What Parents Need to Know About Drugs

Adolescence is the critical period for starting to smoke, drink, or use other drugs. This is also a critical time to reinforce the importance of educating your teen about making healthy choices. As the teenage brain is still developing, it is much more vulnerable to drugs’ harmful effects. Even relatively low levels of substance use can have disastrous consequences for teens, including accidents, violence, unsafe sexual activity, cardiac and respiratory problems, and even death.

During their high school years, most teens will have the opportunity to drink alcohol or smoke marijuana; some will have the opportunity to try harder drugs. The fact is most kids will experiment and most won’t get into trouble. Nevertheless, as a parent you need to be aware of what is out there, what the risks are, and what signs to look for if you suspect a problem. If your child shows signs of a serious problem that could lead to addiction, it is important to know how to get help for them, and for you.

 

Why kids use drugs

Teenagers use drugs for a variety of reasons. Some of these may include:

  • Rebellion against authority

  • Trying to fit in with a group of friends

  • Self-medicating for their anxiety, stress, or depression

  • Curiosity

  • Relief from unpleasant emotions

It is important for parents to be aware that often drug use and mental health problems go together. Teens are at risk of developing an addiction or addictive behaviors if they are exposed to chaos in the home or if parents have mental health or addiction problems.

 

Alcohol – still the drug of choice

Despite what you may have heard or read about illegal drugs in the news, alcohol continues to be the most widely used substance of abuse among youth. Adolescent drinking poses enormous health and safety risks. Here are a few things for parents to ponder:

  • 70% of Canadian youths reported drinking alcohol in 2012. Canadian youth first consume alcohol at an average age of 16 years of age. [1]

  • Individuals who begin drinking before age 15 are four times more likely to develop alcohol dependence compared with those who have their first drink at age 20 or older. [2]

  • Up to 30% of students report consuming five or more drinks on one occasion. [3]

  • Teens who binge drink (have more than 5 drinks one after another) has also been associated with many health problems including: heart disease, stroke, cancer, liver disease, chemical dependency, pregnancy, STDs, and alcohol poisoning.[4]

  • Children who are depressed and/or suffering from serious health conditions are at an even greater risk for binge drinking, and may be using alcohol to control their pain, or to gain social acceptability.[5]

  • A person who holds parties for minors where alcohol is present is liable for any crimes and injuries related to alcohol consumption, and may face criminal charges or be sued.[6]

If you have a teenager who is going to parties where alcohol is available, check out the “Low-Risk Alcohol Drinking Guidelines for Youth” (LRADG) [7] developed by the Canadian Centre on Substance Abuse.

The guidelines suggest “there is no age at which it is considered “normal” for youth to start drinking, although the legal age to buy alcohol — a law intended to support the idea of postponed drinking — varies from 18 to 19, depending on the province. Often, the earlier an adolescent starts to drink, the more frequently he or she drinks, and the more likely he or she is to develop alcohol dependence or have future problems with alcohol. The LRADG recommends youth delay starting to drink alcohol for as long as possible.” [8]

The report goes on to say that parents “can play a large role in youths’ attitudes towards alcohol by speaking to their children about the effects and risks of drinking, and by ensuring youth are educated so they can make more responsible decisions”. Providing clear expectations about a youth’s drinking and the reasons behind these messages can influence his or her choices. As well, the direction and modelling of moderate alcohol consumption by parents can result in lower rates of alcohol-related problems among children.

“Some parents might choose to introduce their children to alcohol, and research shows that the outcome of this decision depends on the context in which it occurs. For example, parents in some cultures think it acceptable to offer their child a little wine at family dinners on special occasions, and in cultures where this is the practice the rates of alcohol-related problems are sometimes lower. However, problems with alcohol can develop when parents provide alcohol to youth without guidance or supervision. For this reason, if youth should start drinking — and it is recommended that they do not — it would be better for them to drink small amounts of alcohol in the company of their parents, if the parents demonstrate low-risk drinking.”

 

The family medicine cabinet

Our society is used to taking medications to make us feel better. Children see this and can develop the attitude that “pills are okay because they are medicine.” Not surprisingly club drugs like ecstasy are often made to look like pills or capsules, further perpetuating the idea that pills equal feeling better.

Did you know that psychoactive pharmaceuticals (prescription painkillers) are the third most commonly-abused substances, after alcohol and marijuana among Canadian youth? In 2015, over 80,000 Canadian teenagers used prescription drugs to get high.[9] When parents think about their kids experimenting with drugs, they probably aren’t thinking about drugs that may be found in the family medicine cabinet. Here are some facts for parents to ponder when it comes to youth prescription drug abuse:

  • Research shows that teens who abuse prescription drugs say they get them from friends, relatives, or from home. [10]

  • Prescription opioids can be just as dangerous as illegal opioid drugs such as heroin. The most commonly abused prescription drugs are as addictive as some street drugs. [11]

  • The greatest danger with prescription drugs occurs when they are used in combination, particularly with alcohol. [12]

 

Commonly used street drugs and what parents should know

Marijuana is the most common illegal drug used by today’s youth. In Canada, it looks like marijuana will not be illegal for much longer. For those reasons, parents should check our Marijuana 101 for Parents page to learn more about this drug.

When kids buy illegal drugs or prescription drugs illegally, the problem is that they can never be sure of what they are getting. For example, MDMA or ecstasy is often cut with other chemicals, such as caffeine, amphetamine, LSD, PMA, and ketamine. Drugs like “street oxy,” heroin, or cocaine can be cut with fentanyl, so someone could end up ingesting this dangerous substance without even knowing it. [14]

Drugs such as ecstasy, cocaine, LSD, crystal meth, and heroin are not good for anyone, but are particularly bad for a preteen or teen whose body and brain are still developing. Illegal drugs can damage the brain, heart, and other important organs. [15]

Here are a few illegal drugs that parents should know about:

Fentanyl: Fentanyl has been in the news a lot of late. The problem stems from the fact it is finding its way onto our streets either through the street trade of legitimate prescription patches, through illicitly manufactured fentanyl made into pill form to look like OxyContin, or it is cut into cocaine and heroin to create a more intense high.[16] When dealers cut it into street drugs, users have no idea of the level of purity or the potency of what they take.

Fentanyl is a synthetic opioid that is 100 times more powerful than morphine. Typically, it is used in hospitals as analgesic or for pain management in the form of fentanyl patches.[17] In its prescription form, it is known by such names as Actiq®, Duragesic®, and Sublimaze®.  It works in the brain to change how the body feels and responds to pain. Like heroin, morphine, and other opioid drugs, fentanyl works by binding to the body's opioid receptors, which are found in areas of the brain that control pain and emotions. When opioid drugs bind to these receptors, they can drive up dopamine levels in the brain's reward areas, producing a state of euphoria and relaxation. Opioid receptors are also found in the areas of the brain that control breathing rate. High doses of opioids, especially potent opioids such as fentanyl, can cause breathing to stop completely, which can lead to death.[18] The high potency of fentanyl greatly increases risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains fentanyl. The RCMP estimates a lethal dose of pure fentanyl to be in the realm of two milligrams for a typical adult, which is no more than a few grains of salt.[19]

Oxycodone: This is a narcotic (OxyContin, Percocet and Percodan are the most frequently used and abused) prescribed to relieve pain that is twice as potent as morphine. OxyContin is a time-release version of oxycodone that is snorted or injected. Used as a substitute for heroin, abusers use the drug to relieve pain, alleviate withdrawal symptoms, and gain euphoric effects. In 2012 the Canadian government forced the manufacturer of OxyContin to make a “tamper-resistant” version – tough to crush and therefore harder to snort or inject. Police say that virtually every pill stamped as OxyContin (CDN 80) sold on the street today actually contains fentanyl which is very cheap to manufacture and thus lucrative for drug dealers. [20]

Cocaine: There are two forms of cocaine: the white powder which can be snorted, injected, or swallowed and crack cocaine which looks like opaque crystals and makes a popping noise when smoked.[21] Within minutes of snorting, the person’s brain is flooded with dopamine, the neurotransmitter that helps control the brain's reward and pleasure centers and causes feelings of euphoria and stimulation. [22] After the effects have worn off, people find themselves having extreme cravings for that high.[23] This is because cocaine changes the reward pathway of the brain and, over time, more and more is needed to get the same effect. [24] Some people even go on cocaine binges where they take cocaine every 10-30 minutes in order to avoid the negative side effects, such as depressed mood, anxiety and a loss of energy. [25]

Besides potentially causing dependence and addiction, cocaine can have other unwanted effects. Other health effects of cocaine include:

  • Increase in heart rate and blood pressure [26]

  • Constriction of blood vessels [27]

  • Chest pain [28]

Those who binge on cocaine can also experience a “crash” in mood and energy: depression, craving, anxiety, and even paranoia.[29]

Methamphetamine: Also known as speed, uppers, meth, crystal meth, chalk, ice, glass, Christmas tree, and crank, this drug can be unpredictable, addictive, and lethal. It can be smoked, snorted, injected, or taken orally. Immediately after smoking the drug or injecting it, the user experiences an intense pleasurable rush that lasts only a few minutes. Snorting or oral ingestion produces euphoria, but not an intense rush.   

People who abuse methamphetamines feel like they don’t need to sleep and are full of energy. But with repeated use methamphetamines are very damaging to the body and brain. Chronic abuse can result in heart problems, progressive social deterioration, and psychotic symptoms (paranoia, delusions, mood disturbances).[30]

Ecstasy or MDMA: or 3,4-methylenedioxymethamphetamine produces energizing effects like the stimulant amphetamine, but also acts as a hallucinogenic similar to mescaline.[31] Made in the lab, ecstasy usually comes in the form of a colourful pill, often with cartoons and icons stamped into them. Nowadays MDMA is rarely ever pure, and sometimes pills don’t contain any MDMA at all. [32] In 2007, Health Canada found only 3% of tablets analyzed contained pure MDMA.[33] It is one of the most popular drugs when it comes to partying, often found at raves, music festivals, and dance parties for its stimulating and enhancing effects.[34]

 

Signs of a problem

arents naturally are concerned for their children and want to know what the signs would be of drug use. Perhaps the most important thing to remember is that you know your child better than most. As a parent, you probably have experienced the feeling of “just knowing” something is not right when your child has a problem or is sick.

hen it comes to drug use, many of the signs one would look for can also be signs of any number of other things, from being unwell to natural adolescent hormone and mood fluctuations. Whether or not drugs are the issue, these signs are worth looking into because they may be signals that your child is experiencing problems:

  • Bloodshot eyes

  • A lasting cough or stuffiness

  • Unusual gain or loss of weight

  • Unusual mood swings

  • Retreat or withdrawal from family or other social activities

  • Being unhappy or depressed

  • Being suspicious, anxious, defensive, or overly protective

  • Coming home late

  • Being untruthful

  • Having problems with the law

  • Being unusually sleepy

  • A drop in grades

  • Missing or skipping school

  • Stealing money or items

  • Sudden change in friends

Concerns about any of these or other things out of the ordinary can be expressed in an atmosphere of love, trust, and support. It is always best to avoid jumping to conclusions or talking while angry. While over-reacting is usually non-productive, it is important to take seriously the possibility that a child may be in or headed for trouble.

If your child admits to trying drugs stay calm and explain your concerns about drug use. If he or she comes home obviously drunk or high, don’t get angry. Send them to their room and let them know you will discuss the situation in the morning. Check on them during the night and if they show signs of being seriously ill or in danger, call 911.

You also need to set boundaries. If you think your child has a substance use problem, you can start setting limits by not allowing drinking or drug use around you. Be clear about what behavior you will and will not tolerate. Don’t be afraid to set clear rules including not to come home drunk, high, or with drugs on them, or have drugs on the premises. Remember that you love them and your goal is to keep them safe and healthy. Condemn the behaviour, not the person.

 

When kids become addicted

or some young people, alcohol and drug use can quickly become more than just experimenting. They are using drugs on a daily basis or they are binge using on weekends. Use can become abuse if the consequences become serious: there are family problems, they lose friends, get expelled from school, lose a job, or get into legal trouble. If they continue to use despite the consequences, there is a good chance they have become psychologically or physically dependent.  

ngoing abuse causes changes in brain chemical systems and circuits. When these brain changes occur, the individual may need more of the substance to experience the same effect (tolerance) and may experience withdrawal symptoms when the substance is not present.

If you suspect your child has slipped into drug abuse or addiction, the first thing to do is get educated yourself. Read everything you can, take a workshop such as the Heart of a Family put on by the Little House Society in Delta, join an Al Anon or Nar Anon group or meet with other parents dealing with the same issues, or meet with a counsellor. Having the knowledge, support and professional advice will help you when it comes to that difficult conversation with your child about their drug abuse and getting help for them. If your child agrees to seek help, here are some things you should know about treatment:

Treatment: In Canada we have two primary types of treatment for both residential as well as outpatient care: abstinence-based and harm reduction. Although harm reduction has its place – e.g. methadone maintenance, support for marginalized populations, specific youth programs – abstinence should be the end goal.

Treatment should be regarded as a continuum of care that involves:

  • Intervention. The individual agrees to seek help, often reluctantly.

  • Assessment. An expert in addictions undertakes a full assessment to develop an accurate diagnosis and treatment plan.

  • Primary Care. The individual participates in a residential treatment program (or in some cases out-patient treatment). This stage may include a detoxification period.

  • Aftercare. A supervised continuing care program of at least 24 months is necessary to protect against relapse.

Don’t stop there. Remember that agreeing to treatment is only the first step toward getting well. Your child will need your direct support and steady involvement every step of the way if he or she is to get well.

Some parents have difficulty saying no to their children, even when they are abusing themselves and their family. They are in danger of what is called “enabling”; or, making it easier for the child to continue drug use by continually allowing them to break the rules without consequences or consistent consequences. This rarely helps the child and the problem usually continues to get worse until the child gets treatment for his/her addiction.

 

Things to ponder

  • “Adolescent smoking, drinking, misusing prescription drugs and using illegal drugs is, by any measure, a public health problem of epidemic proportion, presenting clear and present danger to millions of teenagers and severe and expensive long-range consequences for the entire population.” [35]

  • “Parents must recognize that substance use is a real and present threat to their teens’ health, safety, and future and take steps to prevent it.” [36]

  • Prescription medicines are now the most commonly abused drugs among 12 to 13 year olds. [37]

  • Teen drug abuse plays a major role in addiction. People who do not use tobacco, alcohol or illegal drugs or misuse prescription drugs before age 21 are virtually certain never to do so. [38]

  • Research shows students who drank in high school are three times more likely to begin heavy episodic drinking in college. [39]

  • “Parents must recognize that substance use is a real and present threat to their teens’ health, safety, and future and take steps to prevent it.” [40]

  • Prescription medicines are now the most commonly abused drugs among 12 to 13 year olds. [41]

 
  1. Youth and Alcohol, Canadian Centre on Substance Abuse. Winter 2014. Web.

  2. Ibid.

  3. Ibid.

  4. Cassandra, Raychelle. "Teen Binge Drinking: All Too Common." Psychology Today. N.p., 26 Feb. 2013. Web.

  5. Machold, Dr. Clea. "1 in 25 Canadians in Middle School Say They Binge Drink." CBCnews. CBC/Radio Canada, 12 May 2014. Web.

  6. Ibid.

  7. Youth and Alcohol, Canadian Centre on Substance Abuse. Winter 2014. Web.

  8. Health Canada. "About Prescription Drug Abuse." Canada.ca. 14 Apr. 2016.

  9. Ibid.

  10. "Drug Free Kids Canada." Drug Free Kids Canada. Web.

  11. Ibid.

  12. "Cough and Cold Medicine Abuse." DrugFacts: Cough and Cold Medicine Abuse | National Institute on Drug Abuse (NIDA). Web.

  13. McKee, Geoff MD, Amlani, Ashraf, MPH, Buxton, Jane A., MBBS, MHSc, FRCPC. BCMJ, Vol. 57, No. 6, July, August, 2015, page(s) 235 — BC Centre for Disease Control.

  14. "Drug Free Kids Canada." Drug Free Kids Canada. Web.

  15. Gatehouse, Jonathon, and Nancy Macdonald. "Fentanyl: The King of All Opiates, and a Killer Drug Crisis." Macleans.ca. 21 Sept. 2015. Web.

  16. Ibid.

  17. Ibid.

  18. Fentanyl Safety for First Responders, Fentanyl Safety. Web.

  19. "Fentanyl." DrugFacts: Fentanyl | National Institute on Drug Abuse (NIDA). 03 June 2016. Web.

  20. "RCMP Releases Video on the Dangers of Fentanyl." Government of Canada, Royal Canadian Mounted Police., 13 Sept. 2016. Web.

  21. Stewart, Eric. "RCMP Gazette." Government of Canada, Royal Canadian Mounted Police., 24 June 2016. Web.

  22. Egred, M. Cocaine and The Heart. Postgraduate Medical Journal 2005, 81, 568-571.

  23. Nestler, E. Historical Review: Molecular And Cellular Mechanisms Of Opiate And Cocaine Addiction. Trends in Pharmacological Sciences 2004, 25, 210-218.

  24. Carlezon Jr., W. Regulation Of Cocaine Reward By CREB. Science 1998, 282, 2272-2275.

  25. Gawin, F. Cocaine Addiction: Psychology And Neurophysiology. Science 1991, 251, 1580-1586

  26. Breiter, H.; Gollub, R.; Weisskoff, R.; Kennedy, D.; Makris, N.; Berke, J.; Goodman, J.; Kantor, H.; Gastfriend, D.; Riorden, J. et al. Acute Effects Of Cocaine On Human Brain Activity And Emotion. Neuron 1997, 19, 591-611.

  27. Kloner, R.; Hale, S.; Alker, K.; Rezkalla, S. The Effects Of Acute And Chronic Cocaine Use On The Heart. Circulation 1992, 85, 407-419.

  28. Pozner, C.; Levine, M.; Zane, R. The Cardiovascular Effects Of Cocaine. The Journal of Emergency Medicine 2005, 29, 173-178.

  29. Boys, A. Understanding Reasons For Drug Use Amongst Young People: A Functional Perspective. Health Education Research 2001, 16, 457-469.

  30. Davis, Kathleen. "Methamphetamine: Side Effects, Health Risks and Withdrawal." Medical News Today. MediLexicon International, Web.

  31. Teter, C.; Guthrie, S. A Comprehensive Review Of MDMA And GHB: Two Common Club Drugs. Pharmacotherapy 2001, 21, 1486-1513.

  32. Gahlinger, P. M. (2004). Club drugs: MDMA, gamma-hydroxybutyrate (GHB), Rohypnol, and ketamine. American Family Physician, 69(11), 2619–26. -

  33. Hudson, A.; Lalies, M.; Baker, G.; Wells, K.; Aitchison, K. Ecstasy, Legal Highs And Designer Drug Use: A Canadian Perspective. Drug Science, Policy and Law 2013, 1.

  34. Gahlinger, P. M. (2004). Club drugs: MDMA, gamma-hydroxybutyrate (GHB), Rohypnol, and ketamine. American Family Physician, 69(11), 2619–26.

  35. Adolescent Substance Use: America’s #1 Public Health Problem, The National Centre on Addiction and Substance Abuse at Columbia University, June 2011

  36. Ibid.

  37. SAMHSA, Center for Behavioral Health Statistics and Quality. "Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings." SAMHSA, CBHSQ. Web.

  38. National Survey on American Attitudes on Substance Abuse XVII: Teens, The National Centre on Addiction and Substance Abuse at Columbia University, August 2012

  39. Wechsler, Henry, and Toben F. Nelson. "What We Have Learned From the Harvard School of Public Health College Alcohol Study: Focusing Attention on College Student Alcohol Consumption and the Environmental Conditions That Promote It." Journal of Studies on Alcohol and Drugs 69.4 (2008): 481-90. Web.

  40. Adolescent Substance Use: America’s #1 Public Health Problem, The National Centre on Addiction and Substance Abuse at Columbia University, June 2011

  41. SAMHSA, Center for Behavioral Health Statistics and Quality. "Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings." SAMHSA, CBHSQ. Web