Question: Hi. I am a 22 year old college graduate. Unlike every other person I know, I have never smoked marijuana or done any drug at all. This is always shocking to people when I tell them. I don’t know why now but I am curious to try marijuana. I am a social drinker but I don’t have any over drinking issues (like a lot of my friends do). Realistically, is there any reason why I should not try this?

Rev. Christopher Smith Says...:

There are long term and cumulative effects of using marijuana. While these types of effects come from repeated use, someone who just wants to "try" marijuana needs to carefully think about their motivation. If they have a good experience, is there the possibility of using it again? If there is then this "simply trying" could really lead to these long term and cumulative effects. While there is not the same degree of addictiveness as some other drugs, it is generally agreed that there can be an addictive nature to use of marijuana. While not having a problem with another substance (alcohol) may mean that it is less likely for you to have the biological and personality base for addictions, there is no guarantee of that.

There are also short term effects of using marijuana, even for a single time. While using it gives the user a temporary high, that is all that it is and after the high it is possible to feel depressed (which is one reason that some people would use again). While high, your senses, reaction time, and coordination are also affected and this can lead to other problems. For some people the high can also be accompanied with anxiety and panic while for others these can be removed for a while. If you are male testosterone levels (and resulting fertility and libido issues) can be effected. Another short term effect of marijuana use is that it can raise the heart rate significantly and there are studies that show that some heart attacks are related to this. This list of effects are related to single use or trial of marijuana. There are also health conditions (such as diabetes) you might have that also create different risk factors when you try it - what would your doctor say about anything that you currently have? Additionally, because marijuana is not regulated, you are not certain about how much THC you will actually be consuming and you do not know if there will be any other contaminants in what you try.

I would also be remiss to not address the premise that has led to the curiosity about trying marijuana. It is highly unlikely that everyone you know has smoked marijuana (or done other drugs). WebMD reports that one in three people have used marijuana. So why is there the difference? Two major factors come into play around this that are similar for other adolescent/young adult behavior (such as drinking, partying, sex). The first is that some people who have not engaged in the behavior will say that they have in order to "appear cool" (or whatever the current phrase would be). The other factor is that adolescents/young adults are more likely to talk about doing the "popular" behavior. As you hear about people who are smoking marijuana, it is easy to think that everyone (those you hear from and those who are being quiet) is smoking marijuana, when in fact this is not the case.

There are real considerations about your curiosity and about the effects of marijuana. As you consider these and make an educated decision, it is possible to be comfortable with not "trying" marijuana and realizing that you are in the company of more people than you think. As you do this, you can find wholeness and peace in your life.

Question: Dear Friend, I am a psychotherapist in South Jersey. Two years ago one of my clients in recovery struggled with how to explain alcoholism to his young daughter. He was concerned that she would hear from neighbors and family members that Daddy was a "drunk". After an unsuccessful search for the perfect children's book to help him and his daughter he asked me to write one. "Daddy's Disease" is the result. “Tommy doesn’t know why his father doesn’t show up for dinners, or soccer games or why he acts funny sometimes. Tommy thinks it’s because his father doesn’t want to be with him, that he hasn’t been the best boy he can be, that he should try harder. But, Mommy tells Tommy that Daddy has a disease called “alcoholism”. She helps Tommy, and his faithful dog Murphy, understand what this disease is and how it affects Daddy, and the whole family. She teaches Tommy that he is not responsible for Daddy’s behavior and that gives Tommy the peace he needs to foster a healthy childhood.” In an easily understood, beautifully illustrated style, "Daddy's Disease" helps families to navigate the difficult waters of alcoholism. It is my hope that you will consider making this information available for the many children and adults who have been struggling with this devastating disease. Please feel free to contact me at 856-296-3775 with any questions. I thank you for your time and consideration and for all the good work you do. Best, Carolyn Hannan Bell - www.alcoholismhurtskids.com

Rev. Christopher Smith Says...:

Carolyn,

Alcoholism is a serious disease that can do a lot of damage within a family.

Having not seen the particular book (which I would be willing to do), I cannot comment on whether the book provides a good message in a way that children would understand. This is certainly a challenge that surrounds addictions and serious mental illnesses alike. Having a resource that explains things without feeding into the stigma that society often surrounds these with is important. This is especially important because of the greater risk that children of people with these conditions have of also getting these conditions. There are appropriate preventative steps that can help to have a greater chance of breaking the cycle and lessening stigma around them will mean one less barrier to be faced to getting treatment if they need it. What has not been described in this description is an understanding of the damage that enabling behavior and codependency can also take. This is something that I would want to carefully review before encouraging people to use this book.

I would also suggest that if the book is good at addressing these matters, that rather than approaching experts about the book that you might want to approach those who run Choose Help to see how they might be involved in your marketing of the book.

Question: I am a scout leader working young teenage boys. Several of the parents have approached me and asked me to add a substance abuse prevention component to our curriculum. Drugs and alcohol are issues in our community. I am not sure whether or not I am an appropriate person to do this but I would like to help if I could. Do you know of any programs that would be suitable for my situation. Ideally I’d like something that I could cover in about 15 minutes, once a week, over 20 or 30 weeks. I would be very appreciative of any direction you could provide. R. Miller.

Rev. Christopher Smith Says...:

There are quite a few educational programs out there for helping youth understand about substance abuse and to change/maintain their behavior towards it. Most of these are not provided in the long series of 15 minute sessions that you describe. You may be able to design something by piecing together different resources that are available.

Over a decade ago, the Boy Scouts of America did have some curriculum pieces on substance abuse. This would be dated by now, but I would encourage you to check with your local council to see what might be available. There is a resource called "Drugs: A Deadly Game" aimed at Webelos that states it is targeted for use through high school but I have not used the program so I cannot comment on it. Information about it does reference a National BSA Drug Prevention Task Force. Beyond the formal programs that are available, consider whether it might be possible to ask your senior patrol leader to lead a series of discussions about how the Scout Oath and Law apply to decisions around drug and alcohol use. If you do this, you would want to sit down with him in advance but this should be something he would be able to do with his experience in scouting.

Other resources to consider are ones affiliated with other youth service programs. For instance, the Civil Air Patrol has a lot of resources as part of their Drug Demand Reduction program. Their program is centered not only on providing information and education but also at engaging youth in alternate activities that will keep them away from beginning or continuing to use drugs. Their programs also tie into the military Drug Demand Reduction programs. If you are located near a military base, you might want to reach out to the Drug Demand Reduction staff at the local base - they might even be a resource to do something as an event for you. See, for instance, http://www.army.mil/article/71395/New_York_Counter_Drug_Task_Force_Works_Against_Drugs_in_Schools/, which even features a picture of a New York unit working with a scout.

When you are looking for resources, there are also some good free resources available from SAMHSA. For instance, there are brochures aimed at youth about different classes of drugs. These could be used within your program, perhaps interspersed with other activities, to provide information about the drugs and their effects on people. Other programs have been highlighted by the National Institute of Health at http://www.drugabuse.gov/publications/preventing-drug-abuse-among-children-adolescents/chapter-4-examples-research-based-drug-abuse-prevention-progr-0 and these programs might have additional resources for you. If you are close to one of these programs, they may also be willing to include you in some of their ongoing work. You should also look at the local treatment options. If there is a counselor or treatment facility that regularly works with adolescents, they might be very willing to have someone come out to speak to your troop. If you could get a couple of them to do this, this would help relieve you from needing to be the one leading the whole initiative. There are likely to be parts of what you are wanting to do that you would not feel qualified to be the one leading.

Hopefully, this will give you some ideas of how to move forward. You probably want to help the parents understand that substance abuse prevention is not just about directly addressing substance abuse but is also about positive alternative programs such as yours. Then the idea of incorporating other resources to have a focused learning also makes sense.

Question: I am an alcoholic but I haven’t had a drink in 14 years. My dad died when I was a boy. He was an alcoholic and my uncle was a drunk who died young also…so as a family we have a pretty strong alcoholic pedigree. The problem is my son, who is now 16, never saw any of it. He was too young to remember when I was drinking and he never knew his granddad or great uncle. So he doesn’t know the horror of it and now he is drinking with his friends. I try to warn him about his risk but he doesn’t seem to listen or it doesn’t sink in. I took him to an open AA meeting but he laughed it off. It is so frustrating to watch this slow motion disaster happening. How do I get him to see that he is going to become a drunk if he doesn’t stop what he is doing?

Rev. Christopher Smith Says...:

With a family history of alcoholism, you are aware of some of the risks involved in problematic drinking. It is natural to want to protect your children from experiencing the negative consequences of problematic drinking.

Before considering your son, let us first consider yourself. Did your knowledge of the consequences of alcohol abuse and dependence in your family stop you from beginning to drink? Did your family try to dissuade you from beginning to drink? Developmentally, adolescents often have a feeling of being invincible and believe that some of the negative things they hear about as long term consequences will not apply to them.

Many years ago, you came to an understanding of the problems that drinking was causing in your life and the dynamics that take place around that. Your sobriety is a good witness, but you had to get to the place where you acknowledged that you were not in control of your drinking and that it was causing problems in your life. You had to get to that point - others may have helped you to that point but they could not decide this for you. Think about what this process was like for you and think about how this process might be for your son.

Family history and adolescent drinking both add to your son's likelihood of becoming "a drunk" but this is not a predetermined fact. This is also something that is in the future and not as influential for your son. However, in the present there are consequences of his drinking. How is his life being affected in the present because of his drinking with his friends? Are there other consequences that are appropriate? Does he understand the possible legal consequences of his underage drinking? Does he understand the risk he is creating for the person or people who are getting the alcohol for him? These aspects are more likely to have an influence on your son. Also, in examining this dimension, consider what your son is getting out of using alcohol and alternatives that might give him some of what he believes he is getting from drinking.

It also sounds like most of the discussions about the family history of alcoholism have been focused more from a scare stance. Talking honestly about strengths and weaknesses, high points and low points, patterns, etc in a way to be more narrative can make it so the stories can be heard more easily. Allow your son the opportunity to draw his own conclusions from them rather than trying to make him live the experiences of the family.

Finally, you only talk of your 16 year old son, are there other children as well? Some of the above ideas can be even more effective before they chose to begin drinking. There are also ways to reinforce positive decisions around alcohol through choices that they are making.

Through all of this, there is the possibility for you and your son, as well as the rest of your family, to experience wholeness and peace. The journey will not be without bumps. The journey will involve making some tough decisions and sticking to them. However, this is possible. You can walk with him as he comes to his own place of realizing the impact of alcohol in his life and where he is at in terms of the power of alcohol in his life.

Question: Hello Dr. Strawbridge, As of September 2012 I will start taking classes in the field of Alcoholism and Drug abuse counseling. Can you tell me in what area there is the most need and demand; either in the field of prevention or cure? Also, how is the field of drug and alcoholism prevention utilized?

Dr. James Strawbridge Says...:

Over
the years, a number of approaches have been used in the field of prevention. These include the community, schools,
the individual, the family, and peer groups. My response will focus on the
community and schools. 

COMMUNITY FOCUS 

Programs that focus on
the community address one or more of the following factors:

Availability. Most community-based
programs attempt to reduce the availability of drugs; raising the drinking age
to 21 years is an example of the principle. 

Social
climate. This concept is based on the assumption that drug abuse arises out
of environmental factors. These programs include increased law-enforcement efforts,
strong school prevention programs, concerned parent groups, and antidrug editorials
in the local papers 

Social bonding. This
concept is based on the assumptions that drug abuse from some young people’s
failure to bond to social institutions and to their norms. Programs with this
focus provide young people with opportunities to make positive contributions to
the community and to develop positive social bonds as a result. They involve
young people in community service programs such as historical restorations,
programs for the elderly, and youth job services. 

SCHOOL FOCUS

Programs
that focus on schools address the following two factors: 

Deterrence. Deterrence-based programs emphasize the importance of
consistently enforcing school drug policies. They advocate a drug-free policy. 

Lack of knowledge. This concept is based
on the assumption that young people use drugs because they are unaware of the
medical, psychological, and social hazards of drug abuse. These programs
attempt to mold attitudes and beliefs that do not support drug abuse.

Question: My wife and I both come from families that with a lot of addiction and alcoholism. Neither she nor I drink alcohol or do drugs because of what we saw growing up. We now have 2 young children and the oldest one is about ready to start pre-kindergarten. My wife was a legal assistant prior to taking maternity leave and eventually taking a few years of to be with the kids while they were very young. Money is tight for us and now that the kids are approaching school age we are discussing when, or if, she should go back to work. If she did, the kids would obviously spend a good part of the day at school and in daycare. I am concerned and have read that when children begin spending a lot of time without their parents they become more socialized by their peers, rather than mentored by an adult. In a daycare situation, there are obviously adults present, but the level of supervision does not equal that found in a family home. I have read that children in such situations grow up to be more susceptible to things like addiction and to other behavioral problems. I realize that without really knowing our situation it is difficult for you to comment on our particulars, but in general, would you say that there is any truth that having one parent remain in the home as a stay-at-home parent offers any long term protection against the problems that kids can run into when they become teenagers, like drinking, and drug use and promiscuity and criminal acts etc.? Although money would be tight if my wife or I chose to stay home, money is not the only or most important thing for us.

Dr. James Strawbridge Says...:

Your concerns are important. One particular thought caught my attention: "I am concerned and have read that when children begin spending a lot of time without their parents they become more socialized by their peers, rather than mentored by an adult. In a daycare situation, there are obviously adults present, but the level of supervision does not equal that found in a family home. I have read that children in such situations grow up to be more susceptible to things like addiction and to other behavioral problems."

States often license daycare and local agencies provide occupational
permits. Contact your state and local agencies. Asked questions. 

Re: socialization: This certainly includes day care centers, neighborhoods, peers, mass media, religion with the most important being the family.

How do parents socialize their children? This is done in two ways. The first is teaching through direct instruction reinforced by a combination of rewards and punishments for acceptable and unacceptable behavior. The second is teaching by example. Of the two, the latter is the more important since most complex human behavior is acquired through observation learning. You learned about addictions by watching your parents. You decided from those experiences that this would not be a part of your lives. Children are much more likely to do as a parent does than as a parent says. That is why parents who drink alcohol and abuse alcohol and drugs tend to raise children to do the same. You are the exception. Congratulation!

Question: My 19 year old son has ADHD and he is a high school drop-out who is only finally now doing reasonably well working as a mountain bike guide?/instructor and bike mechanic. He was never able to really handle school and I am just so relieved that he found a way to take his passion for biking and turn that into reasonably good paying employment. He is very good at what he does. He has been working full time at the shop for more than a year and he just left home to live with a couple of friends last month. I do not know exactly what is going on but my daughter, who is not one to tattle, came to me today and told me that she say James and his friends using cocaine at his apartment and when she confronted him he said that it wasn’t a big deal and that he had only done it a couple of times. I am very scared by this news and I know that his ADHD puts him at a hugely increased risk to have a problem, especially with drugs like cocaine. I do not think he has a problem yet but I want to make sure that he never does get one. I am still helping him financially and we have a good loving relationship, so I think I can ask/demand that he participate in some kind of addiction prevention program. But I am not sure what kind of program is available. Is there some kind of prevention for young adults program available? I do not think he needs like an addiction program yet, but I want to make sure he never does.

Rev. Christopher Smith Says...:

As I have not met with you, your son or otehr involved around your situation, please be advised that the answers I am giving are still for a hypothetical case of someone that might be presenting as you have described. Only someone who is able to do a full assessment can reallly answer about your situation.

It is true that some people with ADHD or ADHD-type symptoms will use substances (including cocaine) as a way of self-medicating because of the way that cocaine (and other substances) can make them feel that they are being more focused. Thus, there is reason for concern. There are two aspects that I would suggest that you consider at this point.

The first aspect is where your son is at with respects to treatment of his ADHD. You speak of him as having ADHD but give no indication as to whether he got and is still getting effective treatment for it. The fact that he never really suceeded in school and the nature of his current work would make me wonder if this is being treated well right now. If it is not, then this would be a clear red flag and possible contributor to having or developing a problem with addictions.

The other aspect is that it may be hard for you to determine the degree to which he has a problem with cocaine and/or otehr substances. Your daughter was clearly concerned enough to raise the issue to you, which is out of her character. Her report is that he admits to having used cocaine multiple times (it could be even more than what he reported and his report that it is not a big deal would be no indication that it is not a big deal - just that he does not believe it to be a big deal even if it is causing other problems). The question is what effects are being experienced as a result of his use? The information you provided and probably that you have is not enough to know where he is at on the spectrum of substance use and its associated problems. What is clear is that at this point he is not seeing his use as being a problem. As a result, he may not be ready for assistance - both in terms of being honest enough with a professional to get a real picture of where he is at and in terms of receptiveness to being impacted by the intervention.

While recognizing that the problem is not your problem, you can make gentle inquiries and encouragement to your son. But remember that this is his problem and not your problem at this stage. It would seem to me that the best initial course of action is to address the treatment of the ADHD. If this can be done in a setting or with a clinician who can also assess then address the substance use, this would be preferable. At least basic screening would be helpful at this stage.