Parents: Kill a buzz, save a life

My 14-year-old daughter insists that she’s never experimented with alcohol or drugs. The statistics tell me that I’ll be lucky if she can say that for very long -- or at least say it and have it be true.

Drug use among teens is pervasive. Nearly 45% of teenagers in grades 9 through 12 drink alcohol, and more than 25% of them binge drink, according to the Centers for Disease Control and Prevention’s 2007 Youth Risk Behavior Surveillance. Further, 1 in 3 teens has smoked marijuana, and 1 in 5 has abused prescription medication, according to a recent survey by the Partnership for a Drug-Free America.

With numbers like these, parents of teens can almost be certain that their children won’t make it to 21 without tossing back a cocktail, smoking a little pot or trying to get high on cough syrup.

Parents’ role in preventing or at least delaying this type of experimentation has been clearly spelled out by the experts: Adults should not only talk openly with their children about the dangers of drugs and alcohol but also articulate and enforce very clear “no use” rules. Such rules have been shown to greatly reduce the likelihood that teens will use drugs and alcohol. (And the logical assumption is that they’re then less likely to get wasted, be involved in an alcohol-related car accident, etc.)

However, many parents can’t seem to bring themselves to impose such rules.

“I recommend that parents tell their children that they expect they will not drink until age 21 and that they’ll never use drugs,” says Dr. John Knight, director of the Center for Substance Abuse Research at Children’s Hospital Boston. “If parents set the bar lower, they risk tragedy.”

He recommends that parents not give in to the data.

“I know what the statistics on teen drug use are,” Knight says. “But that doesn’t mean that kids should be given permission to do it.”

To some parents, no-use policies seem draconian and the mind-set behind them simplistic.

They assume experimentation is inevitable and that no-use policies are doomed to fail. Further, some simply don’t see drug use as a major issue.

“Currently, 61% of parents tried drugs or alcohol while they were kids,” says Steve Pasierb, director of the Partnership for a Drug-Free America. Those who never got into too much trouble because of such use often view their children’s use as relatively harmless experimentation.

Adolescents need increasing amounts of freedom and independence, and buckling down on them feels counterintuitive to some parents. They take the position that teens learn best from their own mistakes and that strict rules won’t teach them to make good decisions over the long haul.

Some parents fear that no-use rules will undermine their relationship with their child. They worry that their kids will stop communicating openly with them, making them less likely to reach out for help if they do get into a bind. For instance, rather than call Mom or Dad for a ride home after a beer or two, they fear, teens might try to drive themselves in an attempt to stay out of trouble.

Other parents are concerned about the way no-use rules will affect their kids’ friendships with peers.

“There’s a lot of concern about popularity,” Knight says. “If parents don’t let their kids drink, they think they won’t be popular.”

But no-use rules work. In a recent survey, the Partnership for a Drug-Free America asked teens about their use of drugs and alcohol on prom night. Among kids whose parents forbid them to drink or do drugs, only 16% did so anyway; among kids who received no clear directives, use topped 45%.

Preventing kids from drinking and taking drugs is critical. Compared with adults, teens are twice as likely to engage in risky binge drinking. Alcohol also has a different effect on their brains, making them particularly dangerous drunks. While adults tend to get sleepy after a drink or two, teens get revved up. They’re far more likely than older people to climb behind the wheel of a car or take a chance performing a risky stunt

“As many as 40% to 50% of deaths among teenagers are alcohol- and drug-related,” Knight points out.

But perhaps the most compelling reason to keep kids drug-free is that it reduces their chances of addiction. The earlier teens start drinking or using drugs, the greater the likelihood that they’ll develop an addictive disorder later in life. A child who starts drinking before age 15 has a 50% chance of becoming alcoholic; the risk falls to 9% for those who wait until they’re 21.

Although teens want to be perceived as independent and in control of their lives, they’re still looking for guidance and direction from their parents.

“They complain bitterly when you set limits but are actually grateful for them,” Knight says.

That doesn’t mean they won’t slip up, and parents need to build some flexibility into the rules for when it happens. The Contract for Life developed by SADD serves as an excellent example of how this can be done. Children pledge their best effort to stay drug- and alcohol-free and promise that they’ll call for help if they’re ever in a situation that threatens their safety; at the same time, parents pledge to provide safe transportation home and promise to remain calm and understanding should a dangerous situation ever arise. (The Contract for Life is available online at www.sadd.org/contract.htm.)

At this point, my daughter quietly abides by our household rules on drugs and alcohol. However, I have little doubt that there will come a time when she’ll roll her eyes in disgust or storm out of the room when my husband and I revisit the topic. She’s a teenager, and that’s simply what she’s supposed to do.

But we’re her parents, and we have a job to do too. We need to keep her safe. She has a lifetime to enjoy wine, beer and spirits, but she has to survive her adolescence first.

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Ulene is a board-certified specialist in preventive medicine practicing in Los Angeles. The M.D. appears once a month.

themd@att.net

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The argument for ‘a sip or two’

Although it runs counter to the spirit of a no-use policy, allowing teens to drink as part of family celebrations and gatherings might not be such a bad idea.

“There’s no harm in parents allowing a younger teen a sip of an alcoholic drink to ‘see what it tastes like’ or permitting an older adolescent one drink at a family event,” says Dr. John Knight, director of the Center for Substance Abuse Research at Children’s Hospital Boston.

In fact, it may protect them by encouraging healthier drinking habits and reducing the attraction of the “forbidden fruit.” A study published in the Journal of Adolescent Health in 2004 found that teens whose parents allowed them to have a drink with them were less than half as likely to binge drink as those whose parents did not.

That’s not to say that parents should ever serve alcohol to their children’s peers. According to that same study, an estimated 20% to 25% of parents let teenagers gather in their home to drink, presumably because they believe they will be safer drinking with supervision.

“They’re mostly well-intentioned but sadly misguided and, in many states, committing a crime,” Knight says.

-- Valerie Ulene