This pamphlet was originally published by Stanton Peele in 1983 with CompCare Publications, Minneapolis. It was revised in 1996 with the editorial assistance of Marianne Apostolides and financial support from The Lindesmith Center, New York.
A Parent's Guide To Understanding and Preventing Alcohol and Drug Abuse
Stanton Peele, Ph.D.
Abstract: Don't Panic offers parents a non-alarmist approach for understanding and dealing with adolescent substance use. In the place of panic, this pamphlet provides a sensible, human, and responsible perspective on raising children in a world where they confront drugs whether legal or illegal every day.
This pamphlet provides parents with tips for understanding and dealing with teenage alcohol, tobacco, and other drug use.
Many parents wish their children would never try drugs. But 8 out of 10 children will try alcohol and/or other drugs before they graduate from high school. Given that fact, what can a parent do? How can a parent prevent abuse? This pamphlet gives parents a sensible, responsible approach for raising children in a world where they confront drugs (whether legal or illegal) every day. It gives parents suggestions about how to prevent substance abuse problems in kids who don't have problems, and how to recognize and help those who do.
Teenagers often use drugs as a part of adolescent exploration. A small portion abuse drugs to escape from problems they can't handle in a positive way.
Almost half of teenagers graduating from high school have tried an illegal drug. Over 80% have drunk alcohol, and 65% have smoked cigarettes.1 These numbers can surely be frightening for parents. But before we become alarmed, we should examine what these numbers actually tell us. They tell us the number of young users, not young abusers. Here's what we mean by this distinction:
- Drug use differs from drug abuse.
Drugs are powerful substances that can have harmful consequences. Teenagers or adults abuse drugs if they rely on drugs or use them to excess. However, many people in all societies use drugs occasionally without disrupting their lives. This is substance use. For example, most adults who drink alcohol do so only occasionally or with meals. These drinkers differ from alcoholics in the same way that drug users differ from drug abusers.
- The most important question is: Why do some kids move from substance use to substance abuse? The answer does not lie in the substance itself. The answer lies in the way a teenager relates to him/herself, other people, and his/her surroundings.
Problems arise when a teenager is not involved in activities that express positive values and does not have a supportive family and social environment. Without these anchors, some children seek ways of escape. Drugs offer such an escape, although their long-term consequences can be harmful. Teenagers susceptible to drug abuse can often be identified by "risk factors" such as poverty,2 emotional problems like depression or anxiety, antisocial peer groups, and a disturbed family environment. These factors in turn create low self-esteem and a desire to escape feelings like self-doubt, powerlessness, and hopelessness.
- A child with risk factors is not destined to abuse drugs. He or she is simply at higher risk.
Up to 70% of kids in the highest risk conditions do not become substance abusers.3 These teenagers can build on their strengths (known as "resilience" or "protective" factors) to prevent the negative factors from dominating their lives. Resilience factors include having a strong relationship with an adult and confidence-building experiences at school, work, or other extracurricular activities. Such factors build self-esteem, a sense of personal control, a desire to be healthy, and a link to mainstream activities and values.4
- Most adolescent substance users do not become abusers.
It can be very reassuring to know that the large majority of people who try drugs do not go on to become regular users or abusers. This does not mean that parents should never discuss drug use with their children. But it should give parents greater comfort in thinking about teenage drug use, drug abuse prevention, and drug abuse treatment.
With this new comfort level, parents can focus on helping their children develop skills, confidence, and decision-making abilities. By giving kids some room for experimentation while still establishing boundaries (curfews, avoiding driving while intoxicated, upholding responsibilities at home, and so on according to your own values), parents can help their children to make responsible decisions and, eventually, to mature into adulthood.
Parents can play an important role in preventing and dealing with drug abuse. They do so by fostering healthy and responsible attitudes in their children.
The best drug prevention program is simple: supporting, educating, and caring for children. This prevention program starts in the family and continues in school and social activities. Here are some concrete ways that you as a parent can continue your drug prevention program by helping your child develop decision-making skills and positive interests.
- Teach your child to avoid excess by practicing moderate substance use, whether the substance is alcohol, tobacco, marijuana, food, caffeine, etc.
Your own habits are very important for determining your child's habits. For example, when parents diet or eat excessively, they may affect not only their child's eating habits, but they may preoccupy him/her with concerns about body image that persist for a lifetime. When parents chain smoke or allow smoky air to fill the home, they teach their child a lack of respect for health. Parents are most effective at preventing substance abuse when they demonstrate moderate substance use themselves. 5
- Talk with your teenager openly and honestly.
Communication is one of those truisms in parenting: Everybody thinks it's good, everybody thinks they should do it, and few know exactly how! A large part of communication is the ability to relax and listen to hear what your child is saying rather than what you want your child to be saying or what you fear your child is saying.
Try this approach in speaking with your teenager: "What do you think is the difference between sensible and dangerous drinking?" Ask your child to tell you his/her thoughts and feelings about smoking tobacco or marijuana. The chances are your child sees other kids at school drinking and smoking. Ask how your child thinks and feels about this. Ask your child what it means to him/her that some kids are using drugs that are illegal.
Together, you and your teen can then discuss the issues surrounding substance use, and can adopt principles of healthy behavior.6 These principles will vary according to your own beliefs and circumstances. But whatever principles you and your child adopt, open communication is important.
- Talk with your child about feelings as well as ideas.
The inability to deal with emotions can lead to excessive substance use or other problems like violence or irresponsible sexual behavior. Parents can help their children learn to deal with emotions. Talking with your teenager about his/her emotions is the first step. Let him/her discuss feelings openly. Try to listen calmly and react without judgment or punishment. Talk about your feelings too. This discussion can help a teenager accept his/her emotions and recognize that he/she has choices for dealing with emotions.
- Encourage supportive relationships between your child and other adults or responsible young people, whether an uncle, older sibling, track coach, boss, etc.
Some of the communication points we've recommended are difficult to achieve, especially since it can be uncomfortable for parents to discuss some issues and feelings with their children. Remember, you can always ask a trusted adult to talk with your child, or stay out of the way as a relationship grows between your child and a responsible older person.7
- Encourage your child to develop positive interests, even if those interests are not the ones you would choose for him/her.
Your child's interests and positive involvements can help him/her take responsibility, build confidence, channel energy and feelings, and generate enthusiasm, creativity, and productivity. Children with interests whether in sports, music, the school newspaper, photography, drama, volunteer or paid work, etc. learn about life while developing skills and a sense of self-worth. These activities can also give your child a powerful stake in growing up healthy.
- Show your child that his/her opinions and decisions matter.
As children get older, they form more definite ideas about matters that concern them. Parents can't always follow their children's preferences, but they can take them into account and treat their kids as contributing members of the family, community, and society. Children get a true sense of their importance when they see that their opinions and actions are taken seriously and can affect another person, like a parent. For example, your child learns that what he/she says has meaning when you ask for, consider and/or act on your child's opinion.
You can also teach your child about responsibility by following through on promises you make, and by explicitly expecting him/her to follow through on the promises he/she makes. When children show they deserve trust by responsibly following through on their word, parents should give them that trust.
- Give your child the respect and leeway to follow through on and take responsibility for his/her own decisions.
We're asking you to do a lot: We're asking you to let your child make mistakes. In practice, you need to judge which experiences your teenager can safely manage. But we as parents have to allow our children to face situations that require them to use self-control and good judgment. In these situations, children will have to consider their options and the consequences of each option. They will make their own decisions decisions for which they take responsibility. This ability to make good decisions is important, considering that parents can't always be around to protect their children. When we realize that about 90% of high school seniors say alcohol, cigarettes, and marijuana are easy to get,8 we see that children must be able to make choices on their own in order to stay out of trouble.
Parents can play an important role in dealing with drug abuse. They can do so by remaining calm and taking steps to help their children deal with the causes of their problems.
Even though most teens who experiment with substances never go on to abuse those substances, parents need to be aware of actions they can take when a child is abusing drugs or alcohol. It is important for parents to remain calm, to deal with the root causes of problems, and to communicate with their children either themselves or through another trusted adult. As a part of this process, parents and teens may find counseling helpful.
- If a child is having trouble with substances, try to address the sources of the trouble rather than the expression of the trouble (i.e., drug misuse).
The sources of a child's problems can be poverty, depression, uncontrolled anger or anxiety, family turmoil, and/or an absence of purpose. The source is not the drug itself. Substances can certainly make things worse, and can help that child feel trapped. But taking away drugs (or attempting to do so) will not eliminate the causes of substance abuse. On the other hand, changing the causes can alter substance use patterns. If a teen's problems and substance use seem manageable, formal counseling may not be necessary. The teenager may simply need to get involved in positive activities and to have open, nonjudgmental discussions with an adult that he/she can relate to.
- If you are unsure about whether your child has a problem, calmly ask yourself and your child certain questions, consider the answers seriously, and withhold moral judgment.
You and your child can determine the severity of drug use: is it experimentation, outright dependence, or somewhere in between? To answer that question, ask yourself some questions: "Is my child dropping out of activities that were important to him/her without replacing those activities? Does he/she ever come home drunk or high? Has a parent or a teacher called me to express concern about my child? Has my child stopped doing schoolwork and meeting family responsibilities?" If the answer to several of these questions is 'yes,' you need to make your child aware that you are concerned. Discuss your concerns with your child and professionals such as a teacher or school counselor (after checking first that this discussion will be confidential).
Since it is easy, even natural, for parents to get over-concerned about their children, be sure to ask your child some questions rather than tell him/her that he/she has a problem: "Your behavior concerns me, can you tell me or someone else what's going on? Am I right to be concerned?" At the same time, you can state: "I feel like you need to talk with someone. I feel like you need to think about your own behavior. Who do you feel that you can talk with?" As much as possible, let your child know that you are serious without panicking. Convey the importance of the issue without making him/her feel cornered and attacked.
- Once you and/or another adult has talked with your child, you and your child can decide whether counseling would help him/her progress out of unhealthy substance use.
Children need to be a part of the decision to seek treatment. Otherwise, parents are in a position of coercing their children. This kind of "tough love" can be a highly risky business: It strips children of their identities and attacks their insecure egos. Going this far is only necessary when a child is seriously harming him/herself. Even then, less aggressive interventions which respect the child's identity may achieve the same protective purpose.9
If your child needs treatment but resists it, ask someone whom your child trusts and respects to talk to him/her. That peer or adult can start an honest discussion that can help your child decide to get counseling.
- There are several ways to find an appropriate therapist.
In finding a therapist, you and your child can talk to psychiatrists, psychologists, and psychiatric social workers. Your family doctor, school social worker, or even close friends or relatives may have some suggestions for finding appropriate local therapists. When choosing a therapist, it is most important to:
- Find a person your child feels comfortable with and responds to (even if that means changing therapists after a few sessions)
- Find someone who won't focus exclusively on your child's substance abuse itself, but will help your child recognize the problems that underlie his/her substance use
- Take economics into account, because breaking the family bank will only make it more difficult for you to help your child and yourself
- Remember, you and your child have the right to ask questions of a potential therapist.
There are many therapists; some are good, some are not. Listen to what your instincts tell you and what your child says after talking to a therapist a few times. We emphasize 'what your child says' because it is important to check in with your child's feelings, to make sure that he/she does not feel shut down or manipulated.
- Always keep in mind the goal of treatment.
The goal of treatment is to ease the child away from substance abuse by fostering independent thinking and decision-making, and by creating a positive stake in life. This objective can be met through three factors we spoke of earlier:
- Encouraging a teenager to develop a strong relationship with an adult
- Encouraging a teenager to discover and develop interests
- Helping a teenager control the sources of his/her problems rather than focusing only on the expression of those problems the substance abuse
- These goals are not often achieved through hospitalization or inpatient treatment programs.
Inpatient treatment programs are rarely justified for children's healthy development.10 They can even harm children by giving them identities as alcoholics or substance abusers, and setting them up for relapse.11 The programs also foster relapse by isolating children in a setting that's very different from the setting they'll face outside treatment. This is the case for a parent who says, "My child does very well in treatment, but the second he comes home he heads right over to the local marijuana dealer's home."
A lot is asked of us parents, but we can meet the challenge!
The recommendations in this pamphlet add up to a stiff set of demands on parents. But there is nothing in this pamphlet, or about being a parent in general, that cannot be approached through careful thought and attention to our children, ourselves, and other people.
Raising children does not require perfection. It requires the willingness to jump in, even though 'jumping in' means that we'll make mistakes. We must believe that mistakes can provide useful experiences that will improve us and our children as people. We must have enough confidence in ourselves and our children to take risks, and enough strength to change course if we are dissatisfied.
When we recognize the true dangers in a situation and proceed with our eyes open, we create a cautious but optimistic map that our children can follow. This map can help our kids discover their own ability to face the challenges of life. As parents, we must make our children partners while still keeping the final say. In this way, we accept responsibility for being parents while helping our children accept responsibility for themselves. This must be our ultimate goal.
1. L.D. Johnston, P.M. O'Malley, and J.G. Beckman (1996) National Survey Results on Drug Use from The Monitoring the Future Study Rockville, MD: NIDA. (back to text)
2. Although drug use is spread among all groups, the most destructive teenage drug use occurs among inner-city youth alienated from the mainstream. M. Newcomb and P. Bentler (1988) Consequences of Adolescent Drug Use: Impact on the Lives of Young Adults Newbury Park, CA: Sage Publications. (back to text)
3. E. Werner (1986) "Resilient Offspring of Alcoholics: A Longitudinal Study from Birth to Age 18" Journal on Studies on Alcohol 47(1): 34-40; J.H. Brown and J. Horowitz (1993) "Deviance and Deviants: Why Adolescent Substance Use Prevention Programs Do Not Work" Evaluation Review 17(5): 529-555. (back to text)
4. R. Jessor and S.L. Jessor (1977) Problem Behavior and Psychological Development: A Longitudinal Study of Youth New York: Academy Press; J. Shedler and J. Block (1990) "Adolescent Drug Use and Psychological Health: A Longitudinal Inquiry" American Psychologist 45(5): 612-630. (back to text)
5. This process is well-known. In the case of alcohol, see D. Heath "Socio-cultural Variance in Alcoholism" in E.M. Pattison and E. Kaufman (eds.) (1982) Encyclopedic Handbook of Alcoholism NY: Gardner Press, 426-440; M. Marshall (ed.) (1979) Beliefs, Behaviors, and Alcoholic Beverages: A Cross-Cultural Survey Ann Arbor: University of Michigan Press. (back to text)
6. A good book for understanding basic facts about drugs is From Chocolate to Morphine: Everything You Need to Know About Mind-Altering Drugs by Andrew Weil and Winifred Rosen (Boston: Houghton Mifflin Co., 1993). (back to text)
7. J. H. Brown, M. D'Emidio-Caston, K. Kaufman, T. Goldsworthy-Hanner and M. Alioto (1995) In Their Own Voices: Students and Educators Evaluate California School-Based Drug, Alcohol, and Tobacco Education (DATE) Programs, Washington, DC: Pacific Institute for Research and Evaluation; E. Werner (1986), op. cit. (back to text)
8. L.D. Johnston et al. (1996), op. cit. (back to text)
9. S. Peele (1986) "The Cure for Adolescent Drug Abuse: Worse than the Problem?" Journal of Counseling and Development 65: 23-34. (back to text)
10. Even though the expansion of hospitalization of teenagers more than quadrupled from 1980 to 1986, remission rates for outpatient counseling in the United States are typically at least as good as those for hospital stays. W.R. Miller and R.K. Hester "Inpatient Alcoholism Treatment: Who Benefits" (1986) American Psychologist 41: 794-805. In addition, although the United Kingdom does not rely on hospitalization for alcohol and drug abuse, it shows effectiveness at least as great as that found in private American treatment centers. D. Cameron (1995) Liberating Solutions for Alcohol Problems Northvale, NJ: Jason Aronson. (back to text)
11. S. Peele (1987) "What Can We Expect from Treatment of Adolescent Drug and Alcohol Abuse?" Pediatrician (back to text) 14: 62-69.
About the Authors
Stanton Peele, a distinguished alcohol and drug expert, has received the Mark Keller Award for Alcohol Research from the Rutgers Center for Alcohol Studies, and the Lindesmith Award for Career Scholarship from the Drug Policy Foundation. He is the author of Love and Addiction, Diseasing of America, and The Truth about Addiction and Recovery.
Marianne Apostolides, is author of Inner Hunger: Dealing with the Realities of Anorexia and Bulimia which will be published by W.W. Norton & Co. in 1997.