By John Messmer
Penn State Family and Community Medicine
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine
As children return to school this fall, they will face many challenges from math to research papers to exams. Additionally, they will be learning to manage life and its complex choices. One of these will be whether to partake in alcohol or drugs. Because alcohol is a legal product, it is readily available. Many parents think that drinking is a rite of passage for all adolescents. It is not taken as seriously as other "hard drugs" like heroin, meth or cocaine. The reality is a drug is a drug. Any substance capable of producing a high or euphoria can be addicting.
When a person without an addiction potential uses drugs, he or she may get high, but after the drug has worn off, they might use it again in some circumstances or not. They might have enjoyed the experience, but doing it again is only mildly important to them. The addictive personality by contrast, after the first high, seeks to repeat the high again and again. But because of different brain chemistry, the potential addict can never repeat the high. They are compelled to work harder at it, increasing their use or combining drugs in an effort to get the original high which never happens again. This is the driving force behind addiction.
Some addicted people will use the drug repeatedly until their bodies adapt to it. When deprived of the drug, they have withdrawal symptoms. In the case of drugs which produce withdrawal, the symptoms reinforce the desire for the drug in order to relieve the symptoms.
Addiction is not predictable. It has a genetic basis, that is, people inherit the potential for addiction. The genes could be anywhere in a family tree, and since families are often reluctant to discuss it, people may be completely unaware of any addiction problems in their relatives.
Mood-altering drugs are more or less interchangeable. Anyone with the potential for addiction could have a problem with any mood-altering substance. More importantly, people can not predict whether or not they will have an addiction problem until exposed to the substance. A person has to get high first to turn on the addiction. After that, seeking the substance becomes the most important activity for that person.
The unpredictable nature of addiction is the reason behind the "just say 'no'" campaigns. Children's brains are more susceptible to mood-altering drugs. An adult with an addiction potential getting high for the first time could take a long time until the addiction is out of control. There is more time to seek help. A child develops addiction quickly. Combined with impulsivity and risk-taking behaviors of adolescence, drugs and alcohol have more potential for lethality and lifelong consequences for youthful users.
A quarter of eighth-graders have used alcohol in any 30-day period, so clearly this is too late to begin telling children about drugs. More than half of high school seniors have used alcohol in any 30-day period and a quarter have been drunk. The message must be clear and unambiguous -- that drug and alcohol use will not be allowed. Parents must come to grips with denying permission for alcohol use by teens. It is just as addictive as heroin and just as likely to kill.
If parents "supervise" drinking parties by taking car keys away with the rationale that at least they're not driving, they are kidding themselves. Teens will view this as tacit approval and feel permitted to drink anytime. The ones with addiction potential -- who we can not be identified beforehand -- will head down a long, sad road of drinking problems, assuming they survive adolescence. Some will seek other drugs for experimentation at first, then to fill a need.
Parents, teachers and community leaders must communicate a clear and consistent message starting in middle school that this society does not condone drug use by its children. It is tough work for parents to raise children, but the message must be clear. Parents may be required to intervene in choices of their children's friends and the activities they pursue. If a child's school performance or behavior changes or he or she takes up with a completely different group of friends suddenly, it may be necessary to forget privacy rights and search the child's room thoroughly for evidence of drugs or alcohol. This is a very difficult step because it is unpleasant to consider a child may have a drug or alcohol problem, but ignoring it, like ignoring any illness, will only allow it to get worse.
Alcohol is only for adults over 21. It is the law in all states, so people don't have to negotiate this with their children, even if they feel ambivalent about it. Parents should clearly express their opinion about alcohol use to their children regularly and ask them what they see and hear outside the home about drugs and alcohol. Although parents may wish to respect their privacy, it is their obligation as parents to know where they are going and who will be there. Find out if someone's parent will be supervising activities and talk to other parents about their attitudes. Don't be afraid to set limits and curfews or to visit a party personally to check up on things. Over time, as all parents sing the same tune about drug and alcohol use, they have a chance to reduce the risk of addiction problems for their children.