Right at the
top of virtually every parent's concerns is the fear that their
children might become involved with drugs. And they are right to
be concerned. Whether in cities, suburbia or rural communities,
whether in wealthy or poor neighborhoods, drugs are now readily
available to all young people. And even the seemingly nerdiest kids
can speak with apparent fluency and familiarity about marijuana,
cocaine, heroin, and such strange-sounding things as blunts, ecstasy,
roofies, Special K, and crystal meth.
Drugs are an
equal opportunity destroyer. Fifty percent of young people have
used an illegal drug by the time they leave high school. What's
a parent to do? How can you predict if your children are going to
use drugs? What can you do to prevent it? How can you help
The first step
is to understand why Sally or Johnny might be using drugs. Researchers
have identified over 50 factors that might put someone at risk for
drug use. These risk factors can be found at the individual, the
family, peer groups, and broader community levels. They include
things like having too much free time, weak family structures, peer
group, social pressures, and the glorification of drug use by some
in the popular media. But those risk factors really only talk about
overall probabilities of whether young people with certain characteristics
might be more or less prone to using drugs.
Knowing about
these risk factors can help keep a parent alert, but no set of risk
factors determines that a particular child will use drugs, and many
kids who have many of those risk ractors don't even try drugs. So
parents really have to deal with the individual child's situation
and state of mind.
Two Paths To Drug Use
Research on the pathways to drug use and addiction suggests the
immediate decision to use drugs is driven, basically, by one of
two types of reasons.
One group of
young people seems to use drugs simply to feel good. They are seeking
novelty or excitement, to have a good time. I include in this group
those who say they use drugs just because all their friends are
doing it; they just want to join in common fun or to be "cool."
These kids are the ones most likely to be responsive to prevention
programming that educates about the harmful effects of drugs on
their bodies, and are most influenced by the powerful protective
factor of having strong and loving parents interested and involved
in all aspects of their lives. These kids also seem to have the
best chances of being successfully taught to seek alternative ways
of having fun and to resist the temptation to seek novelty in drugs
and other harmful ways.
But there is
also a second, very different group of young people who are using
drugs for quite different, actually more intractable reasons. These
are kids who in some way or another are suffering and use drugs
to try to make themselves feel better, or even normal. This group
often includes people stuck in very difficult life situations -
poverty or abusive families, for example. It also includes kids
suffering from a variety of untreated mental disorders, like clinical
depression, manic depressive illness, panic disorders, schizophrenia.
Estimates are that as many as 10 million children and adolescents
may suffer from emotional and psychiatric problems of such magnitude
that their ability to function is compromised, and the majority
of those kids are at extremely high risk of becoming addicted to
drugs.
These young
people are not using drugs just to feel good. These children are
actually trying to medicate themselves with drugs. they use drugs
becase they think they will make them feel better, or normal, in
the same way that other people might be given anti-depressants or
anti-anxiety medications.
The problem,
of course, is that using illicit drugs is not an effective treatment.
In addition to other, perhaps more obvious problems - like that
their use interferes with normal functioning - this kind of drug
use actually will ultimately make them feel worse, not better. Medical
research has shown clearly that this kind of drug use only exacerbates
underlying psychological problems.
Treatment Different For "Self Medicators."
Both the preventive and the treatment approaches for these "self-medicating"
young people need to be quite different from the approaches one
would use with novelty seekers or social users. For example, it
can't be very meaningful to warn people who feel terrible today
that using drugs may alter their brains a month from now. Their
problem is getting through today. And encouragement to seek alternative
sources of fun or to seek nicer friends doesn't seem very meaningful
for them either. Again, they are trying to get through today's issues.
Even the otherwise powerful protective factor of loving, supportive
family involvement in the life of the child is not very effective
in these areas. Those young peopie who are trying to self-medicate
must have help with their underlying problems. They need professional
treatment.
Whatever the
reasons, how do you know if your children are using drugs and what
do you do if they are? Telltale signs include recent mood and energy
level changes, changes in eating habits, specific signs like redness
around the eyes, and changes in social and educational performance.
Listen carefully to what your children are telling you about their
lives and how they feel. And watch how they behave. It may seem
natural for an adolescent to be a bit surly, but most adolescents
are not actually sullen, withdrawn, apathetic and lethargic. You
should talk to your child about any of these symptoms. You do need
to know.
What Can Parents Do?
What, if the answer is "yes," your child is using drugs? What do
you do? In a small percentage of cases, parents can work with their
own kids to get them to stop using drugs. This might be easiest
when the young person is just using drugs occasionally to have a
good time. And, of course, the earlier you start talking to your
children about drugs, the better the chances are they won't become
involved with them. If a child reaches the age of 20 without using
alcohol, tobacco or marijuana, the probability is almost zero he
or she will ever develop a serious drug problem.
But if you
suspect your child is really trying to self-medicate, or if you
suspect your child is using regularly or even is addicted, you need
to get help right away from the professionals. These are not problems
the typical parents can handle alone. And help is available. There
are many professional social workers, nurses, drug counselors, psychologists
and psychiatrists well trained to deal with both mental disorders
and drug use problems. Your child's school, your family doctor,
or community health center can help get you a referral. Do not assume
Sally or Johnny's drug use is just a passing phase or something
every kid must go through. It isn't. It may well be the beginning
of a lifetime of problems that could be prevented with early intervention.
Alan I. Leshner, Ph.D.
Director, National Institute of Drug Abuse, National Institutes
of Health
6001 Executive Boulevard, Room 5213
Bethesda, MD 20892
Phone: (301) 443-1124
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| An evaluation
of a family-directed program designed by public-health experts at
the University of North Carolina (UNC) at Chapel Hill found that
the program works in reducing adolescent tobacco and alcohol use,
according to a March 30 press release.
According to
UNC public-health experts, the family program they designed, implemented
and evaluated reduced first use of tobacco among adolescents by
about 25 percent among white teens for at least a year, and possibly
much longer. When all teens in the study were included, the reduction
was 16.4 percent. Furthermore, the program helped to discourage
alcohol abuse.
"We had a national
sample of pairs of adolescents and parents, which we randomly assigned
to receive the program or not receive it," said Dr. Karl E. Bauman,
professor of health behavior and health education at the UNC School
of Public Health. "We gathered data from all the pairs before the
program began and then at two points after it was finished, at three
months and again at 12 months. The intervention had substantial
effects in reducing beginning tobacco use among adolescents."
Called "Family
Matters," the UNC-designed program is home-based rather than school-based.
The program centers around better communication and includes telephone
calls from health educators and a series of four work booklets designed
to offer information to parents and adolescents about the dangers
of tobacco and alcohol, improving family communication skills, tips
for avoiding peer pressure, and the like.
"Smoking has
been identified as the single-most preventable cause of premature
death in the United States, and most people begin using tobacco
products during adolescence," Bauman said. "Programs currently or
recently in use in the vast majority of school systems in the U.S.
have been found not to have any behavioral effects at all or effects
that are modest. That's why it's important to look for other ways
to impact adolescent tobacco and alcohol use."
Bauman added,
"Involving families has been a key obstacle to successful implementation
of family-directed programs not closely tied to the adolescent's
school homework assignments. Participation in our program, however,
compared favorably with that in other programs, presumably because
the demands on the family for participation were relatively low."
A report on
the continuing research is published in the April issue of the American
Journal of Public Health.
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Hello Patients,
For
many years I have been fearful about the potential of disease caused
by prions. Prions are like a medical science fiction writers nightmare.
They are way smaller than bacteria, smaller even than viruses and
contagious. They are also passed on genetically. They are too small
to easily identify. Long ago I used to tell people that the UCSF
researcher who discovered them would win the Nobel Prize for his
discovery. Foolishly perhaps, I neglected to place a bet. He did
win the Nobel Prize and we now have Mad Cow Disease. I am afraid
that there will be other prion-induced disease or maybe there already
are ones that we don't recognize.
Scary huh?
Mad Cow Disease
(medically we call it bovine spongiform encephalopathy - BSE) has
now been identified in most countries of western Europe. This disease
is transmitted through eating contaminated meat. The disease takes
years to develop so no one who has lived in Britain since the late
1980's, regardless of the present health condition, is allowed to
donate blood in the US. The US bans importation of beef and bone
meal from British cows. Bone meal has been identified as the source
of the spreading European epidemic. The US continues to import other
bovine products including milk, blood, fat, gelatin, bone mineral
extracts, collagen etc. The most heavily prion contaminated parts
of the animals are nervous tissue (brain, spinal cord) and digestive
tract.
European scientists
believe that infectious prions do not appear in cattle until they
are over 30 months of age. The older the animal the more infectious
they are. All meat from cattle older than 30 months must be destroyed
unless the brain tissue has been tested free of BSE. In France they
test 20,000 slaughtered animals every day. The animals must be killed
to be tested.
The problem
has risen essentially from cannibalism. The first disease now known
to be caused by prions was Creutzfeld-Jacob disease which is a brain
disease among South Pacific peoples who practice cannibalism. Animals
that eat their own species - now resulting from modern feeding practices,
give rise to these diseases.
I am concerned
about farm raised salmon as they are commonly fed fish meal. Whole
Foods recently told my wife the salmon they were selling was wild.
I asked her to confirm and they told her it was farm raised but
"our producers give them organic feed". I asked to see the feed
contents - It was a Monsanto product (not exactly organic huh) containing
"fish meal".
I am concerned
about chondroitin as it is usually produced from beef trachea.
I am concerned
about calcium supplements containing "bone meal" or hydroxyapitate
(also derived from bone meal).
I am concerned
about glandular extracts used as dietary supplements. In the past
I contacted Phytopharmica, a company who sells these extracts. They
told me "we test for all diseases". This was disturbing as there
was no commercially available test at that time. Today they told
me they are concerned so they import animal products from South
America and New Zealand where this disease has never (YET I fear)
been identified. I also called Standard Process who having been
making glandulars longer than anyone I know of but I haven't heard
back from them.
What about
other diseases? Could other mysterious diseases have prion origins?
We just don't know. I think we are just starting to see beyond the
tip of the ice berg.
I think you
can now understand why I am concerned. I am sorry if this frightens
you but you need to know. Glucosamine is good. Wild Pacific salmon
is great. Calcium citrate or malate is fine. I even eat farm raised
salmon occassionally. However, it is hard to use the fork with my
fingers crossed.
Best,
Michael Carlston
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Hello Patients
And Friends,
First in a reminder of the dangers of unthinking overuse
of medication the FDA has recommended that a common ingredient in
over the counter cold and diet medicines be changed to prescription
or withdrawn. The FDA panel has determined that phenylpropanolamine
causes strokes, most notably in people under age 50. The point is
that this agent is hardly effective anyway so why use it given the
risk?
Second
is that my office is sponsoring a talk on therapeutic cosmetic products
that contain herbs and newly devleoped topical antioxidants. I am
particularly excited about the antioxidants as I've been looking
for skin products of this sort for over six years. That was when
some of the first studies appeared showing the ability of topical
vitamin C to reverse serious skin damage. The technology to create
an effective stable form of topical C and put it into a commerical
product took awhile. Among these products are sun blocks that can
reverse precancerous skin damage and prescription cosmetics that
treat acne, dry skin, age spots and some wrinkles. This free talk
will take place Thursday November 2 from 6:30 - 7:30. The speaker
will give away a gift basket of products worth $175 to one audience
member. Call the office (545-1554) to register.
Last
but not least - Here are two ways to get foundations to donate to
breast cancer research that are legitimate.
1.) Go to http://www.nfl.com/
and click on NFL for her. Help the NFL fight breast cancer.
Log on to NFL.com on Tuesday, Oct. 24, the NFL's Breast Cancer Awareness
Day, and visit NFL For Her. The NFL will donate $5 for every page
view, up to $50,000, to the Komen Foundation. Plus, check out Nicole
Miller's NFL products that are aiding the fight against breast cancer.
Log on to make a difference!
2.) Click on the pink ribbon on
http://health.yahoo.com/, Yahoo will donate $1.00 to the Susan
G. Komen Breast Cancer Foundation.
You have to click on the ribbon not the line below it.
Best,
Michael Carlston, M.D.
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