A Slippery Slope...
“Drug addiction" is not an instantaneous state of affairs.
It is usually a gradual transition into a deeper and deeper hole of dependence and behavior changes. In our dental practice we've seen families struggle on this slippery slope and it is heart breaking. But there are some good strategies for catching things before they go too far, so I thought I'd share some observations today.
First, let's be honest about our own youth. We all tested the waters on a few things we don't like to admit. But most of us did not fall over the edge into an abyss. Why do some people become addicted and others not? Where is that tipping point?
Finding it is the key to keeping our kids out of a life long battle.
I've noticed that addiction most often starts at one of two simple starting points:
1. And innocent prescription drug exposure, like taking a heavy duty pain reliever after wisdom tooth extraction.
2. Or a poor social/recreational decision influenced by friends that are already down the path of experimenting with drugs.
There are many other starting points, but those are the most common, so if we can keep our kids out of those two situations, we might have a fighting chance at keeping them out of harms way.
As to the prescription pain relievers after wisdom teeth...
I've had so many people tell me that an authentic prescription from a doctor was their first foray into "altered states." And since it all seemed above board, the line was too blurry to observe later when they were offered another dose at a party or by a "friend."
Every journey starts with the first steps.
My advice is to try to tough it out with Ibuprofen and Tylenol after wisdom teeth and small surgeries. Pain is part of life. Most people can get through those first few days with over-the-counter pain meds if you take them exactly by the clock. Don't wait for things to hurt again before taking more. Take them every 6 hours like clockwork. Then after 3 days, you should be out of the woods.
If the prescription pain relievers can't be avoided, keep those kinds of pain meds to the first 2 days only after wisdom teeth extraction and then just tough it out with Ibuprofen and Tylenol.
As to the influence of friends who may already be experimenting with drugs...
As a parent myself and a healthcare provider, the best advice I can give you is to be mindful of the kinds of friends your kids keep. We have been given good parental instincts by evolution. Use them.
It's ok to just say "no" to things, and then be an active part of redirecting their time and focus. Now it's much harder to start bossing kids around at age 14, when they've already been independent all along. So the sooner your kids learn to hear an unambiguous "no", the better. It's something we have to commit to, and stick with early on.
If you've got a bad feeling about a friend, girl friend and boy friend, your instincts may be right. Have them around your house more often, find something you can all do together and you will have the opportunity to check out your intuition. If you were right, just say "No, I don't think Bobby values the same things we do in our family. You need to find a different friend that is a better fit."
And then that's it. Stay firm. Have consequences laid out and enforce them if you don't get buy in. Most importantly, find some positive alternatives. Offer to host some pizza parties with kids you trust more. Engage in inviting others over.
Again; it's hard to start this in the teen years, but nothing says you can't do it then. You'll just have to be much more engaged in creating alternatives and keeping better choices positive.
But the bottom-line is this: You have a lifetime of experience telling you who to avoid. Our kids don't have that experience, so we have to be responsible for teaching them how to use this kind of intuition.
DON'T BLAME YOURSELF: HERE'S IS A LITTLE SCIENCE...
And important thing to remember if you are already in this downward spiral is that blame is not very useful. There is plenty of evidence to show that some kids are wired differently. It's brain chemistry and there are certain dispositions that make addiction a possibility.
Here is an excerpt from a great article in the journal Scientific American, which can be found at: https://www.scientificamerican.com/article/the-addictive-personality-isn-t-what-you-think-it-is/
Longitudinal studies looking at addiction risk have found three major pathways to it that involve temperamental traits, all of which can be seen in young children.
The first, which is more common in males, involves impulsivity, boldness, and a desire for new experience; it can lead to addiction because it makes it hard for people to control their own behavior.
The second, which tends to be seen more in women, involves being sad, inhibited, and/or anxious. While these negative emotions can also deter experimentation, when they do not do so, people may find themselves on a “self-medicating” path to addiction, where drugs are used to cope with painful feelings.
The third way involves having both an adventurous and a cautious side. This is where people alternatively fear and desire novelty and behavior swings from being impulsive and rash to being compulsive, fear driven, and stuck in rigid patterns.
All three pathways really involve the same fundamental problem: a difficulty with self-regulation.
This may appear predominantly as an inability to inhibit strong impulses, it may be largely an impairment in modulating negative emotions like anxiety, or it may have elements of both. In any case, difficulties with self-regulation lay the groundwork for learning addiction and for creating a condition that is hard to understand. The brain regions that allow self-regulation need experience and practice in order to develop. If that experience is aberrant or if those brain regions are wired unusually, they may not learn to work properly.
I like the way they put that because we can often see those tendencies early and be more judicious as parents, and if we already have a child in some addictive difficulty, we can look back in retrospect and see where this all comes from.
Again, blaming ourselves is not very useful, so let's get to taking action as early as possible...
Next up: A Good Course of Action:
The following information is adapted from some resources given to me by a local physician whose opinion I value greatly.
Act Now: Begin to more closely monitor your loved one’s activities. Keep track of changes in behavior, appearance and friends. If appropriate, find out who is on your loved one’s social media and buddy list, and what sites are bookmarked as favorites. If your loved one is very young, and you are suspicious, you may have to be bold enough to put "privacy" issues aside.
Don't Make Excuses: It's natural for parents to be tempted to make excuses for their child or loved one’s behavior - but this type of enabling actually makes it harder for a young person to become responsible and self reliant.
Have the Talk: Let Them Know You Know. It's not easy to confront someone with your concerns, even when it is your own child. It is much harder to simply watch and worry when you believe your family member is following a self destructive path. Have the talk when you are calm and have plenty of time. Pick a time when your loved one could not possibly have become high in the last 12 hours - even if it means waiting a day.
Remember that you are not the first parent to deal with these issues, and you don't have to do it alone. Discuss the situation with someone you trust. Take the time to take care of yourself while you are in the midst of this situation.
Here is a great script for having your first confrontation with a loved one about the problem:
The 'See It - Say It' Six Step Process
Information adapted from Central CAPT's “Walking The Talk” manual- (800)-782-1878.
After looking over the signs and symptoms of meth use, do you think it is time to have "The Talk" with your child or loved one? Take a deep breath. This might be one of the hardest things you'll have to do as a parent or friend.
Be prepared. Practice what you want to say, and how you want to say it. Brace yourself for any type of reaction from your child or loved one - from denial to anger to confrontation. Children will sometimes try to throw their parents' history at them to deflect attention from their own behavior. Your child may ask questions about what you did when you were young. If so, it is best to be honest. If you try to deceive your child and the truth comes out later, you will lose credibility. If you drank underage, or used drugs in the past, connect your use to negative consequences: "I drank alcohol and smoked marijuana because I was bored and wanted to take some risks. But I soon found out I couldn't control the risks. I lost the trust of my parents and my friends. There are better ways of challenging yourself than doing drugs."
The following process may help you initiate and complete a conversation with your teen if you are concerned about Meth use or other substance abuse.
"I Care" - Don't just jump in to the conversation with a list of complaints or accusations. Let your teen know your love and concern is still uppermost in your mind. This can help to diffuse defensive feelings and responses.
"I See" - Be specific about the things you have observed that cause you concern. Try to remain calm, unemotional and factually honest in talking about your child’s behavior. Explain what changes you've seen in your child’s behavior, appearance or attitude that is causing your concern. Focus on the concerns and why they worry you.
"I Feel" - Be honest about how your child's behavior makes you feel. This will remove the sense of blame, helping you sound less judgmental. You don't need to make assumptions about the cause of the behavior, or diagnose anything. You just need to be concerned. This is no easy task; your feelings may range from anger to guilt that you have "failed" because your kid is using drugs. This isn't true, and by staying involved you can help your child or loved one stop using and make positive choices.
LISTEN -This may be the hardest step for some parents. It requires you to be quiet and respectfully listen to what your child or loved one has to say. Allow plenty of time for your child to share feelings, problems and explanations. Be prepared for a variety of responses, including silence, tears, the disclosure of a significant problem, anger or even hostility.
"I Want" - Be ready to be specific about what changes you want to see in your child’s behavior. First, acknowledge what your child has said and shared. Then, explain what action steps you want to see taken. Suggest, don't demand, what you want to see happen. If possible, allow your child or loved one to come up with a workable solution. ****Remember, often referring for professional help is the most caring thing you can do.
"I Will" - Be ready to share what you will do to help your child or loved one change and reach the new goals. Will this include providing moral support? Arranging a meeting with someone who can help? More listening? Make it clear that you are willing to keep talking, and if your child chooses to say nothing right now, the door is open for future discussion. When discussing these next steps, you can include setting new rules and consequences that are reasonable and enforceable. Be firm but loving with your tone and try not to get hooked into an argument.
And as always, if you have any inclination to suspect someone you love is on a slippery slope with addition, discuss this with professionals: a doctor, counselor, mental health provider. This is too important to ignore.