, & Bachman, 2003) of 43, 700 adolescents in nearly 400 schools nationwide indicated that more than half (53%) have tried an illegal drug. If we count inhalants in the definition of illegal drugs, nearly one third of students have experimented with drugs by the time they reach eighth grade. And it isn’t just marijuana—30% of the students surveyed reported using a drug other than marijuana by twelfth grade.

The survey also showed that teenagers continue to experiment with alcohol and cigarettes. Again, although there is evidence that, over time, alcohol use among youth is declining, a recent national survey indicated nearly 11% of youth age 12–17 were binge drinkers (U.S. Department of Health and Human Services, 2002).

Parents and teachers need to recognize that substance abuse is a serious threat to the physical well-being of children and adolescents (such as danger to the brain and other vital organs) and their psychological functioning (such as impaired memory, judgment, ability to learn, and decline in academic performance). Children who use drugs and alcohol are also more prone to accidents, risky sexual behavior, violence, and thoughts of suicide. According to the U.S. Department of Health and Human Services (2003), 15% of 18 year-olds surveyed in 2002 reported driving under the influence of alcohol. In addition, another recent study found that high school students using marijuana on a frequent basis had much higher rates of delinquent and criminal behavior, including serious aggression, sale of illegal drugs, and carrying a handgun (U.S. Department of Health and Human Services, 2004).

Causes of Substance Abuse

Attitudes. Children and adolescents use drugs and alcohol for many reasons. Not only are the consequences of substance abuse a problem, but so are the attitudes teens have adopted toward substance use. For example, data from a Substance Abuse and Mental Health Services Administration report (2000) indicated that, as the number of young people who use marijuana has increased, the number who view marijuana as harmful has decreased. Most teens do not see any major risk trying marijuana once or twice. Researchers have suggested that changes in risk perception and knowledge may be due to a decrease in anti-drug messages in the media, an increase in pro-drug messages through the popular culture, and a lack of awareness among parents about the prevalence of drug and alcohol use.

Social, emotional, and family influences. Parents must understand why children and adolescents use drugs and alcohol. The desire to be accepted into a social group, peer pressure, and curiosity are common reasons. Children also use drugs to deal with depression, boredom, anger, and anxiety. However, research suggests that drug use by family members plays a strong role in whether children in the family start using drugs.

It is important to keep in mind that parents are the first and most powerful influences in a child’s life. As a parent, your child looks to you for help and guidance in making important decisions, including the decision not to use drugs. As a role model, your decision not to use illegal drugs will reinforce your message to your child.

Prevention Strategies for Parents

Preventing a child from using drugs and alcohol makes more sense than having to help the child to stop once he or she has started. It is more difficult to stop using drugs or alcohol when there is a psychological or physical dependence.

One of the biggest deterrent to substance abuse is the fear of disappointing a parent. Therefore, prevention starts at home. There are a number of actions parents can take to create an environment where substance abuse is discouraged.

Trust and Mutual Respect

Develop a sense of respect and trust between you and your child. Spend time in activities together:

Do fun things such as going to movies.
Encourage participation in family decisions.
Build trust and establish open lines of communication early. What you say and what you do must be consistent.
Stay involved in your child’s friendships and schoolwork.

Communication

Effective communication involves talking to and listening to your child:

Communicate that you care: Children do not care about what a parent says to them unless they know that the parent cares about them. Actions are just as important as words. Your child can spot hypocrisy miles away.
Do not preach: Discuss concerns without delivering a lecture.
Have facts handy: Know what you are talking about and use brief examples to make your points.
Be a good listener: Listen to what your child has to say. Avoid interruptions. Ask questions for clarity, state what you think is meant, and verify that you understand correctly. This shows that you did listen, and what your child says is important to you.
Do not judge: Try to understand what your child is saying without judging his or her motives, opinions, or conclusions. Use appropriate body language.
Encourage your child to recognize and express his or her feelings: While you are talking to your child, it is important to let your child know you care not only about what he or she thinks but also about what he or she feels.

Talking to Your Child About Drugs and Alcohol

Be informed and give your child the facts about drugs and alcohol, and your expectations, unemotionally and straightforward:

Scare tactics and exaggerated stories do not work: Children see and hear a great deal about drugs and alcohol at school. They see other children in the halls and on the playground who use drugs and alcohol. Children can see first-hand what is true and what is not.
Clarify your standards and expectations: Make sure you let your child know where you stand and what your expectations are regarding the use of drugs and alcohol.
Share appropriate information: Make sure the information about drugs and alcohol is developmentally appropriate to your child (your choice of words and the type of information should be at your child’s grade/ability level).
Teach your child about choices and consequences: For every choice there is a consequence. Stress the importance of evaluating the consequence before making the choice. Consider what may happen first and then decide if it is worth the cost.

Interventions for Home and School

Strategies for Parents

Know the signs of substance abuse. You need to be aware of dramatic changes in your child’s behavior (sometimes it is gradual; some children may use drugs and alcohol for a time and go undetected). Children may experiment with drugs and alcohol to fit in with their peers, but discontinue using after the experience. Some children continue to use drugs and alcohol and develop a psychological and/or a physical dependency. Look for the following warning signs:

Depression, fatigue, withdrawal
Poor grooming
Hostility and deteriorating relationships with family and friends
Changes in academic performance
Increased absenteeism or truancy
Lost interest in sports or other favorite activities
Changes in eating or sleeping habits

Although these signs may be indicative of other problems, they are usually present among substance abusers. Within the home, be aware of the following signs:

Drugs and drug paraphernalia such as pipes and rolling papers
Odor on clothes and in the bedroom and/or the use of incense and other deodorizers
Use of eye drops

Talk with your child, family, friends, and school personnel. If you believe your child is using drugs and alcohol, talk with the child. A child who is confronted may deny any substance abuse, may confess and ask for help, or may confess an experimentation that has occurred but is now over. Talk with siblings and your child’s close friends who you know do not use drugs or alcohol and see if they have concerns for your child. You can contact your school psychologist, social worker, counselor, or chemical-dependency specialist.

Most school districts have professionals who can conduct a screening and help identify the need for referral for evaluation and treatment. Many treatment centers and some counselors in private practice will complete the initial assessment without charge and offer advice or referrals as necessary.

Strategies for Teachers

Model and teach healthy behaviors. Next to their parents, teachers typically are the most powerful role models for children and youth. You can provide a good model for students to follow as well as provide drug education:

Talk to students about drugs and let them know how you feel about substance abuse.
Help students develop skills and attitudes that will keep them away from drugs and alcohol.
Incorporate drug education and prevention strategies in class presentations. For example, the biology instructor can discuss the impact using drugs has on the development of the prefrontal cortex, which is the part of the brain responsible for planning and reasoning and which is not fully developed until age 20.

Intervene directly. Teachers may be the first to suspect a student is using drugs and alcohol. Obtain appropriate training on ways to identify students with substance abuse problems. Intervene if you believe a student is using drugs or alcohol and discuss substance abuse by students with school personnel (such as school nurse, school psychologist, principal). Warning signs of substance abuse that you might observe in your students include:

Slurred or unintelligible speech
Excessive sleeping in class
Bloodshot eyes
Many absences or truancy
Significant drop in academic performance

Other Sources of Help

Additional information can be found in local libraries and from health departments, mental health agencies, and youth groups. The school psychologist, guidance counselor, and school nurse are excellent resources at school. Most treatment facilities in your area can offer information and referrals. Videos, the Internet, books, and local support groups such as Narcotics Anonymous and Alcoholics Anonymous for teens are also good resources.

Summary

Parents and teachers are the most influential people in the lives of children. Consequently, it is crucial that parents and teachers respond proactively rather than reactively in preventing substance abuse in children by understanding the warning signs and acting appropriately and decisively.

Resources

Botvin, G. J. , & Griffin, K. W. (2000). Preventing substance use and abuse. In K. Minke & G. Bear (Eds.), Preventing school problems—Promoting school success: Strategies and programs that work (pp. 259–298). Bethesda, MD: National Association of School Psychologists. ISBN: 0-932955-89-4.

Gerne, P. J., & Gerne, T. A. (1991). Substance abuse prevention activities for secondary students: Readyto- use lessons, fact sheets, and resources for grades 7–12. Englewood Cliffs, NJ: Prentice Hall. ASIN: 0138767076.

Johnston, L., O’Malley, P., & Bachman, J. (2003). Monitoring the future: National results on adolescent drug use. Washington, DC: U.S. Department of Health and Human Services. Overview available: www.nida.nih.gov/PDF/overview2002.pdf

Levant, G. (1998). Keeping kids drug free: D.A.R.E. official parent’s guide. Berkeley, CA: Thunder Bay Press. ASIN: 1571456252.

Pagliaro, A. M., & Pagliaro, L. A. (1996). Substance use among children and adolescents: Its nature, extent, and effects from conception to adulthood. New York: Wiley. ISBN: 0471580422.

Severson, H., & James, L. (2002). Prevention and early interventions for addictive behaviors: Health promotion in the schools. In M. Shinn, H. Walker, & G. Stoner (Eds.), Interventions for academic and behavior problems II: Preventive and remedial approaches (pp. 681–702). Bethesda, MD: National Association of School Psychologists. ISBN: 0- 932955-87-8.

South Carolina Department of Alcohol and Other Drug Abuse Services. (2001). The power of parents in a kid’s world: A parent’s guide to keeping children free from alcohol, tobacco and other drugs. Columbia, SC: Author. Available: www.daodas.org/web/infosite/readroom/scprevents. html

Substance Abuse and Mental Health Services Administration. (2000). Summary of findings from the 1999 National Household Survey on Drug Abuse (DHHS Publication No. SMA 00-3466). Rockville, MD: Author. Available: www.DrugAbuseStatistics.samhsa.gov

U.S. Department of Health and Human Services. (2002). National Survey on Drug Use and Health. Washington, DC: Author. Available: www.samhsa.gov/oas/nhsda/2k2nsduh/Results/ 2k2results.htm

U.S. Department of Health and Human Services. (2003). National Survey on Drug Use and Health: Quantity and frequency of alcohol use. Washington, DC: Author. Available: www.samhsa.gov/oas/2k3/AlcQF/AlcQF.htm

U.S. Department of Health and Human Services. (2003). National Survey on Drug Use and Health: Marijuana use and delinquent behaviors among youths. Washington, DC: Author. Available: www.samhsa.gov/oas/2k4/MJdelinquency/ MJdelinquency.htm

Websites

National Institute on Drug Abuse (NIDA)— www.nida.nih.gov/NIDAHome.html

The National Youth Anti-Drug Media Campaign— www.theantidrug.com/teachersguide/index.html

Substance Abuse and Mental Health Services Administration (SAMHSA)— www.findtreatment.samhsa.gov

Stephen N. Campbell, PhD, is an Associate Professor in the Center for Psychological Studies at Nova Southeastern University, Ft. Lauderdale, FL.