Experimentation with drugs for many kids begins around age 11 or 12, just as brain development is kicking into its highest gear since infancy. Drug use during this time may permanently change the brain—particularly the high-level reasoning and decision-making centers. All told, more than half of teens will try an illicit substance at least once, and almost all will try alcohol, tobacco, or both. What can parents do to keep their kids safely off the path to abuse or addiction?
Clearly, the conversation needs to start well before the teenage years. Around age 10, have a "serious, specific sit-down talk" about the health, emotional, and legal risks of using drugs, alcohol, and cigarettes, says Ken Winters, director of the Center for Adolescent Substance Abuse Research at the University of Minnesota. Be honest if your child asks about your experimentation, he advises, and explain why you wouldn't make the same decisions today. Your child may still be tempted. But the longer kids delay that first try, the better, says Michael Dennis, a psychologist at Chestnut Health Systems in Illinois and a principal investigator of the Cannabis Youth Treatment study, which looked at the effectiveness of several treatment models. Dennis has found, for example, that kids who first try pot under age 15 are 2.5 times more likely to be dependent on it as an adult than those who first try the drug after age 18.
Bored? The way your kids spend their time matters, too: Certain activities can combat boredom, nurture passions, and be "protective" against use and abuse, says Paula Riggs, associate professor of psychiatry at the University of Colorado School of Medicine. Martial arts is a good example; it offers a healthy peer group, adult role models, opportunities for praise and mastery (with the belts and medals to prove it), and principles to believe in (nonaggression and respect for others). Cultivating healthful activities is also critical during and after treatment for substance abuse.
How to judge whether intervention is needed? The signs haven't changed: bloodshot eyes, trouble in school, a hostile or withdrawn attitude, and a laid-back view of drug use. But families need to assess the evidence of other issues, too. The majority of kids who have substance-abuse problems also have a mental-health disorder such as depression, attention deficit hyperactivity disorder, or anxiety, says Riggs. A treatment' s success may depend on its being comprehensive.
When selecting a program, consider local options first. "If a kid goes off to boot camp in Utah, they're the only one who's done the work," says Riggs. Family involvement is key, since everyone will need to support the child's new direction and watch for signs of relapse. Seek a program whose effectiveness is supported by research, that tracks its results, and is willing to share the data. (A success rate of 70 or 80 percent abstinence or significantly reduced use one year after treatment is just plain unrealistic; 50 percent is more reasonable.) Also, choose a program that exclusively serves youth.
Research suggests that treatment plans that use cognitive behavioral therapy (to recognize triggers and cope with cravings) with "motivational enhancement therapy" (to determine appropriate rewards, say, for a clean urinalysis), often have good outcomes. And find out what happens once the intensive work ends. Since addiction is a chronic condition, says Dennis, "treatment is only as good as the continuing care." This goes for all options, he says, from three months of weekly therapy sessions after school to residential programs.