Parents In Action

UNIQUE 21^st CENTURY PARENTING CHALLENGES

So why is it that parenting teenagers today seems to be so much more of a stress-inducing proposition than, say, 20 years ago?  What are the important issues that parents should be aware of when dealing with teenagers in the house?  What, if anything, can they do to either prevent problems from occurring or get help if they suspect their child has a problem? 

In order to address these challenging questions it is important to point out the fact that being a teenager today is a much different experience than it was as recently as 10 or 20 years ago. The already daunting task of parenting a teenager is now rife with new challenges that we are only now even becoming aware of.   With that in mind, the following will provide guidance for parents who are navigating this difficult task of raising a teen in New York City.

There is a combination of several factors that contribute to the challenges of parenting a teenager today:

First, advances in technology (which are almost always taken advantage of first by young people), have far out-paced society’s ability to keep up with the social risks that are created.  Thus, in today’s era of Facebook, Twitter and MySpace, teenagers have an entirely uncharted social venue where adolescent expression and experimentation takes place.  While certain aspects of technology seem to have a legitimate upside (many parents feel better knowing they can be in “real-time” contact with their child), the truth is that a lot of teen-age rebellious behavior manifests online, in chat-rooms, through email and on social networking sites.  The online generation gap in knowledge is so wide between parents and adolescents, that kids in general have an easy time evading parental limits on such behavior.  Today’s technology allows adolescents worldwide to communicate with each other, thereby allowing them to be targeted by entertainment media, the press, advertising, even sexual predators in unprecedented ways.  Thus, they are exposed at a much earlier age to potentially negative influences.  No teenager is immune from bullying, and much of this is occurring online where adults and teachers cannot see.  This was brought up on the panel and it was noted by the teens themselves that, online, everyone can see what everyone else was doing and what parties they were at.  An example of this would be a teen that looks at pictures from a party online and is upset that they were not invited.  That teen may look towards drugs and alcohol to score the invitation to the next party. In addition, thanks to the Internet, teens can now search to see which medications do what and the effects are of each. Thus, the combination of bullying, information about and access to substances bought online, societal and media influences and personal exposure can lead to a teenager’s vulnerability to drug use and abuse.

Second, drug use behavior among today’s adolescents has a different flavor than what was going on as recently as a decade ago.  It is true that trends in teen-age drug use have historically demonstrated shifts and cycles.  Since the 1960’s, the most consistent drugs of experimentation were marijuana, alcohol, and cigarettes.  Of course, even then, many teenagers experimented with other so-called “hard-drugs” like cocaine and heroin. Historically, kids who went on to develop real problems with those drugs were the exception, not the rule.  Today, the landscape of teenage substance use looks dramatically different, and many parents are not aware of this.  While marijuana and alcohol are still by far the most popular “gateway drugs”, today’s teenagers commonly experiment with, and often go on to abuse and even develop significant problems with, many other agents.  In fact, studies show that drugs like painkillers and stimulants, once thought of as only problems for kids with severe substance use disorders, are finding their way into the repertoire of common teenage drug experimentation behavior more than ever before.  Nowadays, it is not uncommon for adolescents to report that the first drug they ever tried was a prescription drug like Oxycontin, a powerful opiate analgesic that is fatal in overdose, or Adderall, a powerful stimulant used to treat patients with attention deficit disorder which, when crushed and snorted, closely mimics the effects of cocaine and crystal meth.   But the problem is more than just a demographic shift in substance use behavior.  The ominous thing about today’s teen-age mentality is that kids don’t seem to understand how dangerous this “new” drug-using behavior can be.  One of the real problems we are seeing is kids who think that abusing prescription drug abuse is much safer because they are legitimately prescribed by doctors to treat real disorders.   We live in a culture that is heavily medicated and, as such, children and adults are being prescribed pills for mental health and physical health reasons.  Rates of attention deficit disorder among teen-agers is upwards of 8-12%, so practically every adolescent knows someone who is being medicated with a potentially addictive medication like Adderall or Ritalin.  Most opiate analgesics, commonly prescribed for chronic back pain, are procured from a parent’s medicine cabinet.  Household medicine cabinets are filled to the brim with medications that can be used to get high. Today, parties occur in which teens partake in “pharming”- the trading of prescription and even some over-the-counter medications.  These “newer” gateway drugs are dangerous, especially in overdose, and seem to make some teen-agers more vulnerable to developing severe addictions because of their extremely high abuse potential.

Finally, it is important to point out that we are starting to see a change in some of the classic behavior among teen-agers who develop problems with substance abuse.  Drug users are often stereotyped as wearing clothing that suggests deviant behavior and who walk around un-kept with dazed expressions and glassy or red eyes.  While true for many teen-age drug abusers, this is not always the case.  Today, many teenagers do not present with the usual symptoms of drug abuse such as failing grades, withdrawal from school activities and social withdrawal.  Sometimes, the situation is quite the opposite:  kids abusing stimulants like Adderall, Ritalin and even cocaine do so to compete academically – the result of today’s increased societal pressure to perform at the highest level in order to get into a good college.   Prescription drugs like Adderall and Ritalin, which allow kids to pull all nighters to study, gives them increased energy for sports, and makes them feel like they can focus better on exams.  Problems associated with stimulant abuse include increased blood pressure which can lead to heart attack or stroke, severe mood swings that can rise to the level of mania and psychosis, and addiction to other powerful stimulant drugs like cocaine or even crack.  A complicating issue is that some kids may look like they are doing great (studying a lot, participating in extra-curricular activities, looking energetic and happy), when the reality is that they are in the midst of a severe drug addiction. 

TIPS AND SOLUTIONS FOR CONCERNED PARENTS

One of the most important aspects of parenting a teenager seems to be establishing an effective system of communication.  Ask any teenager what it would take for them to be less angry at their family and they will tell you that they want to be listened to and heard.  Far from a one-size-fits-all proposition, what works for one family may not be as effective for another.  Therefore, it is important to figure out what works best for your family.  If it feels like a daunting task, a good family therapist can be very helpful.  It is also important to realize that the adolescent brain is changing very rapidly, so the experience of communicating with your daughter will likely look a lot different when she is 14 than when she is 16.  Parents need to be able to have some idea of where their kids are developmentally in order to figure out how best to communicate with them.   Some ideas on how to interact with your teenager are below:

1. Trust your instincts – if you think your child may have a problem with substances chances are they do.
2. Timing – pick a convenient and safe time to talk.
3. LISTEN when your child talks. Be open-minded and validate his or her feelings.
4. Be non judgmental  
5. Talk about how you feel i.e. “you use of drugs makes me worried and scared.”
6. Set clear boundaries and expectations and consequences for expectations that are not followed. i.e. Drug use is NOT permitted in this family. If you use drugs, X will be the consequence.
7. Stay away from blame and punishment. Punishing a child for using drugs and/or alcohol is not as effective as getting them help.
8. BE A GOOD ROLE MODEL.

When it comes to figuring out what parents can do to feel that they are protecting their kids from developing problems with drugs, there are a few things to consider:

First, parents should become as technologically savvy as they can in order to best understand how their kids are spending time online, and whom they are associating with.  That way, they are in a better position to set appropriate limits on what their teenagers are doing.  

Second, though not 100% effective, research has shown that things like getting good grades, participating in after-school activities, having family dinners and living in a home where the idea of ‘rules’ are important can be protective against teenage substance use problems later on.

Third, as a parent you know your child well, and if you think there is a problem, there probably is.  The best course of action is to seek professional help early on, before serious issues emerge.  It is a myth that a child must hit rock bottom before he or she can get better.  The fact is that the earlier problems with drugs and alcohol are addressed the better.  The longer use continues, the stronger the addiction becomes and it is harder to treat.  Studies show that the longer a person delays experimenting with an addictive substance, the less likely it is that they will go on to develop and addictive disorder.  Another myth is that you cannot force or coerce a person into treatment.  The fact is that kids who are made to enter treatment for a substance use problem are as likely to benefit from those who enter voluntarily.

SIGNS AND SYMPTOMS OF SUBSTANCE ABUSE FOR PARENTS TO LOOK FOR

While some kids may not show obvious signs of drug use as discussed earlier, the fact remains that for most kids abusing drugs there are tell-tale signs:

1. Decrease in grades, skipping classes, trouble at school.
2. Sleep disturbances – either sleeping more or less than usual.
3. Appetite changes – weight loss/weight gain. Eating more or less than usual.
4. Bloodshot eyes – pupils larger or smaller than usual – excessive use of eye drops
5. Grooming and physical appearance deteriorate OR new interest in clothing, music, or items that highlight drug use.
6. Heightened secrecy about friends, possessions, activities
7. Increased demand for privacy – locking doors, avoiding eye contact, sneaking around.
8. Missing money or valuables or unexplained need for increased amounts of money.
9. Odors on body, breath, clothing
10. Legal issues
11. Relationships problems with family and/or friends. Change in friendships.
12. Abandonment of activities one used to enjoy (ie: sports).
13. Mood issues: irritable, angry, agitated, giddy, lack motivation, lethargic, periods of hyperactivity, isolation, withdrawn, depressed
14. Increased use of incense, perfume, air fresheners.

In today’s high-pressured environment, drugs and alcohol act as equalizers for teenagers who are searching for a sense of integration and validation in a world where they feel less accepted.  As a result, not only is drug use on the rise, but there are clear and concerning shifts in teenage drug-use behavior.  One of the healthiest approaches that parents can take is to set positive examples for their kids by becoming educated on the topic of teenage substance abuse, and discussing the matter together in an open, honest manner. While there are some things that parents cannot control, what they can control is the way in which they communicate with their children, in order to create a safe space that invites honesty and welcomes open dialogue.

It is crucial to be mindful of the fact that the disease of addiction has many faces; it does not discriminate against gender, sexuality, age, nationality or demographic. Everyone is at risk, and for those with a history of mental illness or a family history of addiction, the risk is even higher.  Unfortunately, there remains a stigma that surrounds the illness of addiction, but with continued efforts at creating public awareness and parental involvement, the stigma is lessening.  The “medical model” of treating addiction considers it to be like most other physical diseases;  seeking help should never be something to be ashamed of.  If your child were suffering from physical symptoms of a disease such as diabetes or cancer, medical intervention would happen swiftly and without second thought.  You would take your child to get more than one opinion, and your actions would be considered to be proactive and responsible.  Consider substance abuse in much the same way. If you think you are seeing the signs of drug use or abuse, it is best to seek an expert opinion.  Substance abuse and addiction are serious health issues which can be challenging to diagnose. Seeking help for your child is proactive, responsible, and in most cases the best thing that any parent can do.  Early intervention is key, and substance abuse issues that are caught earlier have a higher percentage of a successful recovery.

When it comes to prevention, the most effective parenting strategy is to be a positive role model for your kids.  Since using drugs or alcohol in front of your children sends a clear message that the behavior is acceptable and safe, don’t do it.  Be mindful of the medicine cabinets in your household and keep them locked!  Similarly, do not keep bottles of alcohol around the house or in the freezer where probing teenagers are sure to find them. Part of being a role model is staying educated on the topic of teenage addiction and other behaviors.  Remember: much like technology, teenage drug-use behavior is continually evolving so staying current with the most up-to-date information can be a challenge. 

Parents who attended the PIA Teen Scene Program, and those who are reading this article right now should be commended and applauded for their willingness to understand and become educated on such a difficult topic!  The teenagers who participated in the PIA Teen Scene Program should be congratulated for their enthusiasm, and their ability to engage in an honest and open dialogue with the parents who are concerned about them.  Judging from the audience, New York City has a multitude of parents who are both dedicated to, and concerned about their kids.  The PIA Teen Scene Program is an excellent tool which helps channel that concern into practical support for parents of teenage children.