Friday, May 12, 2006
Parents hear straight talk on drugs and alcohol
Filling the Robbins Library to capacity, parents and community members, including Carlisle Chief of Police John Sullivan, gathered on April 27 to hear Dr. Henry Abraham speak. He is a co-recipient of the Nobel Peace Prize, and the author of What's a Parent to Do? Straight Talk on Drugs and Alcohol. He is also a member of the psychiatry department of Harvard Medical School, director of the Substance Abuse Programs and clinical professor of psychiatry at Tufts University School of Medicine and chief of Clinical Alcohol and Drug Treatment Services at Brown University.
With a warm approach to a serious subject, Abraham immediately made the audience feel at ease, using his "not-so- perfect" family at times as examples. Abraham said he was driven to write his book for personal reasons. "Two children of friends of mine died from drugs and alcohol," he said. "I wondered what we are doing wrong that we are losing good, healthy kids." He is himself a parent of three kids — "A good week was when one kid did not appear in the Lexington Police Blotter" — he wanted to pull together information which would help parents "prevent disasters."
Cigarettes — a "gateway" drug
When he asked the audience what the most dangerous drug is, most said alcohol. However, Abraham said it is cigarettes, which he defines as a "gateway" drug. Kids start out with what is legal, he explained. If they are smokers, it is easier for them to try marijuana. He told the audience a story about his son, who came home with a pack of cigarettes. After destroying the cigarettes, he told his son, "I have a technique of checking you. I smell you. I am going to hold you and smell you." In response to a question from a parent who used to smoke, he said modeling behavior is "terribly important." Smoking parents lead to smoking children, he said.
Recognizing that a gene is associated with alcoholism, studies are being done with identical twins to determine the impact of the gene. Unexpectedly, the study showed the incidence of alcoholism is 50% of the genetically suseptible twins. "The other 50% is environmental," he explained. The largest environmental factor, he said, is the influence of the child's mother and father.
Abraham suggested that, "If alcoholism is in the family, break the news to your kids." All families have genes that can lead to illnesses such as heart disease, and it is important to explain the role a gene may play in the child's life.
How parents portray alcohol in the home is important. If parents need two or three drinks every night to relax, their actions are sending a message to their kids that drinking is the way adults cope with stress. In response to a question on social drinking in the home, he said he himself drinks socially in his own home and feels moderation is a good model. "What you do is a message to your kids," he explained, "Clean up the act at home and that makes an important impact to the kids." But, asked a parent, saying they have alcohol "all over the place," does that mean they should lock it up? No, replied Abraham, people should not live in an "armed camp." Parents need to educate their kids and set limits. And, he suggests, simply "count the beers," and let your kids know you are "on the watch."
Children drink in own home?
Two parents asked about the practice of allowing older children to have wine with dinner. He agreed that legally a child can be given alcohol in their own home. "The answer has to reflect the culture of the family," he said. In France it is common to have children drink wine with a meal. But, he pointed out, "France has one of the highest levels of cirrhosis of the liver in the world."
The problem, which he details in a study he authored, is "the livers of children are not the same as 40-year-old males." A small amount of alcohol causes brain toxicity in children. Additionally, older children lack judgment to know when they have had enough. Alcohol makes them drunk very fast and very sick, he explained. A partying teenager could drink six beers without first feeling the effects, but after an hour the beers will metabolize and the child will have alcohol poisoning. And, he pointed out; teenagers seldom have one drink with a meal, but are instead drinking to get drunk. His best advice, he said, is that parents do not offer alcohol to their children.
If a child who has experimented with alcohol shows such behaviors as blackouts, the child "has crossed the line." If the child can't wake up from drinking, he said, it is very important to go to the emergency room.
In his book Abraham lists "red flags:" behaviors which are indicators of problems for which parents should watch. Kids who talk a lot about drugs, or have friends who talk about drugs, is a red flag, indicating, he said, the child may be moving toward the direction of using a drug. Another red flag is a child who is a risk-taker. He held his hands out to demonstrate a horizontal scale, with wild kids on one side and the children who are afraid of attending proms and would rather "stay home and practice the cello" on the other side. "If you have one of those (who are afraid of proms), don't buy my book; you've got to buy another book." In the middle are moderate risk-takers who want to have fun but are not in immediate danger.
Abraham also described what he calls "golden halos," which are behaviors that help keep kids from drugs. A child is less at risk if he or she understands the point of doing well in school and receives good marks — it doesn't have to be 'A's', he pointed out. "If your child comes home with a 'B,' you say 'Bravo.'" Other golden halos include religion and sports. "If you have kids that are interested in religion and you are an atheist, you drive them to Sunday school." Sports offer a child a way to identify with a team. All these behaviors are positive and lower the risk for children to become hooked on drugs or alcohol. Evidence shows, he said, that family dinner affects the risk of drugs because everyone is connecting.
Depression is a warning sign, Abraham said. Describing a scenario in which a child would be tempted to take drugs, he said if a child is walking alone in a playground, feeling depressed, and a kid offers him something to make him feel better, he may try it. All street drugs are anti-depressants. After the child feels better he may "go looking" for the kid who gave him that drug and "a new drug addict is born. If a kid gets "A's" in sixth grade, and in seventh, eighth, and ninth, his grades go down," and he is less and less interested in school, get him evaluated by a social worker, a pediatrician and a psychologist.
A parent asked if a child with ADHD (attention deficit hyperactive disorder) has a higher risk factor. "Good premise," Abraham said, "but not correct. Kids with ADHD have no higher risk than kids without ADHD." However, kids with conduct disorder are at risk. These children, he explained, are the ones that break windows at age three, fight, are rough, and attack teachers. They are at high risk for drugs.
But if a kid who has ADHD can't sit still in class, the child will have a problem with the school, he continued, and noted that ADHD is a treatable disorder. "I hate to say it," he said and hesitated, looking around. "Do you have anyone from the School Committee here?" After the laughter ended, he continued, "You've got to protect the child from the school system." The school system, he warned, will identify the kid as tough to work with. "This child will begin to think there is something wrong with him, that he must be dumb. Treat him."
Caffeine is not considered a gateway drug but, Abraham said, "it is an interesting drug." It can be used to speed up cognitive functioning, he said, relating a story of a college student who needed to "tune up her nervous system" to work a bit faster. He prescribed caffeine rather than put her on drugs. Though caffeine is safe, he added, if a child can't sleep, or is having migraines or panic attacks, "then the line has been crossed for caffeine."
A parent who said she had perhaps a "checkered past" wanted to know at what age should a parent share the truth about their drug experimentation. It depends on how "checkered" the past is, Abraham said. He suggested the parent offer this explanation: "Yes, I did try marijuana in college, but I made a mistake and I was lucky. I saw how drugs did terrible things to people in my generation."
If parents suspect a child is using marijuana, check the child's room, he suggested, especially under the mattress. "Why do they always hide things under the bed?" he asked.
If a child has experimented one time with marijuana, he said, don't have hysteria about it, he suggested, but do "play all the cards you have as well as you can," and take control of the situation. He pointed out that marijuana is dangerous to those who are in recovery from drug abuse. The symptoms of marijuana use can be seen for more than three days, and include a reduction in caring about things the child would normally care about, and inability or lack of desire to focus.
A parent asked about the effect of the socio-economic class on the risks for the child. "All kids are at risk," Abraham answered, but it is a complex situation. Kids in the suburbs can afford hallucinogenic drugs, whereas kids in the city may use drugs such as heroin to "turn off" their environment.
Clean out medicine cabinets
Abraham pointed out that drugs are already available in the home. The medicine cabinet is lethal, he said. He suggested parents check for old medicines which are out of date, or were used only once, and throw them away." A parent asked about cold medicines, saying her child seems to need Nyquil multiple times a day. Abraham expressed concern and suggested it was something to discuss with her pediatrician. Also, he explained, "a small percentage of kids get involved in breathing in organic substances." He said they are called "Huffers," and can be identified because "they smell like paint, look bad, dress bad, and can't keep up with other kids."
Transition to college
Abraham said the most dangerous school year is the first year of college, when they leave home and the protection of their parents.Though drinking under the age of 21 is illegal, colleges continue to have problems with drinking and drug use. Many colleges are offering "wellness dorms," in which students agree to a host of rules about drugs, alcohol, smoking, and noise restrictions. Studies show the dorms are effective, but the concepts brings into question why the non-wellness dorms are not being more strictly monitored for illegal behavior. Abraham said that one college kid in four fulfills the diagnostic criteria for alcohol abuse.
Peers are important
Peers are very important, Abraham said, and suggested parents take time to find out where their students are going and who they will be with. "Your child's friends really do have a significant impact on your child's behavior." But if the child's best friend only seems to have first name and cellphone, he said, then "something is wrong with that picture."
Abraham encouraged parents to let their child invite kids over, let them hang out in the basement, and supervise what is going on. When children go to parties, he said, make sure there's no alcohol served and that there is an adult there. "These are basic principles. That's why these kids can't run for president and can't have their own apartments," he said. "They're children." He told parents to be firm even if their child complains. If you do not check up on them, "what you are setting up is Lord of the Flies." It is not an easy thing to do , he admitted. "Even sober they may break up the furniture." But better to have broken chairs, he said, then broken children.
"If a kid is using [marijuana], how far do you go?" asked a parent. If a kid is a frequent, heavy marijuana user and can't stop, Abraham responded, it is "time to roll out the artillery." Have the child assessed by a pediatrician, psychologist, and a psychiatrist, he said.
"What are the steps of getting professional help?" asked another parent, who said it is difficult and frustrating to decide on what kind of help to get. "You can't create a treatment by a single therapeutic act," replied Abraham. "You need a network and the more people involved in that kid's life the better the prognosis." In addition to a pediatrician, psychologist and a psychiatrist he recommends integrating many support services such as a therapist, drug counselor, AA (Alcoholics Anonymous), a sponsor in AA, psycho-pharmacologist, guidance counselor and other school support, family therapist, and assessment for depression. "There's a spectrum of things. You have to do
them all and when you do, you increase the chance this kid will make it."
He closed by reminding parents that the goal is to tip the balance from danger to safety. "Every little positive movement moves your children away from the danger," he said.
The evening was a collaborative presentation between the Concord/Carlisle Parents Initiative, the Center for Parents & Teachers, Carlisle School Association and Carlisle Public Schools. Attendees were asked to make a five dollar contribution to the fifth grade Carlisle School D.A.R.E. (Drug Abuse Resistance Education) program, which is a police officer-led series of classroom lessons on ways to resist peer pressure, and refuse drugs and alcohol (see www.dare.com).
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