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O D I R T U A G R T E IS NF IN OR DM CEMENT A GROWING UP DRUG FREE A PARENT’S GUIDE TO PREVENTION The Drug Enforcement Administration’s mission is to enforce the controlled substances laws and regulations of the United States and bring to the criminal and civil justice of the United States, or any other competent jurisdiction, those organizations and principal members of organizations, involved in the growing, manufacture, or distribution of controlled substances appearing in or destined for illicit traffic in the United States; and to recommend and support non-enforcement programs aimed at reducing the availability of illicit controlled substances on the domestic and international markets. www.dea.gov

The U.S. Department of Education’s mission is to promote student achievement and preparation for global competitiveness by fostering educational excellence and ensuring equal access. www.ed.gov GROWING UP DRUG FREE A PARENT’S GUIDE TO PREVENTION

U.S. Department of Justice Drug Enforcement Administration and U.S. Department of Education

October 2012 This publication was funded by the Drug Enforcement Administration under contract number D-11­ CP-0032, and in collaboration with the U.S. Department of Education. The content of this publication does not necessarily represent the positions or policies of the Drug Enforcement Administration or of the U.S. Department of Education, nor does the mention of trade names, commercial products, or organizations imply endorsement by the U.S. government. This publication also contains hyperlinks and URLs for information created and maintained by private organizations. This information is provided for the reader ’s convenience. Neither the Drug Enforcement Administration nor U.S. Department of Education is responsible for controlling or guaranteeing the accuracy, relevance, timeliness, or completeness of this outside information. Further, the inclusion of information or a hyperlink or URL does not reflect the importance of the organization, nor is it intended to endorse any views expressed, or products or services offered. All URLs were last accessed in September 2012.

Drug Enforcement Administration Special Agent Michelle M. Leonhart Administrator

U.S. Department of Education Arne Duncan Secretary

October 2012

This report is in the public domain. Authorization to reproduce it in whole or in part is granted. While permission to reprint this publication is not necessary, the suggested citation is:

Drug Enforcement Administration and U.S. Department of Education, Growing Up Drug Free: A Parent’s Guide to Prevention, Washington, D.C., 2012.

Copies of this report are available online at the DEA’s website at www.getsmartaboutdrugs.com and on the Department of Education’s website at www.ed.gov/about/offices/list/opepd/ppss/reports.html/.

On request, this publication is available in alternate formats, such as Braille, large print, or CD. For more information, contact the Department’s Alternate Format Center at 202-260-0852 or 202-260-0818.

Notice to Limited English Proficient Individuals

If you have difficulty understanding English, you may request language assistance services for Department of Education information that is available to the public. These language assistance services are available free of charge. If you need more information about interpretation or translation services, please call 1-800-USA-LEARN (1-800-872-5327) (TTY: 1-800-437-0 833), or email us via the following link to our customer support team: [email protected]/.

ii U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION CONTENTS

Section 1: introduction – How This Book Will Help You...... 1

Did You Know … ...... 1 How to Use This Booklet ...... 1 What Do You Believe?...... 3 Myth #1: My child isn’t exposed to drugs and wouldn’t do them anyway ...... 3 Myth #2: It’s normal for kids to experiment with drugs ...... 3 Myth #3: I can’t change my child’s future ...... 3 Myth #4: My kids don’t care what I think ...... 4 Myth #5: It’s okay for me to use BECAUSE I’m an adult ...... 4 Myth #6: I don’t want to alienate my child by being too strict ...... 5

Section 2: What Substances Do Kids Use? ...... 7

Tobacco ...... 7 Alcohol ...... 8 Alcohol Poisoning ...... 9 Household Products: Inhalants ...... 9 Over-the-Counter (OTC) Medications ...... 11 Prescription Medications ...... 11 Anabolic Steroids ...... 12 Street Drugs ...... 13 Marijuana ...... 13 Stimulants...... 14 Heroin...... 14 Synthetic Drugs ...... 15

Section 3: Why Do Kids Use Drugs? ...... 17

Risk Factors and Protective Factors ...... 17 Risk Factors ...... 18 Academics ...... 18 Your Own Alcohol, Tobacco, and Drug Use ...... 18 Genetics ...... 19 Online Environmental Risks ...... 19 Other Environmental Influences ...... 20

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION iii Protective Factors ...... 21 Family Time ...... 21 Open Communication ...... 21 Other Role Models ...... 21 Rules and Consequences ...... 22 Positive Activities ...... 22 School and Community ...... 23

Section 4: How Do i Teach My Child About Drugs? ...... 25

Educate Yourself ...... 25 Educate Your Child ...... 25 Be an Involved Parent ...... 26 Be Involved at Home ...... 26 Be Involved in Your Child’s Social Life ...... 26 Be Involved at School ...... 27 Be Involved in the Community ...... 28 Be a Good Role Model ...... 29 Communicate No Tolerance for Substance Use ...... 29 Talk With Your Children About Drugs ...... 29 Talking With Preschoolers ...... 29 Talking With Elementary School Students (6–10 years old) ...... 30 Talking With Middle School Students (11–14 years old) ...... 32 Talking With High School Students (15–18 years old) ...... 34

Section 5: What if i Think My Child is Using Drugs? ...... 37

Signs of Abuse ...... 37 Is It Okay to Snoop? ...... 38 How to Proceed ...... 38 Addiction ...... 40 Finding Treatment ...... 40 Recovery ...... 41

Section 6: Resources ...... 43

For Youths ...... 43 For Parents ...... 44

Section 7: Drug identification Chart ...... 49

iv U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION INTRODUCTION – HOW THIS BOOK WILL HELP YOU SECTION 1: INTRODUCTION – HOW THIS BOOK WILL HELP YOU

Section 1: introduction – How This Book Will Help You

arenting can be the most current when you communicate with rewarding job on earth—and your child about drugs and alcohol. HOW TO USE THiS Psometimes the toughest. You BOOKLET cradle your newborn the first time and DiD YOU KNOW … Rather than reading this publica­ promise, either silently or aloud, to According to a national survey called tion from front to back as you would provide the best life possible for him Monitoring the Future (MTF) taken read a book, we hope you will use or her. The years quickly fly by—and 1 in 2011 the Table of Contents to find a topic suddenly, your youngster is about to ❯ Daily marijuana use is now at a 30­ that interests you or to find a specific enter school. year peak level among high school substance you’d like to know more If you’re like most people, that is a seniors. One in every 15 high about. We’ve also included some per­ scary day. How will little Sara react to school seniors today is smoking sonal stories from parents who’ve lost being away from me? What will happen pot on a daily or near daily basis. children to drugs and a Resource sec­ if Noah misbehaves? Will the teacher tion in the back that suggests online ❯ Energy drinks are being consumed provide the attention that Riley needs in sources where you or your children by about one-third of teens, with order to learn? can learn more. use highest among younger teens. As your child grows older and These drinks are particularly continues to achieve new milestones, dangerous—even deadly—when your concerns grow, too. Can I trust consumed with alcohol. Sara being home alone after school until I ❯ Although rates of smoking have get home? What will Noah do if his friends declined among youths, 40 offer him a cigarette? Will Riley’s friends percent have tried cigarettes by tempt her to try drugs? 12th grade, and 10 percent of 12th These types of worries are normal and graders are daily smokers. show that you are a loving, attentive ❯ Alcohol remains the most widely parent who wants what is best for used drug by today’s teenagers. your child. Reading this booklet also Despite recent declining rates, sev­ shows that you are concerned and that en out of every 10 students have you want to help your child achieve a healthy, drug-free lifestyle from consumed alcohol (more than preschool through high school—a just a few sips) by the end of high dozen or so critical years when school, and one-third of students attitudes about drug use are formed. have done so by the eighth grade. Many school districts across the ❯ One of every nine high school country have had to cut funding for seniors said they’ve used alcohol and drug education programs, synthetic marijuana, sometimes making it even more important that called K2/Spice, within the you are informed, consistent, and previous 12 months.

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 1 SECTION 1

❯ The proportion of 12th-graders ❯ How to talk to your children about is more than from all illegal drugs misusing psychotherapeutic drugs and alcohol. It will suggest combined.2 prescription drugs (i.e., ways to initiate conversations with ❯ The importance of maintaining a amphetamines, sedatives, your child at different ages and close relationship with your child. tranquilizers, or narcotics other at various stages of physical and A child who gets through age 21 than heroin) is over 15 percent. mental development. without smoking, using illegal This publication was designed to ❯ What role social media play drugs, or abusing alcohol is much help you understand in what your child learns less likely to do so as an adult.3 No ❯ The substances children are about drugs. one has greater power to influence exposed to and where they get ❯ The steps to take if you suspect your child’s behavior than YOU them. It will explain the names your child may already be using do, and a close bond can spare (and “street names”) of common drugs or alcohol. your child the negative experienc­ drugs, how they’re used, their es associated with illegal drug use. This booklet also provides answers to It may even save your child’s life. effects, where children obtain questions your child may have and them, and how to know if your resources you can use to find more Throughout this publication, we child is using them. information or get help with your refer to what you, as a parent, ❯ Which children are most at risk concerns. It covers important topics can do. However, raising a drug- for using drugs and how you can such as free child is seldom done alone. Children also spend time with other offset some of those risk factors. ❯ Why drinking alcohol—even caregivers—older siblings, aunts and ❯ The importance of providing once—is a serious matter. Each uncles, family friends, stepparents, what are called protective year, approximately 5,000 young grandparents, extended family factors—at home, in school, people under the age of 21 die as a members, and many others who have and in the community. result of underage drinking, which the power to influence them. So when we say “parents” on these pages, we really mean all of the caregivers in your child’s life. We also encourage you to share the information here with them so that your child receives consistent information. We hope this booklet answers many of the questions you have about raising a drug-free child. For more information, please also visit the following websites. ❯ United States Drug Enforcement Administration: www.justice.gov/dea ❯ Get Smart About Drugs: www.getsmartaboutdrugs.com ❯ National Institute on Drug Abuse: www.nida.nih.gov ❯ The Partnership at Drugfree.org: www.drugfree.org ❯ National Institute on Alcohol Abuse and Alcoholism: www.niaaa.nih.gov Additional resources are listed at the back of this publication.

2 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION INTRODUCTION – HOW THIS BOOK WILL HELP YOU

WHAT DO YOU BELiEvE? A myth is something we believe FAMiLY TiES without having any proof one way The National Center on Addiction and Substance Abuse (CASA) defines family or the other. Many parents maintain ties as the quality of the relationship between teens and their parents, how myths about drugs because it is easier often parents argue with one another, how good teens say their parents are than finding out or accepting the truth. at listening to them, how often teens attend religious services, and how often Believing a myth doesn’t make it true, the family has dinner together. In a National Survey of American Attitudes 7 just like denying that a problem exists on Substance Abuse, CASA researchers learned that compared to teens in does not mean there isn’t one. And if families with strong family ties, teens in families with weak family ties are trouble signs appear, ignoring them y Four times likelier to have tried tobacco won’t make the problem go away. y Four times likelier to have tried marijuana MYTH #1: MY CHiLD y Almost three times likelier to have tried alcohol iSN’T EXPOSED TO DRUGS AND WOULDN’T ❯ Two-and-a-half times as likely to involuntary actions such as breathing DO THEM ANYWAY be able to get marijuana in an hour and the gag reflex (which prevents Some parents don’t believe their or less choking). A fatal dose of alcohol caused child has access to drugs and alcohol, by alcohol poisoning can happen the ❯ One-and-a-half times as likely to be very first time a child drinks alcohol, or they think, “My child would never able to get prescription drugs with­ causing serious brain damage or death. do anything so risky.” These are out a prescription in an hour or less serious misconceptions! Also, it’s extremely dangerous to So it is NOT a myth that drugs are minimize the effects of one substance Sadly, children of all ages are exposed available. The question is whether compared to another. The 2011 CASA to drugs. In 2011, almost 26 percent of YOUR child is getting them—and survey revealed that teens who have youths had been offered, sold, or given using them. an illegal drug on school property, used tobacco are 11 times likelier to ❯ according to a national survey of ninth- One in four kids who have tried have used marijuana than teens who alcohol had their first drink at age have never used tobacco. And simply through 12th-grade students in public 8 and private schools.4 Children being 12 or younger. trying marijuana one time can lead in this type of environment is alarm­ ❯ Every day, more than 4,000 teens your child to experiment with other ing, since the earlier a child begins to try an illicit drug for the first time.9 drugs and put them at risk for abuse. smoke, drink, or use drugs, the likelier ❯ Some 60 percent of teens who have Experimenting with drugs or alcohol is that child is to become addicted. abused prescription painkillers to not normal. USE can lead to ABUSE, Additionally, CASA’s 2011 National get high did so before age 15.10 which can lead to ADDICTION, so any use is unacceptable. Survey of American Attitudes on Sub­ ❯ 5 By the time they graduate high stance Abuse found that almost one in school, about 44 percent of U.S. MYTH #3: i CAN’T CHANGE four middle school students perceive teens will have tried marijuana at MY CHiLD’S FUTURE their school as drug-infected (mean­ least once.11 ing drugs are used, kept, or sold on While it’s true that children often school grounds); the number jumps to MYTH #2: iT’S NORMAL idolize sports heroes and celebrities, more than 60 percent for high school FOR KiDS TO EXPERiMENT they also idolize YOU. As a parent or 6 caregiver, you have the power to help students. Compared to teens attend­ WiTH DRUGS ing drug-free schools, teens attending shape their attitudes about drugs. One drug-infected schools are Some parents believe that experiment­ way to do that is by talking to them ing with drugs or alcohol is a normal regularly about what is going on in ❯ Twice as likely to have used to­ part of growing up. Those parents are their lives. Kids who learn a lot about bacco, alcohol, and marijuana wrong. Alcohol poisoning can occur the risks of drugs and alcohol from ❯ Almost twice as likely to be able to when someone drinks enough alcohol their parents are up to 50 percent less get alcohol in an hour or less to depress the nerves that control likely to use than those who do not.12

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 3 SECTION 1

Talking to your child meal fun, such as eating a picnic meal According to a 2010 national survey in the back yard, having a contest to by the Substance Abuse and Mental about drugs and alcohol see who can create the best pizza, or Health Services Administration doesn’t mean lecturing. setting up a burger bar with outra­ (SAMHSA), youths aged 12 to 17 were In fact, there are many geous toppings. Enjoy the process, and less likely to use a substance if they spend the time together talking with believed their parents would strongly things you can do (or may your children about their day. disapprove.16 This was particularly already do!) to provide Simply being there for your child—day true for tobacco and marijuana. the type of environment or night—is also helpful. A child who Your children do listen to you, even that may keep your child feels you are available will be more if they roll their eyes and pretend likely to come to you with questions not to. Don’t want them drinking or from experimenting about drugs or challenges with peer using drugs? Tell them how you feel with drugs or alcohol. pressure or other situations that make and what you expect from them. For your child feel uncomfortable. It is example, you might say especially important to be there for ❯ “I want you to have fun and enjoy your child during times of transition, Talking to your child about drugs this time in your life, but I also such as changing schools, moving, or and alcohol doesn’t mean lecturing. want you to stay healthy because I divorce, because the risk of drug use In fact, there are many things you can love you. The best way to do that increases greatly during these times.14 do (or may already do!) to provide is to stay completely away from As children advance from elementary the type of environment that may drugs and alcohol. Can you prom­ school to middle school, for example, keep your child from experimenting ise me that you will?” they face new social situations. They with drugs or alcohol. One is to will be exposed to cigarettes and ❯ “I know you may be tempted to spend more time with your child. alcohol—if they haven’t been already— try drugs, but I also know you’re A 2011 national survey about the and friends may encourage them to really smart. That’s why I expect importance of family dinners try new things. As they later go from you to stay clean—no matter what revealed that 18 percent of teens said middle school to high school, they will your friends do. Agreed?” they would like to spend more time 13 face a larger variety of substances and ❯ with their parents. That’s important “It scares me to know how easily have more of a desire to fit in or seem because those who spent seven hours you could damage your brain or cool to their classmates. or less per week with their parents get addicted to something. Will you were twice as likely to have used Additionally, teens who attend re­ give me your word that you won’t alcohol and twice as likely to have ligious services four or more times try things just because the people tried drugs (including marijuana a month are less likely to have used you hang out with try them?” and prescription drugs) to get high. tobacco (11 percent vs. 3 percent), con­ Your children do care what you say, Imagine! Simply spending time with sumed alcohol (27 percent vs. 13 per­ but you have to tell them what you your children may make them less cent), or used marijuana (15 percent vs. think—and what you expect. likely to try drugs or alcohol! 5 percent) than those who attend such services less frequently or not at all.15 MYTH #5: iT’S OKAY FOR Family dinners are an excellent way to spend time with your child. And Remember, preventing the first use ME TO USE BECAUSE i’M make no mistake—those family din­ prevents abuse, and preventing abuse AN ADULT ners matter. Teens who have fewer prevents addiction. You can change Some parents may believe that because than three family dinners per week your child’s future. they are adults, it’s okay for them to are almost four times as likely to have drink alcohol excessively or to smoke used tobacco, more than twice as MYTH #4: MY KiDS DON’T cigarettes (even marijuana) even likely to have used alcohol, and two­ CARE WHAT i THiNK though they tell their children not to and-a-half times as likely to have used Kids—especially teenagers— do it. This is especially true if adults marijuana. Family dinners don’t have sometimes act like they don’t care think their use isn’t affecting their to be elaborate or expensive. Think of what their parents think. Studies have family. But because your children look simple, inexpensive ways to make the shown, however, that they do care. up to you, they want to be like you.

4 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION INTRODUCTION – HOW THIS BOOK WILL HELP YOU

So when they see you smoking, they States is exposed to alcoholism or drug an effective parent. Consequently, 17 are going to think it is okay for them addiction in the family, and these some parents are afraid to set rules to do it, too, no matter what you say. kids have a significantly increased risk and enforce them. However, if they watch as you struggle of becoming alcoholics themselves But children need a clear to quit smoking, they understand the when they grow up. understanding of your expectations. difficulty of breaking the addiction. So if you portray your beliefs about Sure, they may test you occasionally Similarly, if you come home from work the danger of using drugs and alco­ by pushing the boundaries of the rules complaining that you had a hard day hol through your actions, your child you set. But that is the exact moment and drink heavily and excessively, is more inclined to believe you. And when you must be a parent—an or drive while under the influence if you have a problem with tobacco, enforcer—and follow through with of alcohol, you may be sending an alcohol, or drugs, speak to your family whatever consequences you outlined unintended message. It is certainly not doctor about getting help. a message about drinking responsibly. as punishment. MYTH #6: i DON’T WANT Some parents choose to believe this Developing a strong bond with your TO ALiENATE MY CHiLD BY myth because they are in denial about child at an early age is important, but their own behavior and don’t like to BEiNG TOO STRiCT it needs to be a parent-child bond in think about how their own drug or In some homes today, parents try very which YOU take control. The best way alcohol use is affecting their children. hard to be a friend to their child, and to do that is to (1) set rules and (2) One in four children in the United this interferes with their ability to be enforce them consistently.

Family dinners are an excellent way to spend time with your child.

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 5 SECTION 1

1 Johnston, L. D., O’Malley, P. M., Bachman, J. G., and Schulenberg, J. E. Monitoring the Future national results on adolescent drug use: Overview of key findings, 2011. National Institute on Drug Abuse. Ann Arbor: Institute for Social Research, The University of Michigan. 2012. 2 National Institutes of Health. National Institute on Alcohol Abuse and Alcoholism. Underage Drinking. Alcohol Alert, Publication Number 67. January 2006. 3 The National Center on Addiction and Substance Abuse (CASA) at Columbia University. National Survey of American Attitudes on Substance Abuse XVI: Teens and Parents. August 2011. 4 Centers for Disease Control and Prevention. Trends in the Prevalence of Tobacco, Alcohol, and Illegal Drug Use on School Property. National Youth Risk Behavior Survey 1991–2011. Accessed September 21, 2012, www.cdc.gov/healthyyouth/yrbs/pdf/us_taodu_trend_yrbs.pdf. 5 National Survey of American Attitudes on Substance Abuse XVI: Teens and Parents. 6 Ibid. 7 The National Center on Addiction and Substance Abuse (CASA) at Columbia University. National Survey of American Attitudes on Substance Abuse XV: Teens and Parents. August 2010. 8 The Police and Communities Together (PACT 360) website. Home page, accessed September 21, 2012, http://pact360.org/programs/parents360. 9 Ibid. 10 The Partnership at DrugFree.org website. Home page, accessed September 21, 2012, http://notinmyhouse.drugfree.org. 11 U.S. Department of Health and Human Services, National Institutes of Health. Marijuana: Facts Parents Need to Know. A Letter to Parents. NIH Publication No. 10-4036. Printed 1995, Revised November 1998, November 2002, September 2004, August 2007, March 2011. Reprinted April 2001, February 2007. 12 The Partnership at DrugFree.org sponsored website. Home page, accessed September 21, 2012, www.drugfree.org/prevent. 13 The National Center on Addiction and Substance Abuse (CASA) at Columbia University. National Survey of American Attitudes on Substance Abuse XV: Teens and Parents. September 2011. 14 National Institute on Drug Abuse. Drugs, Brains, and Behavior - The Science of Addiction. NIH Pub No. 10-5605. Printed April 2007. Revised February 2008, August 2010. 15 National Survey of American Attitudes on Substance Abuse XVI: Teens and Parents. 16 Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality. Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings. NSDUH Series H-41, HHS Publication No. (SMA) 11-4658. September 2011. 17 Tian Dayton, PhD. Portrait of an Alcoholic Family: Forgotten Children; Right Next Door? National Association for Children of Alcoholics. Kensington, MD. (n.d.) Accessed September 21, 2012, www.nacoa.org/pdfs/Portrait%20of%20an%20Alcoholic%20Family.docx.pdf.

6 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION INTRODUCTION – WHATHOW SUBSTANCESTHIS BOOK WILL DO KIDSHELP USE? YOU SECTION 2: WHAT SUBSTANCES DO KIDS USE?

Section 2: What Substances Do Kids Use?

NOTE: Please also see the Drug use and experimentation with tobacco Identification Chart at the end of products have declined for middle this publication. school and high school students compared to previous generations,18 hildren today are exposed to according to the Centers for Disease drugs and alcohol because they Control and Prevention (CDC). Even see them used in movies, in C so, over 19 percent of high school music videos, and on television from a students were cigarette smokers in very young age. They also learn about 2009, as were 5.2 percent of middle them on social networking sites, where school students.19 In 2009, every day, information is instant and available about 3,800 teens began smoking and 24/7, and they learn from classmates. 20 1,100 become regular smokers. It Exactly what they learn depends on is illegal in all states to sell tobacco what they listen to, read, or watch, and products to persons under age 18. who they hang out with. Smoking continues to be the single At the end of this publication is a leading preventable cause of death detailed Drug Identification Chart and disease in the United States,21 that lists many drugs commonly so it’s important to establish your abused today, along with the side household as one where tobacco use is effects and “street names.” In this NOT tolerated. section, we’ll talk about some ❯ Many tobacco products are eas­ commonly abused substances, the ily recognized: a cigar, a pack of risks they pose to children, and cigarettes, or a container of smoke­ where children acquire them. Once less tobacco (chewing tobacco or you know that, the most important snuff). However, some companies thing you can do is to talk with have developed products that you your children rather than leave their may not know about and that are drug and alcohol education to a specifically aimed at young people. random website or television sitcom. One tobacco product you may not We’ll discuss ways to have those be familiar with is called a bidi conversations in Section 4. cigarette, which consists of tobacco wrapped in leaves of plants that TOBACCO are native to Asia. Typically tied on Whether smoked or chewed, nicotine one or both ends with string, bidis is one of the most highly addictive come in flavors such as chocolate, drugs used in today’s society—and mango, vanilla, lemon-lime, mint, the addiction is extremely hard to pineapple, and cherry—flavors break. The good news is that tobacco that appeal to young smokers.

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 7 SECTION 2

the globe, including in the United ALCOHOL States. In recent years, there has Why have we included alcohol in a been an increase in hookah use book about drugs? Alcohol is a drug. around the world, most notably It’s illegal for kids under 21 (in most among youths. 25 states) to use it, and it’s dangerous. ❯ Also, smokeless tobacco is not a Kids who drink are more likely to safe alternative to smoking, as it be victims of violent crimes, have contains 28 cancer-causing agents serious problems in school, and be (carcinogens), and adolescent involved in drinking-related traffic 26 smokeless tobacco users are crashes. Underage alcohol use is more likely than nonusers to more likely to kill young people than 27 become adult cigarette smokers.22 all illegal drugs combined. According to the 2011 MTF survey, As children approach adolescence, 3.5 percent of eighth-graders, 6.6 they want to fit in with their peers, percent of 10th-graders, and 8.3 and alcohol is a common drug of percent of 12th-graders reported choice. You may think your child smokeless tobacco use during hasn’t begun drinking yet. You may 23 the past month. These products be right, but by the time they reach may be attractive because they are the eighth grade, nearly half of all flavored and produce less saliva adolescents have had a least one than previous versions (so no one drink, and over 20 percent report has to know you are using them). having been drunk. The trend continues as students enter high Regardless of the product, teenagers school. A recent national study of who use tobacco are at risk of Hookah 12th-graders showed that nearly a developing cancer, heart and lung third of these students binge drink, disease, and many other diseases Though not widely used (estimates which was defined as drinking at associated with smoking. The best are that about 3 percent of current least five drinks at one time within ways to prevent your child from 28 high school students smoke bidi the last two weeks. smoking are to (1) not smoke, and cigarettes), they are especially (2) not allow smoking in your home. Using alcohol is a poor choice that dangerous because they contain Teens whose parents smoke are almost likely leads to more poor choices for more than three times the amount three times as likely to use tobacco young people. Seventy-five percent of nicotine and carbon monoxide themselves.24 And remember, teens of teens reported that the teens they as traditional cigarettes and five knew who drank alcohol or used times as much tar as cigarettes. who smoke cigarettes are much more likely to use marijuana than those who illegal drugs were more likely to ❯ 29 Another method of using tobacco have never smoked. engage in sexual activity. that you may not recognize is Alcohol affects the mind and body in If you discover your children are with a hookah. Sometimes called unpredictable ways, and teens lack the already using tobacco, remind them a water pipe, hookahs are used to judgment and coping skills to handle that it is illegal for them to purchase smoke specially made tobacco that alcohol wisely. As a result30 is available in a variety of flavors tobacco products, and let them know ❯ (e.g., apple, mint, cherry, choco­ you expect them to quit immediately. Alcohol-related traffic crashes late, coconut, licorice, cappuc­ Be firm but supportive, as breaking are a major cause of death among cino, and watermelon). Hookah a tobacco addiction can be extremely young people. Alcohol use also is smoking is typically practiced in difficult, but continue to emphasize linked with teen deaths by drown­ groups, with the same mouthpiece that quitting is imperative. If ing, suicide, and homicide. passed from person to person. necessary, your family physician may ❯ Teens who use alcohol are more While used in Persia and India prescribe medication to help break the likely to be sexually active at for centuries, today, hookah cafés habit or direct your child to support earlier ages, to have sexual inter­ are gaining popularity around programs for quitting smoking. course more often, and to have

8 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION WHAT SUBSTANCES DO KIDS USE?

The risk of alcohol poisoning is also increased caffeinated drinks were reported in 2009; nearly half the emergencies when teens drink alcohol along with energy occurred after beverages were mixed drinks or consume energy drinks that contain with alcohol or other drugs.33 alcohol. These drinks, which are on most grocery Discuss the signs of alcohol poisoning store shelves, are loaded with caffeine, other with your children. Those signs include plant-based stimulants, and other additives. ❯ mental confusion ❯ stupor ❯ coma (or inability to be roused) unprotected sex than teens who Alcohol Poisoning do not drink. ❯ vomiting Myth #2 at the front of this publication ❯ seizures ❯ Young people who drink are more mentioned that alcohol poisoning, likely than others to be victims of which can happen the very first ❯ slow breathing or irregular violent crimes, including rape, ag­ time someone drinks alcohol, can breathing gravated assault, and robbery. cause serious brain damage or death. ❯ hypothermia (low body ❯ Teens who drink are more likely to A person (of any age) who drinks temperature) have problems with school work enough alcohol will eventually get ❯ bluish skin color and/or paleness and school conduct. sleepy and pass out. Particularly troubling is that if the person If you suspect someone has alcohol ❯ The majority of boys and girls consumed alcohol rapidly, the level poisoning, call 911 immediately. who drink tend to binge (five or of alcohol in the bloodstream (called more drinks on an occasion for blood alcohol content or BAC) will HOUSEHOLD PRODUCTS: boys; four or more on an occasion continue to rise even after the person iNHALANTS for girls). passes out. A high BAC suppresses Items in your cabinets at home may ❯ A person who begins drinking as natural reflexes, such as the ability to be enough for your child to get high— a young teen is four times more gag, so a person who vomits while even items that you might not con­ likely to develop alcohol depen­ passed out can literally choke and die. sider “drugs.” Hundreds of products dence than someone who waits And a person who survives may suffer such as nail polish remover, cleaning until adulthood to use alcohol. irreversible brain damage. fluid, hair spray, gasoline, spray paint, What can you do? Well, you can The risk of alcohol poisoning is also and the propellant in aerosol whipped restrict your child’s access to the increased when teens drink alcohol cream contain chemicals that youths liquor stored in your home. In a 2011 along with energy drinks or consume inhale to get high. Because these 31 survey, teens whose parent(s) had energy drinks that contain alcohol. inhalants are easily available, they are consumed alcohol in the previous These drinks, which are on most often among the first drugs that young 34 30 days were more than twice as grocery store shelves, are loaded with adolescents abuse. likely to say they could get alcohol caffeine, other plant-based stimulants, Why do children in this group in an hour or less (32 percent vs. 14 and other additives. They are very experiment with inhalants? They’re percent). If you keep alcohol in your popular and regularly consumed by cheap. They’re available. And most home, keep track of the supply, and 31 percent of 12- to 17-year-olds and important, kids don’t understand the lock it up if possible. 32 34 percent of 18- to 24-year-olds. But dangers of inhalant use—that these Your disapproval of underage when mixed with alcohol, caffeine inhalants starve the body of oxygen drinking is key to keeping your child masks the depressant in the alcohol, and can cause unconsciousness, severe sober. Don’t underestimate your and people feel more alert and sober damage to the brain and nervous power as a parent—let your kids than they really are. They eventually system, and even death. know what you expect by talking with go to bed—not realizing they have them and by setting an example for consumed a lethal dose of alcohol. A Inhalants generally fall into the them. Keeping quiet may give your person who appears to be sleeping it following categories. children the impression that you think off may be in real danger. More than Volatile solvents are liquids that their drinking is okay. 13,000 ER visits related to the highly vaporize at room temperature. They

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 9 SECTION 2

MEET SETH BRAMLEY SHOULD YOU SCREEN YOUR CHiLD When Seth Bramley changed high FOR DRUGS? schools in 10th grade, his new The American Academy of Pediatrics (AAP) suggested in 2011 that all friends introduced him to alcohol adolescents should be screened for alcohol, tobacco, and other drug use at and marijuana. That was also when every office visit because their vulnerability to addiction is particularly high, he started to get into trouble. He as are risk-taking and injuries related to alcohol, tobacco, and drug use.35 and his mom thought it would Screening may consist of the pediatrician simply asking your child about be a good idea to change his the use of alcohol, marijuana, or anything else to get high. Depending on environment and go to Arkansas the answers, the pediatrician can provide positive feedback, advice, or a to live with his dad. After a month, treatment referral when needed. This type of screening is one indicator of Seth’s dad caught him smoking pot whether you are on the right track with keeping your child drug free. and sent him back home.

Seth realized that he had a drug are found in many easily available ❯ Spraying aerosols directly into the problem, and he went to rehab products such as paint thinners nose or mouth (rehab means a drug abuse and removers, dry-cleaning fluids, ❯ Sniffing or inhaling fumes from treatment facility). He did well, degreasers, gasoline, glues, correction substances sprayed or placed into although it was very hard on fluids, and felt-tip markers. a plastic or paper bag (“bagging”) him and he wanted a different Aerosols are sprays that contain program. He went to another ❯ “Huffing” from an inhalant- propellants and solvents, such as rehab, graduated, and went to soaked rag stuffed in the mouth spray paints, deodorant and hair a halfway house. But the grip of ❯ Inhaling from balloons filled with sprays, vegetable oil sprays for addiction was still there. He told nitrous oxide cooking, and fabric protector sprays. his mom, “Mom, I so much want to The lungs absorb the inhaled live … I don’t want to get high, but Gases include medical anesthetics chemicals into the bloodstream (ether, chloroform, and others), as I just can’t stop.” On Father’s Day, very quickly, and the user feels well as gases used in household Seth came home for a visit and got effects similar to those produced by or commercial products. Nitrous high with friends. alcohol (e.g., slurred speech, lack of oxide—the most abused of these Giving up wasn’t Seth’s way, so he coordination, euphoria, dizziness). gases—is found in whipped But because the high lasts only a told his mom he wanted to get his cream dispensers and products few minutes, people often inhale life back on track and go back to that boost octane levels in racing repeatedly for several hours. southern California to live with his cars. Other products containing grandmother. He was there for two gases include butane lighters, Inhalants can damage brain cells days. He went to dinner with his propane tanks, and refrigerants. by preventing them from receiving mom and grandmother on Friday enough oxygen. Repeat abusers may Nitrites, unlike most other inhalants, night. On Sunday morning, he died have difficulty learning, carrying act directly on the central nervous after “bagging” a can of shaving on conversations, and solving system to dilate blood vessels and gel. He was 19 years old. problems. Long-term inhalant users relax the muscles. Nitrites are now can experience muscle spasms prohibited by the Consumer Product Would you have pursued further and permanent difficulty walking, Safety Commission but can still be rehabilitation options in this case? bending, and talking. Inhalants can be found, typically labeled as video head Rehab is often not a one-time addictive and can cause heart damage, cleaner, room odorizer, leather cleaner, event. Do not give up hope if your liver failure, and muscle weakness. or liquid aroma. child relapses after being in a drug Prolonged sniffing of these highly treatment facility. Continue to work People who abuse inhalants breathe concentrated chemicals can cause with your physicians, counselors, in the vapors through their nose or irregular or rapid heart rhythms, and and other substance abuse mouth by can lead to heart failure and death professionals to seek appropriate ❯ Sniffing or snorting fumes within minutes. High concentrations treatment and follow-up care. from containers of inhalants also can cause death from

10 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION WHAT SUBSTANCES DO KIDS USE? suffocation when the inhalant vapor OTC medications. According to the while.” But when used to get high, takes the place of oxygen in the lungs results of a Partnership for a Drug prescription medications are every and brain, causing breathing to stop. Free America survey, more than half bit as dangerous as “street drugs.” of teens didn’t think using cough Overdosing (especially on prescription OvER-THE-COUNTER (OTC) medicines to get high was risky.38 pain relievers such as Vicodin, MEDiCATiONS Percocet, Loritab, and others) can be Because OTC medications are so fatal. An over-the-counter (OTC) medication widely available, it’s important is a drug sold without a prescription, to know which ones are stored in Another reason for the rising rates such as a medicine for a cold or cough. your home and their potential side of use is that prescription drugs are Many of these medications contain effects. More importantly, keep all so readily available. The majority of dextromethorphan (DXM), and the medications—particularly cough and teens get prescription drugs from the products are very effective when used cold medicines—in a secure location medicine cabinets of family, friends, 42 as directed. But sadly, young people (such as a locked cabinet) where they and acquaintances. Some young are abusing this type of OTC drug by aren’t accessible to young people. people traffic among themselves— drinking cough and cold medications handing out or selling extra Ritalin (e.g., Robitussin, Coricidin, and Ny­ PRESCRiPTiON or Adderall pills of their own or that quil) either alone or with soft drinks or MEDiCATiONS they’ve acquired or stolen; some alcohol. Gelcaps and pills are swal­ get theirs illicitly from doctors, For decades, people have taken lowed or crushed and put into drinks. pharmacists, or online. prescription drugs—prescribed by Products containing DXM are a doctor or dentist and dispensed What drugs in your medicine cabinet available over-the-counter in by a pharmacist—to relieve a can potentially be abused? pharmacies and grocery stores; DXM host of symptoms. The number of ❯ Also known as opioids, narcot­ is also sold on the Internet. Some prescription drugs available today is ics dull the senses and relieve websites even tell users how much to mind-boggling, as is the number of pain. Hydrocodone products are take, what drugs to combine it with, young people abusing these drugs. It the most frequently prescribed and how to extract the DXM from is sometimes their first introduction to cough medicines—some even sell a drug use. powder form of DXM for snorting. ❯ These products are easy enough to get Research indicates that as many such that one in 10 teens (10 percent as one in five teens say they or 2.4 million) report abusing cough have taken a prescription drug medicine to get high.36 without having a prescription for it themselves.39 As part of CASA’s 2011 national online survey, teens aged 12–17 were asked ❯ Every day, 2,100 teenagers use a if they knew a friend or classmate prescription drug for non-medical 40 who used OTC medicines to get high. use for the first time. Those who answered YES were asked One reason for this increase is that if they knew more than one friend or many teens mistakenly believe classmate who used OTC medicines prescription drugs are safer than to get high. An astounding 70 percent “street drugs” because they are 37 said they did! medicine prescribed by a physician. Labels on these medications warn of According to a Partnership for a Drug the side effects when taken in high Free America survey, two in five teens doses, including confusion, dizziness, felt prescription medicines, even if not double or blurred vision, slurred prescribed by a doctor, were “much 41 speech, loss of physical coordination, safer” to use than illegal drugs. rapid heartbeat, drowsiness, and And nearly one-third of those teens disorientation. The problem is that believed there was “nothing wrong” teens rarely read labels and don’t with using prescription medicines understand the danger in using without a prescription “once in a

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MEET JASON SURKS particularly when taken with over-the­ counter medication and/or alcohol. Jason Surks was 19 and in his second year of college, studying to be a In fact, one national study showed pharmacist, when he died of an overdose of pills. After his death, his that 28 percent of parents have taken parents discovered that he had been ordering pills from an Internet a prescription drug without having a pharmacy in Mexico. 44 prescription for it themselves. This His mother, Linda, writes: “I think back to the last several months of my son’s sets a dangerous example for kids, and life, trying to identify any signs I might have missed. I remember that during it is illegal. his first year in college, I discovered an unlabeled pill bottle in his room. I took Just as with OTC medications, talk the pills to my computer and identified them as a generic form of Ritalin. to your teens about the dangers of When I confronted Jason, he told me he got them from a friend who’d been abusing prescription drugs, and prescribed the medication. He wanted to see if they would help him with his safeguard your own medicines by problem focusing in school. He promised he would stop using the drug. But as keeping prescription drugs in a secure a pre-pharmacy major, maybe he felt he knew more about these substances place—preferably a locked cabinet— than he actually did and had a ‘professional curiosity’ about them.” and monitoring the number of pills you have. Regularly dispose of expired As a parent, would you have allowed Jason to self-medicate? If your child— or unused medications in a safe regardless of age—feels there is a medical need for a prescription medication, manner by removing the substance see your family physician or pediatrician. Taking pharmaceuticals prescribed from its original container, mixing for someone else is illegal and can be deadly. it with an undesirable substance (such as used coffee grounds or kitty litter), and placing it in a sealable bag, opioids in the United States, and are the prescription drugs Valium, empty can, or other container prior to they are the most abused narcotic Xanax, Halcion, Ativan, and disposal in household trash. Another 43 in this country. Found in phar­ Klonopin. Others include ProSom, alternative is to drop the substance at maceutical drugs like Vicodin, Dalmane, Restoril, Versed, a medication “take-back” program in Lorcet, and Lortab, Hydrocodone Librium, Tranxene, Paxipam, your community. is used for the treatment of moder­ Serax, Centrax, and Doral. Ambien Finally, report suspicious online ate to moderately severe pain. and Sonata are sedative-hypnotic pharmacies. If you or your teen medications approved for the ❯ Stimulants speed up the body’s is aware of someone distributing short-term treatment of insomnia systems. This class of drugs prescription drugs or selling them on and that share many of the proper­ includes prescription drugs such a suspicious Internet pharmacy site, ties of benzodiazepines. as amphetamines (Adderall and call the DEA hotline at 1-877-792-2873. Dexedrine), methylphenidate Teens take these drugs for a variety of It is open around the clock, 365 days (Concerta and Ritalin), and diet reasons. Some take stimulants (such per year. aids (such as Didrex, Bontril, Pre­ as those used to treat attention deficit ludin, Fastin, Adipex P, Ionomin, hyperactivity disorder, or ADHD) Anabolic Steroids and Meridia). to give them additional energy and Weightlifters, football players, and other ❯ Barbiturates depress the central an ability to focus when studying or athletes often use anabolic steroids nervous system. They have been taking tests. Some try pain relievers illegally to bulk up. They take the drug used as sedatives, hypnotics, to cope with stress. Others abuse in pill form, apply it to the skin, or anesthetics, and anticonvulsants. prescription amphetamines to lose (more commonly) inject it into muscles Abusers prefer the short-acting weight or prescription anabolic steroids with a hypodermic needle. to bulk up. And, sadly, some simply and intermediate barbiturates Abusing anabolic steroids can pose take prescription medicine to get high. such as Amytal and Seconal. serious risks. A 2010 study funded by ❯ Benzodiazepines are depressants Many parents don’t talk with their the National Institute on Drug Abuse that produce sedation, induce children about the non-medical use of (NIDA) asked teens if they had ever sleep, relieve anxiety and muscle prescription drugs—because parents tried steroids—even once. Only 1.1 spasms, and prevent seizures. The don’t realize how popular these drugs percent of eighth-graders, 1.6 percent most common benzodiazepines are or how dangerous they can be, of 10th-graders, and 2.0 percent of

12 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION WHAT SUBSTANCES DO KIDS USE?

12th-graders responded that they As with other substances, young MEET TAYLOR had.45 Still, talk with your child about people tend to form opinions based on the dangers of using them. what their parents think and do. For HOOTEN Taylor Hooten died at age 17. It In some individuals, steroid use example, recent studies and surveys took a while for his parents to can cause dramatic mood swings, revealed that connect Taylor’s recent weight ❯ Marijuana use was much less increased feelings of hostility, and muscle increases with his impaired judgment, and increased prevalent among youths who per­ uncharacteristic mood swings and levels of aggression (often referred to ceived strong parental disapproval violent, angry behavior. He’d been as “roid rage”). Other side effects can for trying marijuana or hashish using a cocktail of steroids and 47 include stunted growth, accelerated once or twice. other hormones to bulk up, and the puberty changes, jaundice, fluid ❯ Compared to teens whose par­ drugs were wreaking havoc on his retention, high blood pressure, ent never used marijuana, teens body and emotions. Taylor went to increases in LDL (bad cholesterol) and whose parent has used marijuana his room and hanged himself. decreases in HDL (good cholesterol), are two-and-a-half times as likely severe acne, trembling, and liver and to have also used it.48 What would you have done if kidney tumors. Abusers who inject Taylor were your son? Frequent It seems that marijuana is easy to steroids may share contaminated extreme or unusual physical or obtain. In the 2010 national CASA needles, putting them at risk for emotional changes that affect survey, 58 percent of teens who said viral infections such as HIV/AIDS or your child’s relationships, health, they can get marijuana do so by hepatitis B or C. academic performance, or other calling a cell phone or by sending a aspects of life are not normal. Those Steroid abuse can cause extreme text message; 57 percent said they uncharacteristic changes may be your mood swings that include depression, simply ask for it face to face; and 14 red flag that your child is addicted to paranoia, and extreme irritability. percent said they use websites like drugs or alcohol. While it is important to stop using Facebook or MySpace.49 anabolic steroids, some users experience dangerous withdrawal symptoms when they stop, including depression, which sometimes leads to suicide attempts.

STREET DRUGS “Street drugs” in this publication means illegal drugs such as marijuana, cocaine, Ecstasy, methamphetamine, and heroin. All street drugs are illegal, and the penalties for possessing them can be harsh.

Marijuana Marijuana use among adolescents is on the rise after a decade of decline.46 Part of this increase appears to be because adolescents don’t accurately perceive the risks associated with marijuana use. This may be because of conflicting messages—they hear and read about drug legalization, decriminalization, and the use of medical marijuana.

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In the 2011 MTF survey, one in drugs or drug combinations that clear crystal of high purity that four—25 percent—of the 47,000 can be harmful.51 Other drugs are is smoked, like crack, in a glass teens surveyed said they had used often sold as Ecstasy, which can pipe. Like other stimulants, meth marijuana during the last year. lead to overdose and death when is highly addictive. The survey, which polled students the user takes additional doses to Heroin nationwide in the eighth, 10th, and obtain the desired effect. Ecstasy 12th grades, also found that nearly one is usually taken in pill form and Heroin is typically sold as a white or in 15 high school students used pot on often combined with alcohol and/ brownish powder or as the black sticky a daily or near-daily basis! or other drugs. In high doses, substance known on the streets as MDMA can interfere with the “black tar heroin” that can be injected, Marijuana use and addiction can’t body’s ability to regulate tempera- smoked, or sniffed/snorted. Because be taken lightly. Approximately ture, which can then result in liver, most street heroin is cut with other 1.1 million drug-related treatment kidney, and cardiovascular system drugs or with substances like sugar or admissions to publicly funded failure—or death. starch, heroin users do not know the facilities occurred in 2009 (the latest actual strength of the drug or its true year for which data are available). Of ❯ Methamphetamine (or “meth”) contents. This puts them at a high risk those, 31 percent reported marijuana is a powerful stimulant derived of overdose or death. Heroin users as their primary drug of choice.50 from amphetamine. It comes in clear crystals or powder and eas­ develop a tolerance to the drug, mak­ Bottom line: marijuana is a drug, it is ily dissolves in water or alcohol. ing it particularly addictive. dangerous, and it is illegal. Meth is sometimes made using When teens were asked in the national Stimulants inexpensive over-the-counter 2011 CASA survey on substance abuse ingredients such as drain cleaner, if they knew a friend or classmate who Stimulants are drugs that speed up battery acid, and antifreeze—defi- used illegal drugs like acid, Ecstasy, the body’s systems. Examples of nitely NOT the kinds of products meth, cocaine, or heroin, two out of illicit stimulants include cocaine, you want your child to consume! five (42 percent) said they did. Of methamphetamine, and Ecstasy. Meth is swallowed, snorted, those who knew a friend or classmate ❯ Cocaine comes in two forms. injected, or smoked. “Ice” (or who used such drugs, 73 percent said Powder cocaine is made from crystal meth) is a large, usually they knew more than one who did. the leaf of the coca plant and is usually snorted or injected into a vein with a needle, while FAMiLY OUTRAGED AT TEENS’ EASY ACCESS 52 crack is a form of cocaine that TO DRUGS is often smoked in a glass pipe. Late in 2011, a young girl in Indiana nearly died, according to her parents, Physiological effects of cocaine after taking a “designer drug” called “bath salts.” She was with a group of include increased blood pressure teens who all tried the drug that’s making its rounds across the country. and heart rate, dilated pupils, insomnia, and loss of appetite. The Her mother was shocked. “I had heard a little bit about it, didn’t know widespread abuse of pure street much about it. I assumed bath salts—like a lot of people—is what you put cocaine has led to many severe in a bath tub, what you buy in a store.” In fact, it’s a chemical compound adverse health consequences such made to be taken as a drug, but packages often indicate that it’s not for as cardiac arrhythmias, ischemic consumption. heart conditions, sudden cardiac “You just go into the gas station, if you’re 18, and you tell them what you arrest, convulsions, strokes, or want, they’ll give it to you,” the girl explained. “And I guess if you’re not, death. Additionally, cocaine is you can just tell them a code word, and they’ll give it to you.” highly addictive. The young girl said she didn’t know the dangers of bath salts but was ❯ Ecstasy (or MDMA) is both a curious, so she tried it. Afterward, she said, “I had no idea where I stimulant and psychedelic—and was or what I was saying or what was even going on around me.” In a it is highly addictive. Researchers cell phone video, her mother shows the teen at the hospital, rocking have determined that many incessantly and crying. Ecstasy tablets contain additional

14 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION WHAT SUBSTANCES DO KIDS USE?

MEET iRMA PEREZ Irma was a 14-year-old girl from Belmont, California, who took an Ecstasy pill on April 23, 2004. She became sick immediately—vomiting and writhing in pain—yet her friends did not seek medical help for her. Instead, they gave her marijuana, thinking it would relax her and possibly help her because they had Synthetic stimulants sold as “Bath Salts.” DEA photos. heard it had medicinal qualities. Irma suffered for hours and when SYNTHETiC DRUGS synthetic marijuana can be much she was finally taken to the hospital more dangerous than plant-based Synthetic drugs have emerged as a the next morning, she was in marijuana. Some of the chemicals serious problem during the past few terrible shape. Five days later, she in synthetic marijuana have been was taken off life support and died. years because they are marketed reclassified as controlled sub­ openly and sold as legal alternatives stances, which makes them illegal. We don’t know if this was Irma’s to illegal drugs. Synthetic drugs first time to experiment with drugs. generally fall into two categories: ❯ Synthetic stimulants (sometimes called Ivory Wave or Vanilla Sky). As a parent, do you know whether ❯ Synthetic cannabinoids (synthetic your child has experimented with Often marketed as bath salts or marijuana, sometimes called K2/ drugs? Have you taken time to plant food, synthetic stimulants Spice). Often marketed as educate your child about the are sold as legal alternatives to incense, K2/Spice and other dangers of illicit drugs like Ecstasy? cocaine, amphetamine, Ecstasy, synthetic marijuana products are Have you also discussed the facts and methcathinone. Much like sold primarily in paraphernalia and myths about marijuana? shops, smoke shops, adult book K2/Spice, they are sold in smoke stores, convenience stores, and shops, paraphernalia shops, con­ smoking it, or injecting them­ online. In the 2011 MTF national venience stores, adult bookstores, selves intravenously. Some of the survey, researchers asked 12th­ gas stations, and online. Over­ chemicals in bath salts have been grade students about synthetic doses have resulted in emergency classified as controlled substances marijuana and were surprised to room visits, hospitalizations, and which make them illegal. learn that 11 percent of the high severe psychotic episodes, some of school seniors surveyed had tried which have led to violent out­ These synthetic drugs are extremely the substance. Emergency room bursts, self-inflicted wounds, and dangerous. Calls to poison control physicians report that individuals at least one suicide. Abusers of centers have risen dramatically since who use these types of products bath salt products have reported these products hit the United States, experience dangerous side effects, that they experienced chest pain, as users of synthetic marijuana and including convulsions, anxiety increased blood pressure, in­ synthetic stimulants can experience 53 attacks, dangerously elevated creased heart rate, agitation, panic severe adverse effects. Nationwide, heart rates, increased blood attacks, hallucinations, extreme more than 4,000 calls about bath salts pressure, vomiting, and disori­ paranoia, and delusions. Users of came in to poison centers during the entation. Synthetic cannabinoids bath salt products self-administer first seven months of 2011—up from 54 are sprayed on plant material that the drugs by snorting the powder, 303 calls in all of 2010. provides a vehicle for the most common route of administration— What are the effects of drugs like marijuana or cocaine? smoking (using a pipe, a water Why are drugs so hard to quit? Does drug treatment work? Get pipe, or rolling the drug-spiked the answers to these and other important questions on the Easy- plant material in cigarette papers). to-Read Drug Facts website created by the National Institute on Because the ingredients are Drug Abuse (NIDA) at www.easyread.drugabuse.gov. unregulated and often unknown,

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18 Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Reports. Morbidity and Mortality Weekly Report, Tobacco Use Among Middle and High School Students. United States. 2000-2009. Volume 59, Number 33, August 27, 2010. 19 Ibid. 20 Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings. 21 Morbidity and Mortality Weekly Report, Tobacco Use Among Middle and High School Students. 22 Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Smoking and Tobacco Use Fact Sheet: Smokeless Tobacco Facts. Last updated August 4, 2011. 23 Monitoring the Future national results on adolescent drug use: Overview of key findings, 2011. 24 National Survey of American Attitudes on Substance Abuse XVI: Teens and Parents. 25 Alcohol Policy Information System. State Profiles of Underage Drinking Laws. Accessed September 21, 2012, www.alcoholpolicy.niaaa.nih.gov/State_Profiles_of_Underage_Drinking_Laws.html. 26 National Institutes of Health. National Institute on Alcohol Abuse and Alcoholism. Make a Difference – Talk To Your Child About Alcohol. NIH Publication No. 06-4314. Revised 2009. 27 National Institutes of Health. National Institute on Alcohol Abuse and Alcoholism. Underage Drinking – A Growing Health Care Concern. Accessed September 21, 2012. http://pubs.niaaa.nih.gov/publications/PSA/underagepg2.htm. 28 Ibid. 29 National Survey of American Attitudes on Substance Abuse XV: Teens and Parents. 30 Make a Difference – Talk To Your Child About Alcohol. 31 National Survey of American Attitudes on Substance Abuse XVI: Teens and Parents. 32 Centers for Disease Control and Prevention. Alcohol and Public Health Fact Sheet: Caffeinated Alcoholic Beverages. Last updated July 10, 2010. Accessed September 21, 2012, www.cdc.gov/alcohol/fact-sheets/cab.htm. 33 Center for Behavioral Health Statistics and Quality Substance Abuse and Mental Health Services Administration. The DAWN Report: Emergency Department Visits Involving Energy Drinks. November 22, 2011. Accessed September 21, 2012, www.samhsa.gov/data/2k11/WEB_DAWN_089/WEB_ DAWN_089_HTML.pdf. 34 National Institute on Drug Abuse. NIDA for Teens, The Science Behind Drugs Abuse. Facts on Drugs: Inhalants. Last updated March 2012. Accessed September 21, 2012, http://teens.drugabuse.gov/facts/facts_inhale1.php. 35 AAP Committee on Substance Abuse Pediatrics. 2011. Substance use screening, brief intervention, and referral to treatment for pediatricians. DOI: 10.1542/ peds.2011-1754. 36 Drug Enforcement Administration. Prescription for Disaster – How Teens Abuse Medicine. A DEA Resource for Parents. December 8, 2008. Accessed September 21, 2012, www.getsmartaboutdrugs.com/Files/File/DEApillbook_1_5_08.pdf. 37 National Survey of American Attitudes on Substance Abuse XVI: Teens and Parents. 38 Prescription for Disaster – How Teens Abuse Medicine. 39 Preventing Teen Abuse of Prescription Drugs Fact Sheet. The Partnership at DrugFree.org. 2010. Accessed September 21, 2012, www.drugfree.org/wp-content/uploads/2010/10/Preventing-Teen-Abuse-of-Prescription-Drugs-Fact-Sheet-2draft-Cephalon-sponsored.pdf. 40 Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings. 41 Prescription for Disaster – How Teens Abuse Medicine. 42 Preventing Teen Abuse of Prescription Drugs. 43 Prescription for Disaster – How Teens Abuse Medicine. 44 Preventing Teen Abuse of Prescription Drugs. 45 Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. Monitoring the Future national survey results on drug use, 1975–2010: Volume I, Secondary school students. Overview of Key Findings. National Institute on Drug Abuse. Ann Arbor: Institute for Social Research. The University of Michigan. 2010. 46 U.S. Department of Justice, National Drug Intelligence Center. National Drug Threat Assessment 2011. August 2011. Accessed September 21, 2012, www.justice.gov/ndic/pubs44/44849/44849p.pdf. 47 Results from the 2010 National Survey on Drug Use and Health, Summary of National Findings. 48 National Survey of American Attitudes on Substance Abuse XVI: Teens and Parents. 49 National Survey of American Attitudes on Substance Abuse XV: Teens and Parents. 50 National Drug Threat Assessment 2011. 51 Drug Enforcement Administration. Drug Fact Sheet: Ecstacy or MDMA Overview. Accessed September 21, 2012, www.justthinktwice.com/drugs/ecstasy_or_mdma.html. 52 Miller, Daniel. Family outraged at teens’ easy access to drugs. LIN Television Corporation at WishTV.com. Published October 31, 2011. Updated November 1, 2011. Accessed September 21, 2012, www.wishtv.com/dpp/news/local/hamilton_county/ family-outraged-at-teens-easy-access-to-drugs. 53 National Drug Threat Assessment 2011. 54 National Institute on Drug Abuse. NIDA for Teens, The Science Behind Drugs Abuse. The Sara Bellum Blog. Keep “Bath Salts” in the Tub. Posted September 16, 2011. Accessed September 21, 2012, http://teens.drugabuse.gov/blog/bath-salts-tub.

16 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION WHAT SUBSTANCESWHY DO KIDS DO USE KIDS DRUGS? USE? SECTION 3: WHY DO KIDS USE DRUGS?

Section 3: Why Do Kids Use Drugs?

hich children are at risk for Protective factors include drug and/or alcohol use? ❯ Experiencing a strong bond with a All of them! W parent or caregiver RiSK FACTORS AND ❯ Having high self-esteem PROTECTivE FACTORS ❯ Having parents who talk regularly Children are more likely to try drugs with their child about drugs or develop abuse issues because of ❯ Being active in faith-based orga­ risk factors—circumstances or events nizations, or school, athletic, or that increase a person’s chances for community activities drug abuse. The more risk factors ❯ Spending time around positive present, the more likely a child may role models who don’t use tobac­ be to develop problems from drug co, drugs, or alcohol use. Those with a higher risk include ❯ children who are Being involved in healthy activities that involve managed risk, such as ❯ Failing in school rock climbing, karate, or camping ❯ Victims of bullying (including ❯ Living in a community that offers cyberbullying) youths activities where drugs and ❯ Experiencing low self-esteem alcohol are prohibited ❯ Living with an addicted family ❯ Attending a school with an effec­ member tive drug education program and a no-tolerance policy for alcohol ❯ Residing in a community with a and drugs high tolerance for smoking, drink­ ing, or drug use among youths Risk and protective factors are present in homes, schools, and communities. ❯ Attending a school without strict As a parent, it is impossible to rules that address tobacco, alcohol, control all risk and protective factors. or drugs and consistent enforce­ However, you can control the risk ment for breaking those rules and protective factors in your home Some kids have a lower risk of and work to change others in your drug use and abuse because of child’s environment. Ideally, it’s not protective factors. A protective factor enough to simply “balance” risk and is a preventative measure, of sorts— protective factors. You want the scales something that makes a child less weighted heavily in your favor! To likely to use drugs. increase your odds of that, (1) remove

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 17 SECTION 3

as many risk factors as you possibly very touchy subject if you like to can, and (2) add as many protective occasionally have wine with dinner factors as you can. or a cold beer on the weekend. With alcohol, you must drink responsibly, RiSK FACTORS limiting the amount you consume. Some risk factors we can control; A 2012 report shows that 7.5 million others we can’t. But we first children under age 18 (10.5 percent need to know what we are up of this population) lived with a against—what influences and parent who experienced an alcohol temptations our children face and use disorder in the previous year.57 what we can do to shift the odds Children of parents with untreated in favor of a drug-free lifestyle. alcohol disorders are at far greater risk for developing alcohol and other Academics problems later in their lives, so don’t How well children are doing in school be afraid to seek help if you need it. might be an indicator of whether or And what if you smoke? While it is not they will use drugs.55 Students legal for adults to smoke cigarettes, it with higher grades are significantly isn’t a habit you want to pass along to less likely to have engaged in your children. If your child wants to behaviors such as know why you smoke, explain why you started, and explain that you ❯ Alcohol use have become addicted and how it has ❯ Binge drinking negatively affected your life. Ask your ❯ Trying alcohol for the first time child to support your efforts to quit. before age 13 Then do it. WHY KiDS USE ❯ Marijuana use At some point, your child is likely to ask, “Have you ever used drugs?” ❯ Taking prescription drugs to Many behaviors, such as the desire Do not be uncomfortable with the get high to do something new or risky, are a question. Instead, be honest and normal part of development. Kids ❯ Using Ecstasy use the opportunity to talk with may also use drugs or alcohol to A national CDC survey found that your child about the importance of y relieve boredom only 32 percent of ninth- through 12th­ avoiding drug use. y feel good grade students with mostly A’s used If your answer is NO, explain to your alcohol, while 62 percent of students child how you were able to avoid y forget their troubles and relax 56 with mostly D’s or F’s used alcohol. temptation and peer pressure, the y satisfy their curiosity Kids who don’t feel they are “making reasons you felt it was important, and y ease their pain the grade” in school likely suffer why you are happy that you chose to from low self-esteem, which further do so. Talk about the opportunities y feel grown up increases their vulnerability to try you’ve had (relationships, college, y show their independence drugs. It makes sense, then, to be sure jobs, etc.) because you resisted the y belong to a specific group your child has every opportunity to temptation. Did it enable you to save learn and to succeed academically. money for college or to buy a home? Parents (and caregivers) are the Did it allow you to enter the military? most important role models in Your Own Alcohol, Tobacco, Point out the positive things in your children’s lives. Young people have and Drug Use life that happened because you chose 24/7 access to information about not to use drugs. drugs and, in some cases, to drugs Myth #5 (on page 4 of this themselves. What we teach them publication) explained that some If your answer is YES, expand on that through our words and through our parents believe it’s okay for them with why you don’t want your child actions can change their future. to use even though they tell their to do the same thing. Don’t forget to children not to. This can be a include: it is illegal! You don’t need to

18 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION WHAT SUBSTANCESWHY DO KIDS DO USE KIDS DRUGS? USE? confess every single event from your It’s also important for older siblings your family physician, professional past. Skip the details and explain to set a good example. According to counselors, and/or any of the sup­ 58 honestly what attracted you to drugs, a 2011 report by CASA, teens who port groups shown in the Resources what you’ve since learned about the believed their siblings have tried an section at the back of this publication. dangers of drugs, and why you want illegal drug were your child to avoid making the same Online Environmental Risks ❯ More than five-and-a-half times as mistake. Was your friend killed in an likely to have used tobacco In past generations, drugs were often automobile accident after getting high purchased from a “dealer on the and leaving a party? Were you denied ❯ Almost three times as likely to corner.” But today, youths can use the your first job at a young age because have used alcohol Internet to buy drugs, learn how to use you couldn’t pass a drug test? You ❯ Six-and-a-half times as likely to and mix them to get high and can see might say things like have used marijuana what to expect from the experience. ❯ “I tried smoking pot to fit in. Now Genetics They can even view photos and videos we know more about the dan­ of other people actually using drugs. gers of drugs than we did then. If substance abuse is a persistent All of that is possible online through If I could do things over, I never generational problem in your fam­ social networking. would have tried it. I hope you ily, explain to your children that they don’t either.” may have inherited genes that put “Social networking” simply means interacting with others on the ❯ “I’m not proud of my mistakes, them at a higher risk of becoming Internet—either on a computer or and it’s hard for me to admit that addicted to alcohol or drugs. Using with a “smartphone” (a smartphone I did try drugs. I’m glad you are the example of a family member— is a cell phone that can connect to smart enough not to make the or yourself—to illustrate why your same mistakes I made.” children should be careful about try­ the Internet). It most often occurs on ing alcohol or drugs makes it easier websites that host blogs, chat rooms, ❯ “I used drugs because I was for them to understand because it or forums, but also on websites where bored, but it seemed like I wanted involves someone they know, and they people post photos and videos. Some to do them more and more. I was have likely witnessed troublesome of the best-known social networking terrified of getting addicted to issues firsthand. And if the abuser sites today are Facebook, Twitter, them, so I got into a drug abuse still lives in the home, get help from MySpace, LinkedIn, and YouTube. treatment program that helped me quit, but it was very hard. I’ve also relapsed a few times … I hope you aren’t ever in that situation.” ❯ “I started drinking and doing drugs when I was young, and I missed a big part of growing up. I love you too much to watch you set yourself on the same path.” ❯ “It was illegal then just like it is now, and there are serious conse­ quences for getting caught. I would hate for you to ruin your future by doing something illegal.” If you are currently smoking marijuana or using other illegal drugs, your child will likely follow in your Monitor what your children do footsteps. As a parent, your own use online by becoming acquainted affects your child’s sense of acceptable behavior. Remember, you are an with the websites they visit. important role model!

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 19 SECTION 3

Chances are good that your child one-third of parents whose teen has survey on substance abuse reveals already has an account on at least a social networking page actually that cyberbullied teens are more than one of those social networking sites. monitor it.60 Clearly this means that twice as likely to smoke, drink, and use Should you be concerned? Yes! The most parents do not. marijuana. Even more alarming is that some kids ultimately kill themselves 2011 CASA survey revealed that, The Internet is a tremendous resource compared to teens who, in a typical because they are embarrassed about that has changed the world, and it can day, do not spend time on a social the chronic bullying and feel helpless provide positive ways for teens to learn networking site, those who do are to stop it. Caution your children not about the dangers of drug abuse. How to post secrets, photos, or anything ❯ Five times as likely to use tobacco can you ensure that your children use that might be embarrassing online ❯ online privileges wisely and avoid Three times as likely to use alcohol that can later be used against them, inappropriate drug-related material? ❯ Twice as likely to use marijuana and encourage your children to report 1. Monitor what your children do cyberbullying—whether it is happening Also alarming is that half of the teens online by becoming acquainted to them or to someone they know. who spend time on social networking with the websites they visit. sites have seen pictures of kids drunk, Bottom line: social networking won’t passed out, or using drugs on these 2. Know what your children are “make” your children use drugs. But sites.59 That is a lot of visual temptation saying on their smartphones spending too much time on social at a young age! and in chat rooms and instant networking sites may increase the messages. Kids are speaking likelihood that they will. Unfortunately, most parents are not in an abbreviated language concerned about the risks of social that evolves, so stay aware of Other Environmental networking. In fact, only about new lingo. At the time of this Influences publication, for example While not interactive like social media, ❯ DOC means Drug of Choice. the power of television on young ❯ PAL means Parents people is worth mentioning. Are Listening. The same CASA survey that asked teens about social networking also ❯ P911 means Parent Alert. asked about whether, in a typical week, ❯ The number 420 is they watched reality shows like Jersey code for marijuana. Shore, Teen Mom, 16 and Pregnant, or any ❯ KPC means Keeping teen dramas like Skins or Gossip Girl. A Parents Clueless. third of all teens (46 percent of girls and 19 percent of boys) watch “suggestive 3. Watch credit card and bank teen programming,” and the survey statements for online purchases says those that do are likelier to use that may indicate your child is tobacco, alcohol, and marijuana. buying drugs on the Internet. Television shows and characters Another sad trend to come from social change from year to year. The ones networking sites is cyberbullying, mentioned here were popular at the which is a widespread problem that time this publication was written— causes serious and lasting harm. so stay involved by monitoring the Cyberbullying includes sending programs your children watch, even hurtful, rude, or mean text messages; if that simply means sitting and spreading rumors or lies about others watching the show(s) with them. by e-mail or on social networking You may not like the characters sites; and creating websites, videos, or or the program, but the plot and social media profiles that embarrass, story lines can provide great ways humiliate, or make fun of others. to start conversations with your More than 4.5 million kids have been kids about what is going on in their cyberbullied, and the 2011 CASA lives. At the very least, you will

20 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION WHAT SUBSTANCESWHY DO KIDS DO USE KIDS DRUGS? USE?

One of the best beyond just getting together for meals, as mentioned in Myth #3. protective factors you ❯ Juggle your schedule so that you can provide is a strong can spend regular one-on-one time parent-child bond. with each child in your family— even if it’s only for short periods. This gives you and your children know what messages your child is time to talk about whatever is seeing and hearing about sex, drugs, going on in their lives without any­ relationships, and other social issues. one else hearing or interrupting. While parents can control what For some, that may mean taking happens within their home, it is a Saturday morning bike ride. For impossible to control every aspect of others, it may mean chatting while your child’s environment when he you drive to or from a school activ­ or she walks out the front door. Risk ity. It may even mean talking while factors that occur at school (such as you’re folding a load of laundry lack of a drug education and enforce­ on Sunday afternoon. Whatever ment program) or in the community works for you, make the moments (such as a high tolerance for youths count. Ask your teens what is go­ who smoke) make your already ing on in their lives, and then listen challenging job even more difficult. to the answer. These formal or Section 4 (How Do I Teach My Child informal rituals help establish the About Drugs?) will present ideas for open communication that is essen­ how you can become more involved tial to raising drug-free children. in school and community efforts to ❯ Family meetings help create reduce risk factors. bonds, too. Once a week, get everyone together to talk about PROTECTivE FACTORS family issues—to celebrate what’s Another time when it’s critical for A number of protective factors are working and resolve what isn’t you to be there is—well, any time! quite effective in helping children working. Set some simple ground Assure your children that you are grow up drug-free. One of the best rules for your meetings, such as available any time they need to leave protective factors you can provide is a (1) everyone gets a chance to talk, a place where alcohol or drugs are strong parent-child bond. Why? First, (2) no interrupting, and (3) only being used. Even if your children it tells your children that you are there positive feedback is allowed. You don’t use drugs or alcohol, you don’t 24/7 for advice. It also tells them they can combine this meeting with one want them riding in a vehicle with are valuable members of the family of your family meals—say, every someone who does. When you can’t and that you love them, and it boosts Sunday night. provide transportation at a moment’s their self-esteem so they feel good notice, such as during your night shift, about who they are without the need Open Communication nominate a responsible adult who can. for drugs or alcohol. Let’s look at some Myth #3 also mentioned the of the ways to strengthen the parent- importance of being there for your Other Role Models child bond. child, especially during times of Parenting can feel overwhelming, transition (e.g., changing schools, especially if you are employed outside Family Time moving, or divorce) because the the home or are a single parent. If Make no mistake: quality family time risk of drug abuse increases greatly possible, try to find other family is a powerful protective factor. With during these transitional times.61 As members or caregivers who can serve school activities, work, and social previously mentioned, family dinners as positive role models in your child’s commitments, it’s not always easy to and one-on-one time are also excellent life to ease some of your burden. get everyone in the family together at ways to let your children know you Grandparents, for example, can bring the same time. But family time goes will be there for them. a calmer, more seasoned approach to

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 21 SECTION 3

interactions with their grandchildren. ❯ Kids receive conflicting messages so! This makes children feel loved They (and other extended family from television, peers, social me­ and secure. members) can use their positions of dia, etc., and may not know which ❯ Finally, praise your child often trust to reinforce the same lessons in way to turn. They need you to for respecting the rules and doing self-respect and healthy living that help them, so state your position what’s right. It only takes a minute you are trying to portray to your clearly. Tell your children that you a day to hug your child and say, children. Even a neighbor or faith- forbid them to use alcohol and “Thanks for being a good kid.” based community member can serve drugs because (1) you love them, This positive reinforcement boosts as a positive role model if one isn’t (2) those substances are harm­ your child’s self-esteem and less­ available in the family. This person can ful for their health, and (3) those ens the likelihood that your child often ask more direct questions than substances are illegal. needs drugs to feel good. parents can (What kinds of drugs do kids ❯ Let them know how disappointed take nowadays? What types of alcohol have you’d be if you found out they Positive Activities you been offered at parties?), and they were using. Rules also give your One reason kids may experiment with might get more honest answers. child a “way out” when tempted. drugs is simply that they are bored. If grandparents or older family If someone offers your child a cig­ While you don’t want to enroll children members who can serve as positive arette, for example, your child can in every single activity, you should role models don’t live nearby, use say, “If my mom caught me smok­ encourage them to find something technology such as email or real-time ing, I’d be grounded and have to they are interested in (e.g., sports, video chats to bridge the miles. miss the homecoming game!” This music, volunteer work, and faith-based takes the pressure off your child activities) and to participate in it. and shifts the blame to you, which Rules and Consequences Being active accomplishes several your child may be more comfort­ Myth #4 mentioned that youths things. First, it fills the empty able doing among peers. aged 12 to 17 who believed their hours after school, on weekends, or parents would strongly disapprove ❯ Establish appropriate consequenc­ during the summer when children of their using substances were less es for breaking rules and consis­ aren’t otherwise occupied. This likely to use that substance. That’s tently enforce them. Be prepared: is especially true if you work and why one critical protective factor is your child may test your rules just can’t be home to monitor what your being consistent in your “NO drugs, to see if you’ll follow through with children are doing during free time. NO alcohol” message. Repeat it consequences. By all means, do It also keeps them from spending frequently so there is no doubt about how you feel. Don’t assume that your children know where you stand— they want you to set boundaries that help them make life choices. Think of it this way: your child is the captain of a ship, and the seas (of life) are rough. The ship’s instruments aren’t wired perfectly, so your child’s judgment may be clouded by inaccurate information. As much as your child wants to steer the ship, your child needs guidance. YOU can serve as a lighthouse—a beacon, of sorts—to help guide your child safely into the harbor (of adulthood). School connectedness is an That example may seem simplistic, but it demonstrates that growing up important protective factor. drug free can be hard.

22 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION WHAT SUBSTANCESWHY DO KIDS DO USE KIDS DRUGS? USE? hour upon hour watching television or surfing the Internet. 10 WAYS TO iNCREASE YOUR CHiLD’S Extracurricular activities help meet CONNECTiON TO SCHOOL other needs, too. For example, 1. Encourage your child to talk openly with you, teachers, counselors, and involvement in activities such as rock other school staff about any ideas, needs, and worries. climbing, karate, or camping fill the 2. Find out what the school expects your child to learn and the appropriate natural desire to engage in something behavior for school by talking to teachers and staff, attending school risky, which may reduce their desire meetings, and reading information the school sends home. Support these to use drugs. Participating in sports expectations at home. activities promotes a sense of team 3. Help your child with homework, and teach your child how to use time building, which shows your child that well. Make sure the tools—books, supplies, a quiet place to work—needed everyone matters. After all, you can’t to do homework are available. play football with only two people! 4. Read school newsletters, attend parent-teacher-student conferences, and Physical activities also encourage your check out the school’s website to learn what is going on at the school. child to stay healthy and drug-free, as Encourage your child to participate in school activities. some schools now perform drug tests 5. Meet regularly with your child’s teachers to discuss grades, behavior, and on athletes. accomplishments. Less athletic children may enjoy 6. As time allows, help in your child’s classroom, attend afterschool participating in art classes, attending events, or participate in a school committee, such as a health team or Girls Scouts or Boy Scouts, parent organization. performing volunteer work for a 7. Offer to share important aspects of your culture with your child’s class. faith-based organization, or helping 8. If your first language is not English, ask for materials that are translated tutor younger children. into the language you speak at home, and ask for interpreters to help you These types of positive activities at school events. have another benefit, too. They may 9. Talk with teachers and school staff to suggest simple changes that can make help children discover a talent for the school a more pleasant and welcoming place. For example, the school something they didn’t realize they had might decorate the eating area with student-made posters, allow families to or a desire to pursue an occupation use the school gym or other facilities during out-of-school times, or create a they never would have otherwise. place in the school or on school grounds for kids and families to socialize. 10. Ask whether your school or school district provides—or could offer— School and Community programs or classes to help you become more involved in your child’s academic and school life. For example, the school or school district might Schools with a drug and alcohol offer training to help you talk with your child and to help manage his or education program and a “no her behavior; educational programs for parents by telephone or online; tolerance” policy for substances and/or General Education Development (GED), English as a second that aligns with yours provide yet language, or other classes to help you work better with your child and another protective factor for your with the adults at school. children because they are hearing the Courtesy of the Centers for Disease Control and Prevention same message at school as at home. Similarly, an organized anti-drug effort in the community—or at least According to the CDC, school connected­ behaviors such as early sexual initiation; a low tolerance for drug and alcohol alcohol, tobacco, and other drug use; abuse—will reinforce the messages ness—the belief held by students that and violence and gang involvement. you are trying to convey to your adults and peers in the school care about child. Again, you can’t control every their learning as well as about them as Students who feel connected to situation in your child’s environment, individuals—is an important protec- their schools are also more likely to 62 but Section 4 will present ideas for tive factor. (See the sidebar above.) have better academic achievement, how you can become more involved Research has shown that young people including higher grades and test in school and community efforts to who feel connected to their schools scores, have better school attendance, increase protective factors. are less likely to engage in many risky and stay in school longer.

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 23 SECTION 3

55 Centers for Disease Control and Prevention. Alcohol and Other Drug Use and Academic Achievement. 2009 National Youth Risk Behavior Survey. June 4, 2010. Accessed September 21, 2012, www.cdc.gov/healthyyouth/health_and_academics/pdf/alcohol_other_drug.pdf. 56 Ibid. 57 Substance Abuse and Mental Health Services Administration. Report shows 7.5 million children live with a parent with an alcohol use disorder. News release dated February 16, 2012. www.samhsa.gov/newsroom/advisories/1202151415.aspx. 58 The Importance of Family Dinners VII. 59 National Survey of American Attitudes on Substance Abuse XVI: Teens and Parents. 60 Ibid. 61 National Institute on Drug Abuse. Drugs, Brains, and Behavior - The Science of Addiction. NIH Pub No. 10-5605. Printed April 2007. Revised February 2008, August 2010. 62 Centers for Disease Control and Prevention. School Connectedness: Strategies for Increasing Protective Factors Among Youth. 2009. Accessed September 21, 2012, http://www.cdc.gov/healthyyouth/adolescenthealth/pdf/connectedness.pdf.

24 DRUGU.S. DRUG ENFORCEMENT ENFORCEMENT ADMINISTRATION ADMINISTRATION • DEPARTMENT • U.S. DEPARTMENT OF EDUCATION OF EDUCATION HOW DO IWHAT TEACH SUBSTANCESWHY MY CHILD DO KIDS ABOUT DO USE KIDS DRUGS? USE? SECTION 4: HOW DO I TEACH MY CHILD ABOUT DRUGS?

Section 4: How Do i Teach My Child About Drugs?

e’ve already mentioned the so you need to be familiar with the importance of establishing substances they may encounter. The Wopen communication names of drugs and how they’re with your child—but many parents used change constantly, so take time find it difficult to actually talk openly to review the more common drugs, about drugs. What if your child paraphernalia, and street names in asks a question you don’t know the the Drug Identification Chart at the answer to? If your children don’t seem back of this publication. interested in drugs, should you talk to them anyway? EDUCATE YOUR CHiLD This section will suggest ways to Another indisputable fact is that kids talk with your child at different ages will learn about drugs. They will and proposes ideas for initiating learn from media (television, music, conversations. It also explains the movies, social networking), and they importance of being an active parent, will learn from friends. But if you which creates a bond that serves as a intervene, they will also learn from strong protective factor for your child. YOU. They will learn how you feel about drugs and how you expect them EDUCATE YOURSELF to act when tempted to use drugs. You aren’t expected to know That’s why it is crucial to (a) begin everything about parenting or drugs. talking with your children about And even if you did, your children— drugs at a young age, and (b) talk at certain rebellious stages—may not with them at a level they understand. seem to be listening to you. They are, Talking to children about drugs isn’t though, so don’t let up! To effectively a one-time event. Instead, strive for communicate with them about a number of talks about substance substance use, it’s important that you use from preschool throughout the understand what they face so you teenage years. Think of each talk as one can provide advice and guidance. “chunk” of an ongoing conversation. Reading this publication is a good first A big part of talking is listening. Ask step in educating yourself about the your kids what they know about types of drugs young people use, how marijuana. Ask if they think alcohol they acquire them, and their negative is dangerous. Ask what they think health consequences. can happen if someone takes heroin. No matter where you live, your These attitudes are important because children will eventually be exposed national drug prevention surveys have to tobacco, alcohol, or other drugs, shown that the level of drug use goes

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 25 SECTION 4

Remember: If children perceive a substance as Be Involved at Home dangerous, they may be less likely to use it. If they see As discussed in the section on social it as not that risky, they may be more likely to use it. networking, children are exposed to all kinds of information online. Be involved in their lives at home by up as the perceived risk of using the MEET MARK BAUER drug goes down.63 In other words, ❯ Monitoring the computers in your if young people think a particular home—and the cell phones, too, if Phil Bauer writes: Since the death of drug is harmful, they are less likely your children use a smartphone to my son Mark in 2004, I have asked to use that substance; if they think a access the Internet. myself many questions. What if I particular drug isn’t as harmful, they had talked to Mark more about the ❯ Knowing what types of websites may be more likely to use it. dangers of drugs? Or spent more they visit and who they commu­ time learning about what kids were In the 2010 MTF survey, for example, nicate with online, as well as what doing at the time? If I hadn’t missed eighth-grade students were asked How they are watching on television and the signs of addiction, would he still much do you think people risk harming what music they are listening to. be alive? themselves if they smoke one or more packs ❯ Establishing some structure for of cigarettes per day? Only 61 percent A few times during Mark’s teen your children so that there isn’t too thought it was a “great risk.” This is years, we found marijuana in his much free time. If you work and especially alarming because that is room. We also knew he occasionally your children will be home alone about the age when most teens are after school, assign age-appropriate drank beer. I talked with him and first exposed to cigarettes—and many household chores to accomplish assigned some form of punishment. of them apparently don’t perceive and set rules about watching televi­ I didn’t see this as a life threatening smoking as risky. The same survey sion or using the computer. behavior and didn’t believe Mark asked the eighth-graders How much do had an addiction problem. you think people risk harming themselves if Be Involved in Your Child’s On May 27, Mark went to school, they try inhalants once or twice? Only 36 Social Life played basketball, and then percent answered that it was a “great Regardless of your children’s ages, went to work. He was looking risk.” Again, students are most likely to you need to be involved in their forward to a camping trip and use inhalants at about this age. social lives. That doesn’t mean to his graduation the following Remember: If children perceive a tagging along every time they leave week. But the next day, Mark substance as dangerous, they may the house, but you need to know never woke up. He died from be less likely to use it. If they see it as where they are going, what they’ll be an overdose of prescription not that risky, they may be more likely doing, and what friends will be there. drugs, including oxycodone, to use it. It’s up to YOU, as a parent When your children leave home to go morphine, acetaminophen, and and role model, to make sure your hang out with friends, for example, amphetamines. I never knew Mark children know that using tobacco, do you know who those friends was using prescription drugs, and drugs, and alcohol has serious health are? When your child asks to attend I don’t recall ever talking with him and social effects, and it’s illegal for a sleepover, do you meet and talk about the dangers. children to use them. It’s up to YOU with the host parents to be sure the Unfortunately, his life here on to explain how USING drugs can group will be chaperoned? Do your earth is over, but I hope his lead to ABUSE, which can lead to teens know the laws regarding teen story will serve as a “second ADDICTION. driving? Did you set a time for them chance” for others. to return home? Do you know how BE AN iNvOLvED PARENT many kids will be in the car? How old What would you have done An excellent way to let your children are they? Who are they? differently—if anything? If you know how strongly you feel about And don’t forget—when your child’s suspect your child is using, talk to not using drugs is to show them by friends come to your home, you are your family doctor or pediatrician example—by being an active parent responsible for their well-being. Most to see about having your child in all aspects of their lives and by not states have stiff penalties for serving assessed for substance abuse. using drugs or alcohol. alcohol to minors or furnishing them

26 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION HOW DO IWHAT TEACH SUBSTANCES MY CHILD ABOUT DO KIDS DRUGS? USE? drugs. It’s not enough to just lock up your wine; you also need to be sure nobody in attendance brings alcohol or drugs with them to your home. Even if you don’t believe your own child is using drugs or alcohol, you should be concerned if you suspect that your teen’s friends are using. In the national 2011 CASA study on substance abuse, two in five teens reported know­ ing at least one friend or classmate who used illegal drugs, like acid, Ecstasy, or methamphetamine; and approximately one in four teens knew at least one friend or classmate who used prescrip­ tion drugs to get high. Get to know the parents of Get to know the parents of your your child’s friends, too. child’s friends, too. They can be terrific allies because they also want to raise a They can be terrific allies. drug-free child. Explain to the parents that your family has a strict NO use policy for tobacco, alcohol, and other and policies reflect the same attitude gram? Do faculty members receive drugs in your home. Exchange contact that you express at home—tobacco, regular training? Is drug education information and ask them to forbid alcohol, and drug use is not provided at age-appropriate levels your child’s use of alcohol, tobacco, acceptable—and if those rules are throughout the year or only once and other drugs in their home. enforced with consistent consequences. during a special “drug-free” week? Promise to do the same for them. ❯ Learn the policies regarding alco­ Does the drug education program If your child is attending a party, hol and drug use at your child’s offer educational material for par­ call the parents of the other child school. For example, does the ents, too? to be sure there actually is a party school have a student handbook ❯ What procedures are in place to taking place and ask who will be that clearly states its drug and al­ ensure that school activities (e.g., chaperoning. Explain your NO use cohol policy? Does it explain what sports events, prom, graduation) policy to the parents and ask that constitutes an offense and the con­ are alcohol and drug free? no alcoholic beverages or illegal sequences for breaking the rules? ❯ Review all drug education materi­ substances be present. Also, don’t Does it include an agreement for als your child brings home. Do be afraid to go check out the party students and parents to sign about they contain a clear message that yourself. If possible, meet with other adhering to the policy? Is there alcohol, tobacco, and other drug parents who have kids the same age fair and consistent punishment so as yours—even if it’s just sharing a use is harmful? Does your child that all students breaking the same have any questions or need clarifi­ cup of coffee now and then or chatting rule face the same consequences? during a school sporting event. It cation on anything in the material? ❯ helps to find out what other parents If there’s no policy in place, sched­ ❯ Does the school have outside are doing or to simply share opinions. ule a meeting with the principal, resources to help educate students My child wants to go to a party where the arrange to meet with school board in school? If not, work through chaperone will be a 20-year-old cousin. members, and/or attend PTA the school to contact agencies Are you allowing your child to go? meetings to help develop a policy. and organizations like the Drug ❯ Ask how drug education is pro­ Enforcement Administration Be Involved at School vided in your child’s school. Does (www.justice.gov/dea); the Your chances of raising a drug-free the school use an evidence-based National Guard child are better if school regulations drug abuse curriculum or pro­ (http://ngbcounterdrug.ng.mil);

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neighbors! Ask them to report DEvELOPiNG A COMMUNiTY PREvENTiON PLAN suspicious or unusual afterschool The first step in planning a drug abuse prevention program is to assess the activity when you can’t be home with type of drug problem within the community and determine the level of risk your child. If you are a stay-at-home factors affecting the problem. The results of this assessment can be used to parent, watch for signs that your raise awareness of the nature and seriousness of the community’s problem and child (or other children) may be doing guide selection of the best prevention programs to address the problem. things they shouldn’t. Next, assessing the community’s readiness for prevention can help determine On a larger scale, it’s important to additional steps needed to educate the community before launching the know what community leaders are prevention effort. Then, a review of current programs is needed to determine doing to help prevent drug abuse. existing resources and gaps in addressing community needs and to identify additional resources. And if it’s not enough, then get involved with that, too. For example, Finally, planning can benefit from the expertise of community organizations does your community support that provide youth services. Convening a meeting with leaders of these service organizations can set the stage for capturing ideas and resources to help student-run clubs where teens can implement and sustain research-based programs. hang out, listen to music, and play sports? If not, meet with officials Prevention research suggests that a well-constructed community plan and/or organizations who can help y Identifies the specific drug and other child and adolescent problems in a you establish such places. Does the community; community have underage ordinances y Builds on existing resources (e.g., current drug abuse prevention that prohibit minors from purchasing programs); or using tobacco and alcohol? If so, y Develops short-term goals related to selecting and carrying out research- are they enforced? For example, in based prevention programs and strategies; stores where signs say the clerks ask y Projects long-term goals so that plans and resources are available for the for identification to ensure patrons future; and are of legal age to purchase beer or y Includes ongoing assessments of the prevention program. cigarettes, do the clerks actually ask 64 for an ID? Courtesy of NIDA You can also check to see if an anti-drug coalition exists in your Drug Abuse Resistance Educa­ ment results by adjusting its sub­ community. To find out, look online tion (D.A.R.E.) (www.dare.com); stance abuse education program. using a search engine such as the Elks organization (www.elks. Finally, being involved in these Google or go to the website for the org); the Mothers Against Drunk efforts at your child’s school serves Community Anti-Drug Coalitions of Driving (MADD) (www.madd.org) another purpose. It lets you observe America (CADCA) at www.cadca. and Students Against Destructive firsthand what is happening and lets org. There you’ll find a link to email Decisions (SADD) (www.sadd. you participate in shaping the drug them, and a CADCA representative org) chapters nearest you; or the will contact you with details about education efforts at that school. And other resources listed in the back of existing community coalitions in your according to a recent CDC report, this publication. area or walk you through the process parent engagement also makes it more of starting a coalition and explain the ❯ Determine whether the school has likely that adolescents will choose various resources available through a school nurse, a school resource healthier behaviors, such as avoiding CADCA to help your coalition officer, or a school counselor on tobacco, alcohol, and other drug use.65 staff or on call. succeed. Since 1992, CADCA has offered training to local and state ❯ Be Involved in the Does the school have a referral sys­ drug abuse prevention coalitions— Community tem to a substance abuse treatment teaching them how to assess their agency for students who need help? Active parenting also includes local substance abuse problems and ❯ Find out how the school assesses knowing what is going on in your develop a comprehensive plan to its alcohol and drug problem and own neighborhood. If you haven’t address them. Each community’s drug whether it responds to the assess­ already done so, get to know your and alcohol problems are different,

28 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION HOW DO IWHAT TEACH SUBSTANCES MY CHILD ABOUT DO KIDS DRUGS? USE? of course, so CADCA brings together fashion, music, or movies they are Talking With Preschoolers concerned citizens, schools, parents, interested in, and it provides you It may seem premature to talk about businesses, healthcare providers, insight into their world. drugs with preschoolers, but the law enforcement, and faith-based These casual conversations don’t have attitudes they form now are the institutions to share ideas, problems, to be long and drawn out, but they foundation for the decisions they will and solutions that are unique to a are an excellent time to introduce the make when they’re older. Talk often particular community. subject of drugs and alcohol. Don’t with your preschoolers, and listen BE A GOOD ROLE MODEL worry that you are giving your child often to what they have to say. ideas. Kids are exposed to alcohol and As previously mentioned, children 1. Playing grownup. At this early drugs through the media every day. learn what they see. This means age, children often like to play Even elementary school children likely that many of their attitudes about grownup by pretending to be know someone who uses prescription substance abuse will be shaped by adults. They mimic what adults drugs for allergies or asthma. If not, your attitudes and your actions. If do and say. What they hear you they probably remember having a cold you occasionally drink alcohol, do say and see you do makes a lasting so in moderation, and never imply and being given medicine to make impression, so when opportunities that alcohol is a good way to handle them feel better. arise to let your child know how problems. Instead, show your child NOTE: The following text suggests you feel about substance use, share how to use healthy ways to cope with ways to talk with children at various those feelings. If you drive up to stress, such as exercising, listening to ages. Although divided into preschool, the supermarket, for example, music, or talking your issues over with elementary, middle school, and high and see someone standing outside a friend. school, the exact age range of students smoking, tell your child that in these grade levels may be different in smoking is harmful and that it COMMUNiCATE NO your area. Also, children don’t necessarily causes people to get very sick and TOLERANCE FOR develop at the same pace, and drug sometimes die. SUBSTANCE USE issues vary among communities. Use the 2. Teaching on their level. As a parent, you can have more suggestions most suitable to your child’s Children this age are capable of influence over your child’s behavior maturity level and environment. understanding your explanation than his friends do, and more influence than music, TV, social networking sites, and celebrities. As mentioned previously, make it perfectly clear that you do not want your child to use tobacco, alcohol, or drugs. Period. Stress that it is unhealthy and it is illegal.

TALK WiTH YOUR CHiLDREN ABOUT DRUGS Parents of very young children must quickly learn to answer a lot of questions—no matter how ridiculous they seem. Taking time to do so lets kids know that it’s okay to ask questions and that you can be trusted to provide answers. Children don’t forget this! As they grow, your own willingness to ask questions and to be a good listener is also important. It tells children you care about what

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important to teach your children DOs AND DON’Ts OF TALKiNG WiTH KiDS how to make good decisions. One ABOUT DRUGS way to do that is to let your chil- dren make their own decisions— When it comes to talking with kids at any age, make your messages clear but only if they don’t endanger and consistent. their well-being. For example: DO: ❯ Explain early (and often) y Tell them the dangers of using drugs and alcohol using age-appropriate about why healthy foods help explanations. children grow up to be fit y Explain why you don’t want them to use drugs. For example, explain how and strong. If they are espe- drugs and alcohol interfere with young people’s concentration, memory, cially enamored by a fictional and motor skills, and that it leads to poorer school performance. Tell them character or famous athlete, you wouldn’t want these outcomes for them. encourage them to eat healthy foods so they will grow up to y Make it easy for your child to talk honestly with you. Also, make yourself be healthy and strong like thier available when your child wants to talk—no matter the time of day or the idols. This gives your child other tasks you face. the background knowledge to y Believe in your own power to help your child avoid using alcohol and drugs. make smart food choices.

DON’T: ❯ When feasible, let your pre- y Don’t react in anger—even if your child makes statements that shock you. schooler choose what cloth- ing to wear—even if they y Don’t expect every conversation to be perfect. They won’t be. make a few mistakes. Letting y Don’t simply demand that your children not do drugs. Instead, educate them them choose builds confi- about the risks so they will be equipped to make decisions about drug use dence in their own decision- based on their own knowledge. making ability. y Don’t talk without listening. Aim for a 50/50 conversation—you talk half the time and listen the other half. Talking With Elementary School Students (6–10 y Don’t make stuff up. If your child asks a question you can’t answer or wants years old) information about something you’re unsure of, promise to find the correct answer so you can learn together. Then follow up on that promise. At the lower end of this age range, children are very perceptive and anxious to learn. This is a good time about poison and bad things When they ask questions, answer to introduce more detail into your in your home, such as cleaning honestly but don’t overwhelm conversations about drugs, especially products, paint, etc. Caution your them with information they aren’t what they are and the consequences children to eat or drink only what capable of understanding. For of using them. Explain the concept of you, a grandparent, or another example, you or another adult addiction—that some people may not caregiver gives them. If your child family member occasionally drink understand how harmful drugs are or becomes sick and you administer wine with dinner or enjoy a beer that some people try drugs and then medicine, use this opportunity on the weekend. Four-year-old have a hard time quitting. Introduce to explain that medicine helps Jimmy wants to know if he can them to the idea that drug use can lead the person it is meant for but can taste it. You might say, “No, Jimmy, to abuse, which can lead to addiction. harm someone else who takes this is only for adults who are at least 1. Good drugs and bad drugs. it. Warn children to never take a 21 years old. It can make children Kids in this age group may ask drug unless it is meant for them. very sick if they drink it. Why don’t why some drugs are good for you you help me fix you a glass of apple 3. Short but honest answers. and others aren’t. With the rise in juice instead?” Preschool children are curious and prescription drug abuse, this is a eager to learn, but they also have 4. Decisions, decisions … Even good time to explain to them that relatively short attention spans. at this early stage of life, it’s prescription medication should be

30 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION HOW DO IWHAT TEACH SUBSTANCES MY CHILD ABOUT DO KIDS DRUGS? USE?

taken only when a doctor tells you to and only when administered by an adult. Tell your child that bad drugs can make you sick or even kill you and that is why it is wrong to take them—even once. They may even understand the sadness that accompanies death if they’ve lost a loved one (such as a grandparent). 2. Honesty and praise. Explain in more detail how dangerous it is for children to drink alcohol and how harmful it is to their developing brain and body. Tell them the truth: even relatively small amounts of alcohol can make a child sick. If your children aspire to be like someone famous, such as a sports figure, remind them that it’s important to take care of their body and not use tobacco, alcohol, or drugs if they want to excel. Children this age crave praise, so give it out freely when deserved. For example, let them know you think they are super smart for disliking the smell of cigarette Talk to your kids often about making smoke. This type of interaction also good choices and about healthy assures children they are capable of making healthy choices—in this living and smart goal setting. case, they dislike cigarettes and don’t want to be around them. 3. Repeat yourself. While in CONvERSATiON STARTERS elementary school, children need to be warned about not using Starting a conversation about alcohol, tobacco, and other drugs with inhalants. (For a review, see the your kids is never easy—but it’s also not as difficult as you may think. Take section on inhalants.) Tell them— advantage of teachable moments to begin a conversation with your child repeatedly—that even one instance when the opportunity arises. of inhaling can lead to severe brain y If you see a young person smoking a cigarette, you might talk about the damage or even death. negative effects of tobacco. 4. When they ask … When y If you see an interesting news story, discuss it with your child. Did a drunk children in this age group ask driver hit and kill a family? Did a young couple lose custody of their chil- questions, it’s often because of dren because they were busted for drugs? How does your child feel about something they have seen or what happened? What consequences does your child think are appropri- heard, and it’s important to know ate in these cases? where they are getting their y While watching TV with your kids, ask them if they think the shows or the information. For example, your advertising make tobacco, alcohol, and drug use look cool? Do they change eight-year-old may ask, “What is the way your child feels about drugs? pot?” First, clarify that your child

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means marijuana by asking where it’s not too late to start! In fact, this HOW ALCOHOL AND your child learned about it and is the time when you should spend DRUGS ALTER BRAiN what exactly was heard, read, or even more time talking and listening, seen. Based on that, you might as your child is likely seeing more DEvELOPMENT AND answer, “It’s a very dangerous drug substance use on television, in FUNCTiON that people smoke—usually like a movies, and online—and at school Most kids grow dramatically during cigarette but sometimes in a pipe. or in social situations. Children the adolescent and teen years. Marijuana has chemicals in it that this age are capable of engaging in Their young brains, particularly the can cause cancer and maybe even kill more in-depth conversations about prefrontal cortex that is used to you. People who smoke marijuana why people use drugs, the potential make decisions, are growing and can get addicted and can’t stop dangers (such as addiction or fatal developing, too—even into their using it, or they might try other very overdose), and the consequences for twenties! Alcohol can interfere dangerous drugs, too. It’s nothing the user and his family. to mess around with, and I hope you with some of the developmental 1. Take the lead. Your child may don’t ever try it. You are a smart girl, processes occurring in the brain. not initiate as many conversations and I wouldn’t want you to mess up For weeks or months after a teen about drugs and alcohol with stops drinking heavily, parts of the your life.” 66 you as before. If that’s the case, brain still struggle to work correctly. 5. involve others. Children it’s important for you to take the Drinking at a young age is also this age still respect adults, lead and engage your child in associated with the development of particularly law enforcement. discussions at every opportunity alcohol dependence later in life. As your child enters elementary by using real-life events in the Long-term drug use causes brain school, offer to help establish news or in your own lives. For changes that can set people up for or administer a drug education example, your child tells you addiction and other problems. Once program that includes outside that a friend named Kevin rode young people become addicted, resources. For more information, in a vehicle driven by an older their brain becomes altered so that review the resources in the back brother, who was smoking drugs are now their top priority— of this publication. marijuana while driving. Explain and they will compulsively seek and 6. Encourage healthy choices to your child the importance of use drugs even though doing so and smart decision-making. not riding in a car with someone brings devastating consequences Talk to your kids often about who is using alcohol or drugs, for their lives and for those who making good choices and about and explain what to do in that care about them. healthy living and smart goal situation. You might say, “What setting. Let them make age- Kevin’s brother did was illegal, and appropriate decisions, and reward he could go to jail if caught. But them when they do well. Doing more important, he could have had so empowers them and gives a serious accident. I hope you know them confidence in their decision- you can call me if that ever happens making skills. to you, and I will come and get you. You’ll be driving in a few years, and Talking With Middle School I’m glad you are smart enough to Students (11–14 years old) know better than to drink or do drugs and drive.” Your child’s transition to middle school (or junior high) calls for 2. Encourage healthy growth. special vigilance. If you began having Conversations with your child regular conversations with your should also include talking about child at a young age, the child should his interests. As discussed in the know by now—without a doubt— section on protective factors, where you stand on the subject of activities such as youth groups, drugs and alcohol. If you didn’t arts, music, sports, community have those conversations earlier, service, and academic clubs keep

32 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION HOW DO IWHAT TEACH SUBSTANCES MY CHILD ABOUT DO KIDS DRUGS? USE?

Your ongoing USE ROLE-PLAYiNG TO HELP YOUR CHiLD SAY conversations with “NO” TO DRUGS your children should Encourage your children to analyze a situation and know how to remove include how to themselves from a dangerous environment. A great way to prepare your respond if someone children for real-life situations is to act out scenarios with them so that offers them drugs or they can practice how they’ll respond. Use the following two scenarios as a starting point, and create new ones based on your child’s age and activities. alcohol. Let your child Scenario #1: Your child goes to a party at a friend’s house and someone practice his answers. has brought some beer. Many of the guys there, including older high school guys, are drinking and they ask your child, “You want some?” Take the role of the older teens or of your child’s friends who casually offer a can of beer children occupied, develop team- to your child. building skills, provide a sense of discipline, and sometimes help Help your child develop firm but friendly responses. Possible answers: kids discover talents they didn’t y “No, thanks.” realize they had. Encourage your y “No, I’m not into that.” children to share their dreams—at the very least, ask what types of y “Nah man, I’m ok. Thanks.” activities they enjoy, and then find y “No, thanks. I’m on the _____ team and I don’t want to risk it.” a way to nurture those interests in y “Nah, I’m training for ______.” positive ways. y “No. I gotta go in a bit.” 3. Self-image. In this age range, preteens begin going through Scenario #2: Your child is at a friend’s house with a few close pals and one of physical changes, and they start to them pulls out a joint. While you play the role of the friend offering it to the care more about their self-image. group, help your child develop firm but friendly responses, and reassure your Girls, especially, tend to pay more child that good friends will respect the decision not to try it. Possible answers: attention to hair and fashion. As y “No, thanks, I’m not into that.” you notice this happening, initiate y “No, thanks. I’m on the _____ team and I don’t want to risk it.” conversations with your child y “Nah, I’m training for ______.” about how he or she looks. Point out the obvious downsides to y “Nah. I get tested at work/school and I don’t want to risk it.” smoking, such as bad breath and y “No, thanks. I don’t like how it makes people act.” stinky hair. You might even expand y “No, I’m trying to stay healthy for ______. that into talking about the long- term risks, such as lung cancer and If your child’s peers keep insisting, suggest that your child use the “broken emphysema. For children who are record” technique—just keep repeating the reason for not wanting to drink, interested in sports, encourage smoke, or do drugs. Then your child can try to change the subject or, if all them to stay healthy and avoid else fails, your child can simply go home. anabolic steroids as a “quick fix” for enhancing their performance. giving a group of kids a ride to child. You may find some who 4. Friends and their parents. the mall, for example, make small do not share your attitude and Friends become extremely talk with the friends by asking beliefs about drugs and underage important during this transition. about their interests, their family, alcohol use. But think of it this Kids want to fit in or feel normal what music or television shows way: if they do agree and your around older teens who may they like, etc. And as discussed child regularly hangs out with expose them to alcohol, tobacco, earlier in this publication, get to the same five friends, you could or drugs. So in addition to talking know the parents of your child’s have as many as 10 extra parents to your own child, get to know friends and share with them keeping their eyes and ears on your children’s friends. If you’re your desire to raise a drug-free your child’s activities!

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 33 SECTION 4

they need to leave a place where graders reported using inhalants DANGERS OF alcohol or drugs are being used. in the year prior to the survey, UNDERAGE DRiNKiNG67 If you can’t be available, find a and 39 percent of eighth-graders responsible adult who will go in didn’t consider the regular use of y Alcohol impairs coordination, 68 your place. inhalants to be harmful. This is slows reaction time, and troubling because inhalants can impairs vision. 6. Asking and listening. cause unconsciousness, severe Remember, your role as a parent y Beer and wine are not “safer” damage to the brain and nervous (or caregiver) isn’t just to talk but than hard liquor. A 12-ounce can system, and even death—the first also to listen. Since your child of beer, a 5-ounce glass of wine, time they are used! Yet 64 percent may not ask as many questions and 1.5 ounces of hard liquor all of the eighth-graders surveyed at this age, it’s up to YOU to ask contain the same amount of al­ didn’t think trying inhalants once open-ended questions that require cohol and have the same effects or twice was risky. Young teens more than a simple “yes” or “no” on the body and mind. may not understand the risks of answer. Conversation starters can inhalant use, so it’s up to you to y On average, it takes 2–3 hours for come from the media (advertising, educate them about the dangers. a single drink to leave a person’s song lyrics, movies, TV shows) or system. Nothing can speed up from real life. For example, you 9. What do they think? Continue this process, including drinking might say to teach your children to be coffee, taking a cold shower, or critical of how drugs and alcohol ❯ In that movie last night, the walking it off. are portrayed in videos, movies, character continued to drink and television shows. Do they y People tend to be very bad at even after she found out she think engaging in promiscuous judging how seriously alcohol was pregnant. How do you behavior after drinking too much has affected them. That means think that might affect her is attractive or disgusting? Does many individuals who drive after unborn baby? drinking think they can control a a video that shows drugs make ❯ car—but they actually cannot. My coworker Mary has a them curious enough to want to 14-year-old child who got try them? Continue to talk to your y Anyone can develop a serious busted for pot and will have kids often about making good alcohol problem, including a teen­ to go into a substance abuse choices and about healthy living ager. This is especially true if there treatment center. What do you and goal setting. is a family history of alcoholism. think that will be like? y Underage drinking is illegal, 7. Your role as a teacher. You Talking With High School and getting caught may mean must also take the role of an Students (15–18 years old) trouble with the authorities. educator. For example, young By the time teens enter high school, y Drinking may cause people to teens may think it’s okay if they they have likely had many opportuni­ engage in risky behavior they “only” drink but stay away from ties to try drugs, alcohol, and/or normally wouldn’t have. drugs. You need to tell them the tobacco. Even if they have resisted real risks of all kinds of substance the temptation, they’ve probably seen 5. Practice makes perfect. Your abuse—including the risks they their peers do it—sometimes to excess ongoing conversations with your may not have heard or thought and perhaps even with serious conse­ children should include how to about—or teach them how to find quences. In fact, they may know fellow respond if someone offers them credible information on websites classmates with addiction issues. You drugs or alcohol. Let your child like www.justthinktwice.com, can’t choose your children’s friends— practice his answers. “Man, that which was developed for teens although parents have been trying for stuff is really bad for you!” or “My and young adults. years! But you can encourage them to mom will kill me if she finds out I 8. A particular concern. Just as develop friendships with kids who do drank a beer!” As mentioned earlier with elementary school students, not smoke, drink, or do drugs. in this publication, assure your the use of inhalants is of particular 1. What they’re thinking. Teens children you will come get them concern at this age. In a 2011 this age typically understand how any time—without scolding—if survey, 7 percent of eighth­ substance use can affect unborn

34 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION HOW DO IWHAT TEACH SUBSTANCES MY CHILD ABOUT DO KIDS DRUGS? USE?

children, how combining drugs 4. Know what’s trendy. Talk can be deadly, and how easy it is with your teen about what to go from casual use to abuse to you learn here and elsewhere addiction. Enforce these concepts about the dangers of abusing when talking with your teenager. prescription drugs. Non-medical During the last few years of high use of prescription medications school, teens are thinking about to get high is rising dramatically, what their future holds, so this is a as shown in the section on great time to keep reminding them prescription medications. The Drug that substance use can ruin their Identification Chart at the back of chances of getting into college, this publication is a good way to being accepted by the military, or help you identify some prescription being hired for certain jobs. Also, drugs, but other medications remind them that keeping the become trendy at times, and other community drug free will make it a drugs may be specific to your nicer place to raise a family if they community that aren’t shown in decide to put down roots there. the chart. Routinely ask your teen which prescription drugs are an 2. Debating what’s legal. An im­ issue at school, in friends’ homes, portant issue to discuss with your and at parties. teenager (and with your preteen in middle school) is the debate over 5. Drinking or drug use while medical marijuana. Make sure driving. As teens begin to your child knows that “smoked drive and become even more marijuana” has not withstood the independent, establish clear rigors of science—it is not medi­ rules about drinking or using MARiJUANA MYTHS cine and it is not safe. Marijuana is drugs while driving. Ask for Myth: Marijuana is not harmful harmful and it is illegal. their input; then develop a because it is all natural and comes written agreement that spells out from a plant. 3. Granting independence—with expectations for behavior and love. Children this age want Truth: Tobacco comes from a specific consequences for breaking plant, too—but that hardly makes it independence, but you need to set the rules. For example, you may safe. Both contain cancer-causing limits. Set curfews and other expec­ want to limit the hours your teen compounds. Smoking anything is tations for your child’s behavior, can drive and grant (or deny) not good for the lungs. establish appropriate consequences permission to transport younger It’s okay to use marijuana as for breaking rules, and consistently Myth: siblings. Whether or not your city long as you’re not a chronic user follow through with enforcement. or state restricts the number of or “stoner.” Finally, tell children often that passengers in your teen’s car, you you care about them and that Truth: You can’t predict when can do so as part of your written occasional use will turn into they are important to you. Show agreement. You and your young frequent use, problematic use, or them you mean it by regularly driver should sign the agreement addiction—and even occasional spending one-on-one time with to give it more credibility, then users can get into car wrecks or them. Developing this strong bond keep it in a public area of the other accidents while under the will make your child more likely home to serve as a constant influence of marijuana. to come to you with questions or reminder of what is expected. Myth: Marijuana isn’t as bad as other concerns about drugs, alcohol, or Here are a few other examples you drugs, and I doubt I’d get in trouble other sensitive issues—encourage might include. if I get caught. that openness. Remember, even as ❯ Truth: Marijuana can be as bad children are pushing for indepen­ I will not drink alcohol and drive. as other drugs—it affects your dence, they need someone they memory, mood, and coordination. It love and respect to be involved. ❯ I will drive only from ____ is addictive, and it is illegal! They need YOU! a.m. until ____ p.m.

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 35 SECTION 4

or at least be familiar with the name of the person who is responsible for campus counseling or prevention programs. Learn about the college’s standards of conduct. Federal regulations require any institution of higher education receiv­ ing federal funding (most of them do) to have a drug prevention program that prohibits, at a minimum, the unlawful possession, use, or distribution of illicit drugs and alcohol by students on cam­ pus property or while participating in its activities. Colleges must enforce these standards or risk serious consequences, including loss of federal student finan­ cial assistance. Ask about and under­ stand the college’s parental notification ❯ I will not stay at a party 7. Continue to praise and policy for standards of conduct viola­ where alcohol is served or encourage teenagers for tions. Make sure your child understands drugs are present. the things they do well and the penalties for underage drinking, public drunkenness, illicit drug use, ❯ I will not ride in a car with a the positive choices they using a fake ID, driving under the influ­ driver who has been drinking make. Knowing you are proud ence of drugs or alcohol, assault, and or using drugs. of them can motivate them to maintain a drug-free lifestyle other alcohol-related offenses. 6. The “at home” party. Some and to serve as a positive role Make certain your child understands parents mistakenly believe “My model for younger siblings. how alcohol and other illicit drug teens and their friends are safer use and abuse can be associated with drinking at home because they aren’t Parenting doesn’t stop when a child 69 date rape, violence, and academic out driving while intoxicated.” Even goes to college. failure, as well as have consequences if state law permits teens to drink Find out if there is a program during after graduation. at home at certain ages under a freshman orientation that educates This is also an important time to stress parent’s supervision, it doesn’t students about campus policies, and the importance of the responsible mean you should let them. Doing health and wellness or prevention consumption of alcohol when your so may be setting a dangerous programs related to alcohol and other college-age children are of legal drink­ example—essentially signaling drug use. If so, attend with your child, ing age, and if they choose to drink. you approve of what may be illegal consumption of alcohol in 63 Monitoring the Future national survey results on drug use, 1975–2010: Volume I, Secondary school stu­ other settings. And if you give dents. Overview of Key Findings your teen permission to host a 64 National Institute on Drug Abuse. Preventing Drug Abuse among Children and Adolescents (In Brief). party in your home, never supply How can the community develop a plan for research-based prevention? NIH Publication No. 04-4212(B). 1997. Updated October 2003. alcohol to your child’s friends. 65 Centers for Disease Control and Prevention. Parent Engagement: Strategies for Involving Parents in Not only is it illegal, but you may School Health. 2012. Accessed September 21, 2012, www.cdc.gov/healthyyouth/adolescenthealth/ well be held liable for anything pdf/parent_engagement_factsheet.pdf. that happens to the minors 66 National Institute on Drug Abuse. NIDA for Teens, The Science Behind Drugs Abuse: The Sara and any damage they cause— Bellum Blog. Real Teens Ask: Got Alcohol on the Brain? Posted May 24, 2011. Accessed September 21, 2012, http://teens.drugabuse.gov/blog/real-teens-ask-alcohol-brain. including what happens when 67 they leave the premises. Make Make a Difference – Talk To Your Child About Alcohol. sure two responsible adults are 68 Monitoring the Future national results on adolescent drug use: Overview of key findings, 2011. present to monitor the festivities 69 National Institute on Alcohol Abuse and Alcoholism. What Parents Need to Know About College Drinking. NIH Publication No. 02-5015. Printed April 2002. Accessed September 21, 2012, in your home. www.collegedrinkingprevention.gov/media/FINALParents.pdf.

36 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION WHATHOW DOIF I ITHINKWHAT TEACH SUBSTANCESMY MY CHILD CHILD IS ABOUT USING DO KIDS DRUGS? USE? SECTION 5: WHAT IF I THINK MY CHILD IS USING DRUGS?

Section 5: What if i Think My Child is Using Drugs?

ometimes—despite the your teen’s breath or on clothing, best efforts of parents— they are reason for alarm—simply Skids still experiment with being around other teens who may drugs or alcohol. And sometimes be drinking or smoking makes experimentation leads to abuse and/ it more likely that your teen will or addiction. too. Follow your nose—and don’t forget that excessive “good” smells, SiGNS OF ABUSE like breath fresheners, heavy per­ What if you suspect your child is fumes, and freshly laundered cloth­ using alcohol or drugs? First, realize ing (especially for a teen who’s that some signs that might indicate a never run the washing machine) problem with alcohol or drugs can can be as telling as the smells simply be normal teenage behavior— they’re trying to mask. And make but that doesn’t mean you should sure that you take a whiff of your ignore them. When you’re trying to teen’s car—the smell of stale beer figure out what your teen has been up or marijuana smoke may linger in to, it makes sense to make use of all of the car’s upholstery. 70 your senses. ❯ Sound: Listen for the clues that ❯ Sight: Take a look at your teen. teens give you by the things they Red eyes and cheeks, or difficulty say, the things they laugh at, or focusing on you, may indicate the fact that they aren’t saying your teen has been drinking anything at all. Silence can speak alcohol. Red eyes and constricted volumes about the fact that some­ pupils can be a sign of marijuana thing’s going on in your teen’s use. A strange burn on the mouth life. By continuing to listen over or fingers of your child can be time, you’ll be able to identify a sign of smoking something which behaviors are the result of a through a metal or glass pipe. short-term mood swing and which Someone wearing long sleeves in are indicative of a more serious the middle of the summer may be underlying issue. trying to hide puncture marks that Is there a potentially rational would indicate intravenous drug explanation for many of these use. Chronic nosebleeds may be a scenarios? Certainly—your teen may sign of cocaine abuse. be suffering from a cold, trying to ❯ Smell: Marijuana, cigarettes, and mask eczema on the arms, may just alcohol all have very telltale smells. be tired, may be feeling stressed by And whether you notice them on a difficult class in school, or may

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 37 SECTION 5

When it comes to that drug abuse is occurring— (items related to drug use), such especially if your teen typically as pipes, rolling papers, medicine identifying the signs of performs well. A loss of motiva­ bottles, eye drops, butane lighters, or drug abuse, the best rule tion, missing homework, skipping homemade pipes and bongs (pipes that to follow is this: No one school, or foregoing extracur­ use water as a filter) made from soda ricular activities may be signs that cans or plastic beverage containers. If knows your kids better there is a drug issue. you suspect your child is drinking, look than you. If you think ❯ Lying and stealing. Your six-pack for empty cans or bottles. of beer has suddenly turned into a something’s going on, HOW TO PROCEED take the steps necessary five-pack. Your after-dinner aperi­ tif tastes suspiciously watered- Maybe you found evidence. Maybe not. to find out for certain. down. You’re missing cash from But even if all you have are suspicions, your wallet or a gold ring from you need to take action. Remember the your jewelry box. When teens section on myths. Denying a problem be having issues in a relationship. want to get drunk or high, one of exists does not mean there isn’t one, By observing your teen using all of the first places they’re going to go and ignoring signs of trouble won’t your senses, combined with your looking for “resources” is within make a problem go away. gut instinct, you’ll be better able to their own homes. If you begin to notice missing items, you must determine if a certain behavior is NOTE: Many of the immediately confront your child “typical” or indicative of drug use. recommendations in this section with your suspicions and say that Other signs to look for that may were adapted from stealing—whether it be $5 from indicate drug use include your purse or a $500 necklace— ❯ http://timetoact.drugfree.org ❯ Stories don’t add up, and social will not be tolerated. and circles change. When your teen When it comes to identifying the signs ❯ www.getsmartaboutdrugs. goes to the football game but can’t of drug abuse, the best rule to follow com/help/intervene.html tell you which team won, or tells is this: No one knows your kids better More tips and videos are available you about staying at a friend’s than you. If you think something’s on those websites. house but the friend called your going on, take the steps necessary to house asking to speak to your find out for certain. teen, it’s time to be concerned. ❯ If you have a partner or spouse, tell No matter how much your teen iS iT OKAY TO SNOOP? him or her about your suspicions denies there’s anything going on, Sometimes parents who suspect their and plan your actions together. If it’s up to you to confront your child is using drugs wonder whether it you’re a single parent, you may child and get to the heart of the is okay to snoop. Only you can decide want to speak with someone else, issue. The same thing holds true that, but keep in mind that you are such as a doctor, psychologist, pas­ if you see a sudden change in suspicious for a reason—and your toral advisor, school nurse, and/or your child’s social circle. If your suspicions may be right. Remember, it a school drug and alcohol coun­ teen is no longer associating with is your house, and you are the parent. selor. Use the person as a sounding childhood friends, seems to be And if you have young children in the board of sorts—someone unbiased interested in hanging out with home, you certainly wouldn’t want who can help you sort out your kids who are older, or is simply them to find something harmful. feelings. spending time with new friends Where would you look? And for ❯ Before talking with your child, that give you a bad feeling, you what? Well, drugs are easily hidden in practice the conversation until should follow your instincts. And drawers, backpacks, the back of closets, you are sure you can remain calm. don’t accept sullen silence as an the corners of bed sheets, small boxes, Also, don’t initiate the conversa­ answer—make sure the conversa­ books or bookcases, makeup cases, tion unless you’re sure your child tion occurs. over-the-counter medicine bottles, is sober or has not been using ❯ School goes downhill. Declining and under the mattresses or beds. You drugs, which may mean waiting grades can be a stark indicator might also find drug paraphernalia until the next day.

38 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION WHAT IF I THINKWHAT SUBSTANCESMY CHILD IS USING DO KIDS DRUGS? USE?

❯ What do you say? Begin by voic­ MEET GARRETT HARNEY ing your suspicions without mak­ Cindy Harney beams with pride as she speaks about her son Garrett. ing accusations. “Susan, I suspect you may be smoking pot occasionally. “Garrett loved to play the piano. He loved all kinds of sports—he wake I love you and I’m concerned about boarded, skate boarded, and played in Little League. He also cared about you. Is there something going on that the community. He loved 4-H and was on the board of a local organization we need to talk about?” for children with learning disabilities. Everyone here knew him by his F-150 pickup. But after a friend shared his mother’s pain medicine, Garrett’s life ❯ Be prepared emotionally for was never the same. Nor was ours.” possible reactions. Your child may Garrett died at the age of 20 from a prescription drug overdose of accuse you of snooping. Your Oxycodone and Xanax. In addition to his parents, Garrett left behind a sister child may tell you that you’re just 16 months younger than he was—a sister who now has no sibling with crazy or call you a hypocrite whom to share her life experiences. (especially if you smoke or “There isn’t a day goes by that I don’t think of my boy,” says Cindy. “I told occasionally have a drink). Your him about all the illicit drugs, but I never told him about legal drugs. No child may express hatred and parent should ever have to pick out the casket for their child or the clothes threaten to leave home. he will wear to be buried in.” ❯ Whatever the response, make your Determined not to let her son die in vain, Cindy now shares her horrific mind up ahead of time to remain experience to help educate others—parents, youths, law enforcement, the calm. Even if your child denies medical community, and lawmakers—about the dangers of prescription drug there is a problem (which will abuse in hopes of enacting change. probably happen), reinforce what “After Garrett’s death, I learned that many kids in my Florida community you believe about drugs and how were dying because of prescription drugs, and I knew I had to do something. much you care about your child. I met a woman whose 18-year-old son had taken his life and asked her if she “I want to believe you, sweetheart, would join me in the fight against drug abuse. We traveled to Kentucky to because there is a lot of evidence that learn about its prescription drug monitoring program, and then we went to young people who use drugs are at Tallahassee in hopes of getting a similar program in Florida.” risk for many bad things. I’d be very Cindy and her new acquaintance also founded Families Against Addictive disappointed if you didn’t finish Drug Abuse to create awareness of the problem and to enact change. She school or if someone took advantage of played a role in the creation of a prescription drug task force in her local you sexually while you were high.” sheriff’s department and in the development of Operation Medicine Cabinet, ❯ Having this type of calm, open dis­ a countywide project to take back old medicine. She also speaks at local, cussion at least lets your children regional, and national events. know you care and that you still “We’re losing approximately 10 Floridians a day, and that’s more than by all love them. Follow up by being a illegal drugs combined. We must take action so no other family has to suffer parent. “And remember, we had a deal the loss that we have. Hopefully, through education and by working together that no member of this family would as a community, we’ll be able to educate our little ones so they never fall use drugs.” Enforce whatever dis­ into this epidemic.” cipline you agreed on for breaking Currently, Cindy Harney the rules (if that is the case). is working with Florida Congressman Vernon ❯ During this conversation, it’s very Buchanan’s office to get important for your child to feel support for the Pill Mill supported, so continue to remind Crackdown Bill (H.R. 1065) your child that you’re always to increase penalties for there for guidance, especially the operators of pill mills. during a stressful time when your (A pill mill is a facility child may be tempted to use. Ex­ that violates federal or press your love, care, and concern state laws that pertain to to your child—both in your words prescribing and dispensing and in your tone. “Sweetheart, I controlled substances.) Garrett Harney and his sister

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 39 SECTION 5

want to discuss this because I love that is characterized by compulsive and care about you, and I want you to drug seeking and use, despite harmful be healthy, safe, and successful.” consequences. It is considered a brain A word of caution. It’s human nature disease because drugs change the to want to believe your children when brain—they change its structure and they say they aren’t using drugs. They how it works. These brain changes may say they are stashing a pipe for can be long lasting and can lead to the someone else or tired because of extra harmful behaviors seen in people who schoolwork, or they may provide any abuse drugs.” number of excuses that sound rational. The good news is that addiction is a But if your suspicions are strong— treatable disease, but the success of and especially if you are faced with any treatment approach depends on a hard evidence—do not pretend that variety of factors, including a child’s everything is fine. It obviously isn’t. temperament and willingness to Also, do not blame yourself. Drug change. It may take several attempts abuse occurs in all kinds of families. before a child remains drug free, so do If the conversation becomes heated or not give up hope. You are not alone! out of control, don’t continue. Assure FiNDiNG TREATMENT your child you love him or her and end the discussion peacefully. You’ve When your child is referred for treat­ at least taken a big step, and you can ment, it’s important to find a program always try again another day. best suited to your child’s needs. If your child flatly refuses to talk ❯ Your first step in this journey is to to you about it, ask for help from a find a certified drug and alcohol school guidance counselor, family counselor. To do that, consult your physician, or a local drug treatment child’s doctor, other parents whose referral and assessment center. Your children have been treated for drug child’s school may even have a abuse, the local hospital, a school counselor qualified to evaluate your social worker, the school district’s child and refer you to a particular substance abuse coordinator, or the agency for treatment. county mental health society. ❯ Or, you may call the U.S. ADDiCTiON Department of Health and No one plans to become addicted. Human Services Substance Abuse Instead, it begins with a single use, and Mental Health Services which can lead to abuse, which Administration (SAMHSA) toll- can lead to addiction—a disease in free at 1-800-662-HELP (4357) for which a person craves the drug (or alcohol and drug information alcohol or nicotine) regardless of the and treatment referral assistance. consequences. Remember, however, When you call this toll-free num­ that children with more risk factors ber, a recorded message gives you may be more susceptible to using and the option to speak to a represen­ becoming addicted. tative concerning substance abuse For many years, society believed treatment, or to request printed that people addicted to drugs lacked material on alcohol or drugs. willpower or were morally flawed. ❯ Online, parents can go to the Today, the National Institute on Drug Partnership At Drugfree.org Abuse (NIDA) defines addiction as (www.drugfree.org), a nonprofit “a chronic, relapsing brain disease organization that helps parents

40 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION WHAT IF I THINKWHAT SUBSTANCESMY CHILD IS USING DO KIDS DRUGS? USE?

and caregivers prevent, intervene Some recovery services already exist Don’t be surprised if—somewhere in, and find treatment for drug within the education community, during the process of getting and alcohol use by their children. including recovery schools. Recovery treatment for your child—a high schools provide a service- suggestion is made that the entire ❯ At www.findtreatment.samhsa. enriched and supportive school family get counseling, too. Treating gov, you’ll find more than 11,000 environment for students recovering addiction isn’t simply about healing addiction treatment programs, from drug and alcohol problems. the abuser. Some parents become so including residential treatment They offer standard academic courses, obsessed with their child’s problem centers, outpatient treatment combined with continuing care that they neglect the other important programs, and hospital inpatient and/or recovery support services, aspects of their own lives: their jobs, programs for drug addiction and but they generally do not provide physical health, and other kids. It is alcoholism. Listings include treat­ substance use or mental health as important to seek help for your ment programs for marijuana, disorder treatment. The Association own emotional well-being as it is for cocaine, and heroin addiction, as of Recovery Schools (ARS) website at the child using drugs. Every member well as drug and alcohol treat­ www.recoveryschools.org provides of the family needs to be committed ment programs for adolescents additional information and includes a to helping the recovering addict stay and adults. list of recovery high schools. clean and sober. ❯ Another drug and alcohol addiction treatment website 70 is www.drugstrategies.org, Drug Enforcement Administration. Get Smart About Drugs. A DEA Resource for Parents. Signs of Drug Use: Behavior. Accessed September 21, 2012, which is dedicated to providing www.getsmartaboutdrugs.com/identify/behavior.html. local resources for fighting 71 U.S. Department of Education, Office of Safe and Drug-Free Schools. Recovery/Relapse Prevention substance abuse. It also offers in Educational Settings for Youth with Substance Use and Co-occurring Mental Health Disorders. 2010 a 24-hour hotline at 1-800-559­ Consultative Sessions. Working Draft May 2011. Accessed September 21, 2012, www2.ed.gov/about/offices/list/osdfs/recoveryrpt.pdf. 9503. Also, check the resources at the back of this publication for other possibilities.

RECOvERY Addiction is typically a chronic disease, so people cannot simply stop using drugs for a few days and be cured. Relapse is not uncommon. Most patients require long-term or repeated episodes of care to achieve sustained abstinence and recovery. Because the risk of relapse is highest for youths in the time period directly following treatment, the transition to the school setting is an important time when appropriate relapse prevention services could increase the likelihood of long-term recovery.71 Families will need to access recovery support services for their child to help successfully navigate the early months of recovery. Some of these services will provide a flexible and cost-effective mechanism for facilitating access to services.

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 41 SECTION 6

42 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION WHAT SUBSTANCESWHAT SUBSTANCES DORESOURCES DOKIDSRESOURCES KIDS USE? USE?

SECTION 6: RESOURCES

Section 6: Resources

NOTE: We don’t endorse any private or commercial products or services that are not affiliated with the federal government, and the sources of information on these pages are intended only as a partial listing. Readers of this booklet are encouraged to research and inform themselves of the many additional products and services relating to tobacco, drug, and alcohol abuse.

PARENTS: Some websites kids go to for information about drugs or alcohol are sponsored by organizations with a hidden agenda, such as trying to get drugs legalized or decriminalized. Encourage your children to visit the following websites instead for credible information about tobacco, drugs, and alcohol.

FOR YOUTHS

AboveTheinfluence.com www.abovetheinfluence.com This campaign is inspired by what teens say about their lives and how they deal with the influences that shape their decisions about not using drugs or alcohol. The goal is to help teens stand up to negative pressures or influences.

Al-Anon Family Groups – Alateens www.al-anon.alateen.org/for-alateen Alateen is part of the Al-Anon Family Groups. Al-Anon is for anyone affected by someone else’s drinking. This link is to the section of the Al-Anon website specifically for teens.

American Council for Drug Education (ACDE) www.acde.org/youth ACDE is an agency that develops substance abuse prevention and education programs and materials. This link is to the section of their website specifically for youthswho are involved (or want to be involved) in a community coalition or who are passionate about keeping their communities safe and drug free.

D.A.R.E – Drug Abuse Resistance Education www.dare.com/kids D.A.R.E.’s primary mission is to provide children with the information and skills they need to live drug- and violence-free lives. This link is to the section of their website specifically for youths.

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 43 SECTION 6

JustThinkTwice.com www.justthinktwice.com Created by the Drug Enforcement Administration (DEA) specifically for young people, this site provides information about drugs and their consequences.

National Suicide Prevention Lifeline www.suicidepreventionlifeline.org This crisis hotline can help with a lot of issues, not just suicide. For example, anyone who feels sad, hopeless, or suicidal; family and friends who are concerned about a loved one; victims of bullying; or anyone who is interested in mental health treatment referrals can call 1-800-273­ TALK (8255). Callers are connected with a professional who will talk with them about what they’re feeling or about concerns for other family and friends. The hotline is funded by the Substance Abuse and Mental Health Services Administration.

NiDA for Teens http://teens.drugabuse.gov The National Institute on Drug Abuse (NIDA) developed this website. Teens can get facts about drugs and drug effects, read advice from fellow teens, watch educational videos, download cool anti-drug material, and try their hand at brain games.

TheCoolSpot.gov www.thecoolspot.gov The Cool Spot was created by the National Institute on Alcohol Abuse and Alcoholism for kids 11–13 years old. Content is based on a curriculum for grades 6–8 developed by the University of Michigan to give young teens a clearer picture about alcohol use among their peers. The Cool Spot also features quizzes, tips for handling peer pressure, and links to educational and support sites.

FOR PARENTS Depending on the age and maturity level of your children, you may wish to share some of the links in this section with them.

African American Family Services (AAFS) www.aafs.net AAFS works with individuals, families, and communities impacted by addiction and mental illness. They provide culturally specific chemical and mental health services that affect family preservation and promote community-based change and wellness in the African- American community.

Alcoholics Anonymous (AA) www.aa.org Alcoholics Anonymous is a fellowship of men and women who share their experience, strength, and hope with each other so they may solve their common problems and help others recover from alcoholism. The only requirement for membership is a desire to stop drinking. There are no dues or fees, and AA is not allied with any sect, denomination, politics, organization, or institution.

Al-Anon Family Groups www.al-anon.org Al-Anon is a free, nonprofit organization that supports and provides literature to family members and friends of alcoholics.

44 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION WHAT SUBSTANCES DORESOURCES KIDS USE?

American Cancer Society www.cancer.org The American Cancer Society offers literature on smoking and referrals to local chapters.

American Council for Drug Education (ACDE) www.acde.org ACDE has educational programs and services designed to engage teens, address the needs of parents, and provide employers, educators, health professionals, policymakers, and the media with authoritative information on tobacco, alcohol, and other drugs.

Association of Recovery Schools (ARS) www.recoveryschools.org The Association of Recovery Schools advocates for the promotion, strengthening, and expansion of secondary and postsecondary programs designed for students and families committed to achieving success in both education and recovery. ARS exists to support such schools which, as components of the recovery continuum of care, enroll students committed to being abstinent from alcohol and other drugs and working a program of recovery.

Boys & Girls Clubs of America (BGCA) www.bgca.org The mission of Boys & Girls Clubs of America is to enable all young people to reach their full potential as productive, caring, responsible citizens.

College Drinking Prevention – Changing the Culture www.collegedrinkingprevention.gov This National Institute on Alcohol Abuse and Alcoholism site contains a wealth of information for parents, students, and educators about alcohol use on U.S. college campuses.

Community Anti-Drug Coalitions of America (CADCA) www.cadca.org CADCA is an organization whose purpose is to strengthen the capacity of community anti­ drug coalitions to create and maintain safe, healthy, and drug-free communities.

D.A.R.E. – Drug Abuse Resistance Education www.dare.com D.A.R.E.’s primary mission is to provide children with the information and skills they need to live drug- and violence-free lives.

United States Drug Enforcement Administration (DEA) www.justice.gov/dea The mission of the DEA is to enforce the controlled substances laws and regulations of the United States and to recommend and support non-enforcement programs aimed at reducing the availability of illicit controlled substances on the domestic and international markets. The DEA has created a drug education website for teens at www.justthinktwice.com and a drug education resource for parents at www.getsmartaboutdrugs.com.

DrugStrategies.org www.drugstrategies.org This is a drug and alcohol addiction treatment website dedicated to providing resources for fighting substance abuse, including helping you find drug treatment centers and addiction rehabilitation programs in your town or city. The toll-free 24-hour hotline number is 1-800-559-9503.

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 45 SECTION 6

Easy-to-Read Drug Facts www.easyread.drugabuse.gov Created by the National Institute on Drug Abuse, this easy-to-read website talks about drug abuse, addiction, and treatment. It has pictures and videos to help readers understand the text and can also read each page out loud. The pages are easy to print out to share with people who do not have computers.

Elks Drug Awareness Program www.elks.org The Benevolent and Protective Order of Elks has a resource center for the Elks National Drug Awareness Program, the largest volunteer drug awareness program in the United States. It provides information for parents and a guide for teachers, as well as educational comics for fourth- through eighth-graders, tips for teens, and contests.

Families Anonymous, inc. www.familiesanonymous.org This organization is a 12-step fellowship for families and friends who have known a feeling of desperation concerning the destructive behavior of someone very near to them, whether caused by drugs, alcohol, or related behavioral problems.

GetSmartAboutDrugs www.getsmartaboutdrugs.com Created by the Drug Enforcement Administration (DEA) for parents, this website provides valuable drug education and prevention resources for parents. Information includes how to identify drugs and tips to help prevent drug abuse.

Higher Education Center for Alcohol, Drug Abuse, and violence Prevention http://higheredcenter.ed.gov Created by the U.S. Department of Education, this site supports institutions of higher education in their efforts to prevent illegal alcohol and other drug use and its consequences, including violence, at U.S. colleges and universities.

Mothers Against Drunk Driving (MADD) www.madd.org Originally founded to combat drunk driving, this organization’s current mission is also to support victims of this violent crime and to prevent underage drinking.

Narcotics Anonymous www.na.org Narcotics Anonymous is a 12-step fellowship of recovering addicts. Membership is open to all drug addicts, regardless of the particular drug or combination of drugs used. Meetings are free.

Nar-Anon www.nar-anon.org Nar-Anon is a 12-step program designed to help relatives and friends of addicts recover from the effects of living with an addicted relative or friend.

National Association for Children of Alcoholics (NACOA) www.nacoa.org NACOA’s mission is to eliminate the adverse impact of alcohol and drug use on children and families.

46 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION WHAT SUBSTANCES DORESOURCES KIDS USE?

National Association of School Nurses www.nasn.org The National Association of School Nurses improves the health and academic success of students by developing and providing leadership to advance the school nursing practice by specialized registered nurses. The organization’s core purpose is to promote student success through the advancement of school health services by professional registered school nurses.

National Council on Alcoholism and Drug Dependence, inc. www.ncadd.org An organization that provides information on how to overcome alcohol and drug addiction, including how to find help in your area.

National Crime Prevention Council (NCPC) www.ncpc.org A private nonprofit organization whose mission is to help families and their communities keep safe from crime, including on the Internet.

National Guard Counterdrug Program http://ngbcounterdrug.ng.mil The National Guard Counterdrug Program uses National Guard resources to help create the best opportunity for America’s youths to make the decision to be drug free. They work with local law enforcement, education and community-based organizations to reduce the chances of exposure of illegal drugs to our nation’s children.

National inhalant Prevention Coalition (NiPC) www.inhalants.org NIPC serves as an inhalant referral and information clearinghouse, stimulates media coverage about inhalant issues, develops materials, and provides training and technical assistance.

National institute on Alcohol Abuse and Alcoholism (NiAAA) www.niaaa.nih.gov The NIAAA website offers pamphlets, fact sheets, and brochures about alcohol-related problems such as underage drinking, alcohol’s impact on health, parenting to prevent childhood alcohol use, and much more. For information on alcohol policy, go to www.alcoholpolicy.niaaa.nih.gov. For statistics and the latest news on stopping underage drinking, go to https://stopalcoholabuse.gov.

National institute on Drug Abuse (NiDA) www.nida.nih.gov NIDA’s mission is to lead the nation in bringing the power of science to bear on drug abuse and addiction through (1) support and conduct of research, and (2) quick dissemination of research results. The website features a section for parents and teachers, as well as a section for students and young adults. NIDA provides educational materials can be downloaded or ordered at http://drugpubs.drugabuse.gov.

National Suicide Prevention Lifeline www.suicidepreventionlifeline.org This crisis hotline can help with a lot of issues, not just suicide. For example, anyone who feels sad, hopeless, or suicidal; family and friends who are concerned about a loved one; victims of bullying; or anyone who is interested in mental health treatment referrals can call 1-800-273­ TALK (8255). Callers are connected with a professional who will talk with them about what they’re feeling or about concerns for other family and friends. The hotline is funded by the Substance Abuse and Mental Health Services Administration.

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 47 SECTION 6

Office of National Drug Control (ONDCP) www.whitehouse.gov/ondcp ONDCP advises the president on U.S. drug-control issues, coordinates drug-control activities and related funding across the federal government, and produces the annual National Drug Control Strategy, which outlines administration efforts to reduce illicit drug use, manufacturing and trafficking, drug-related crime and violence, and drug-related health consequences.

PartnershipAtDrugFree.org (PDFA) www.drugfree.org PDFA is a nonprofit organization that helps parents and caregivers prevent, intervene in, and find treatment for drug and alcohol use by their children. PDFA also maintains the Parents Toll- Free Helpline (in English or Spanish) at 1-855-DRUGFREE (1-855-378-4373).

PreventTeenDrugUse.org www.preventteendruguse.org This organization provides parents with relevant research on marijuana and other drug use. It outlines the serious long-term negative effects drug use can have on youths, including lower academic achievement, school dropout rates, mental health problems, and addiction. Personal stories from a teen, a father, and a physician demonstrate how drug use can adversely affect youths, families, and communities. The website features videos reviewing current information and identifies prevention and treatment resources.

StopAlcoholAbuse.Gov www.stopsalcoholabuse.gov A parent’s gateway to comprehensive research and resources on the prevention of underage drinking. Materials available through this portal are provided by the 15 Federal agencies of the Interagency Coordinating Committee on the Prevention of Underage Drinking.

Students against Destructive Decisions (SADD) www.sadd.org SADD is dedicated to preventing destructive decisions, specifically underage drinking, other drug use, impaired and risky driving, and teen violence and suicide. It has thousands of chapters in middle schools, high schools, and colleges.

Substance Abuse and Mental Health Services Administration (SAMHSA) www.SAMHSA.gov SAMHSA is responsible for overseeing and administering programs on mental health, drug abuse prevention, and drug treatment around the nation. For SAMHSA publications dealing with alcohol and other drug abuse, go to www.store.samhsa.gov.

The National PTA www.pta.org PTA works in cooperation with many national education, health, safety, and child advocacy groups and federal agencies to benefit children. The PTA website can help you locate a chapter, or offer information about organizing or running a PTA in your area.

White Bison Wellbriety Training institute www.whitebison.org White Bison, Inc., Wellbriety Training Institute, is an American Indian nonprofit charitable organization that offers sobriety, recovery, addiction prevention, and wellness (“Wellbriety”) learning resources to the Native American community nationwide.

48 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION DRUG IDENTIFICATION CHART SECTION 7: DRUG IDENTIFICATION CHART

Section 7: Drug identification Chart

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 49 SECTION 7

DRUG iDENTiFiCATiON CHART

DRUG NAME(S) OTHER NAME(S)

Hydrocodone is the most frequently Hydro, Norco, Vikes prescribed opioid in the United States. Usually prescribed for pain or as a cough suppressant, it is the most abused opiod. The most prescribed brands are Vicodin, Hydrocodone Lorcet, Lortab, Vicoprofen, and Hycomine.

Oxycodone products are very Oxycotton, Percs, OC, OX, powerful painkillers. Examples include Oxy, Hillbilly Heroin, Kicker pharmaceutical drugs like OxyContin, Percodan, and Percocet. Narcotics (Opiods) Narcotics Prescription Medications – Medications Prescription Oxycodone

Amytal Amytal and Seconal are two barbiturates, Barbs, Block Busters, which are depressants that slow down the Christmas Trees, Goof Balls, central nervous system and cause sleepiness. Pinks, Red Devils, Reds & Others include Fiorina, phenobarbital, Blues, Yellow Jackets Pentothal, and Nembutal. Prescription Prescription Barbiturates Seconal Medications – Medications Depressants – Depressants

Valium, Xanax, Halcion, Ativan, and Benzos, Downers Klonopin are the most common prescription benzodiazepines, which were developed to replace barbituates. Other brand names include ProSom, Dalmane, Restoril, Versed, Librium, Tranxene, Paxipam, Serax, Centrax,

Prescription Prescription and Doral. Medications – Medications Depressants – Depressants

Benzodiazepines Valium Xanax

Adderall, Dexedrine, Concerta, Ritalin, Didrex, Ice, Crank, Speed, Bennies, Bontril, Preludin, Fastin Adipex P, Ionomin, Black Beauties, Uppers, and Meridia are stimulants used to treat Pellets, R-Ball, Skippy, obesity, attention deficit and hyperactivity Vitamin R, Illys disorders (ADHD/ADD), and narcolepsy. Stimulants

Prescription Prescription Ritalin Stimulants speed up the body’s systems. Medications – Medications

Anabolic steroids are synthetically Arnolds, Juice, produced variants of the male hormone Pumpers, Roids, testosterone. When users stop taking Stackers, Weight steroids, they may experience severe Gainers depression and attempt suicide. Anabolic Steroids Anabolic Steroids Android (Steroid) Testosterone

For more information about these and other drugs, visit www.getsmartaboutdrugs.com.

50 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION DRUG IDENTIFICATION CHART

DESCRiPTiON HOW CONSUMED MiND AND BODY EFFECTS SEE PAGE(S)

Pill forms (including Usually taken orally. Euphoria, drowsiness, dizziness, nausea, constipation, tablets and capsules), urinary retention, and depressed respiration. syrups. Withdrawal symptoms include restlessness, muscle 11 and bone pain, insomnia, diarrhea, and vomiting.

Pill forms (including Usually taken orally. Inability to concentrate, apathy, slowed physical tablets and capsules). activity, constricted pupils, flushing of the face and neck, constipation, nausea, vomiting, and slowed breathing. Withdrawal symptoms may include watery 11 eyes, runny nose, yawning, sweating, restlessness, irritability, loss of appetite, nausea, tremors, severe depression, vomiting, increased heart rate and blood Percocet pressure, and alternating chills and sweating.

Pill forms (including Swallowed (pill form) Mild euphoria, lack of inhibition, relief of anxiety and tablets and capsules), or injected (liquid sleepiness, amnesia, reduced reaction time, impaired syrups, and injectable form). Overdoses can mental functioning and judgment, confusion, slurred 12 liquids. occur easily and lead speech, weakness, headache, lightheadedness, blurred to death. vision, dizziness, nausea, vomiting, low blood pressure, and slowed breathing.

Pill forms (including Usually taken orally Sleepiness, amnesia, hostility, irritability, vivid or tablets and capsules); (pill form) or crushed disturbing dreams, reduced reaction time, impaired Versed is available as and snorted. mental functioning and judgment, confusion. May also an injectable liquid cause slurred speech, loss of coordination, weakness, 12 and as a syrup. headache, lightheadedness, blurred vision, dizziness, nausea, vomiting, low blood pressure, and slowed breathing. Rarely fatal unless combined with other drugs or alcohol; withdrawal can be life threatening.

Pill forms (including Usually taken orally Increased activity, reduced appetite, wakefulness. tablets and capsules). but sometimes Chronic use may cause agitation, hostility, panic, crushed and snorted aggression, suicidal or homicidal tendencies, paranoia, 12 or injected. and hallucinations. Large or extended doses may cause dizziness, tremors, headache, flushed skin, chest pain, excessive sweating, vomiting, and abdominal cramps.

Pill forms (including Ingested Dramatic mood swings, hostility, impaired judgment, tablets and capsules), orally, injected and increased aggression (often called “roid rage”), liquid drops, gels, intramuscularly, or high cholesterol levels and liver damage, viral creams, patches, applied to the skin. infections (e.g., HIV/AIDS, hepatitis B or C), and injectable solutions. bacterial infections. Males: early sexual development, 12-13 acne, stunted growth, shrinking testicles, reduced sperm count, enlarged breast tissue, sterility, and increased risk of prostate cancer. Females: deep voice, increased facial and body hair, menstrual irregularities, male pattern baldness, and lengthening of the clitoris.

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 51 SECTION 7

DRUG NAME(S) OTHER NAME(S)

Marijuana is a mind-altering (psychoactive) Aunt Mary, BC Bud, Blunts, drug produced by the Cannabis sativa plant. Boom, Chronic, Dope, It contains over 400 chemicals; THC is Gangster, Ganja, Grass, believed to be the main chemical ingredient. Hash, Herb, Hydro, Indo, Joint, Kif, Mary Jane, Mota, Pot, Reefer, Sinsemilla, Skunk, Smoke, Weed, Yerba

Marijuana Marijuana cigarette, or “joint”

Cocaine is an intense, euphoria- Coca, Coke, Crack, Flake, producing stimulant drug with strong Snow, Soda Cot addictive potential. Very pure cocaine can cause cardiac arrhythmias, ischemic heart conditions, sudden cardiac arrest, convulsions, strokes, and death.

Cocaine Crack Cocaine

Ecstasy tablets contain MDMA and other Adam, Beans, Clarity, Disco drugs that can be harmful; it is both a Biscuit, E, Ecstasy, Eve, Go, stimulant and psychedelic. In high doses, Hug Drug, Lover’s Speed, MDMA can interfere with the body’s ability MDMA, Peace, STP, X, XTC Street Drugs Street to regulate temperature, which can result in liver, kidney, and cardiovascular system failure—or death.

Ecstasy

Methamphetamine (meth) is a highly Batu, Bikers Coffee, Black addictive drug with potent central nervous Beauties, Chalk, Chicken system stimulant properties; the FDA- Feed, Crank, Crystal, Glass, approved brand-name medication is Go-Fast, Hiropon, Ice, Meth, Desoxyn. High doses may cause death Methlies Quick, Poor Man’s from stroke, heart attack, or multiple organ Cocaine, Shabu, Shards, problems caused by overheating. Speed, Stove Top, Tina, Trash, Tweak, Uppers, Ventana, Vidrio, Yaba, Methamphetamine Yellow Bam

Heroin is a highly addictive drug and the Big H, Black Tar, most rapidly acting of the opiates. Because Chiva, Hell Dust, heroin abusers do not know the actual Horse, Negra, strength of the drug or its true contents, Smack, Thunder they are at a high risk of overdose or death. Heroin Black Tar Heroin

For more information about these and other drugs, visit www.getsmartaboutdrugs.com.

52 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION DRUG IDENTIFICATION CHART

DESCRiPTiON HOW CONSUMED MiND AND BODY EFFECTS SEE PAGE(S)

Dry, shredded mix of Usually smoked as Bloodshot eyes, increased heart rate, coughing, flowers, stems, seeds, a cigarette (called a increased appetite, decreased blood pressure, and leaves; typically joint) or in a pipe or problems with memory and learning, distorted green, brown. bong. Also smoked perception, difficulty thinking and solving problems, in blunts (cigars that and loss of coordination. Long-term effects may have been emptied include bronchitis, emphysema, and bronchial asthma; 13-14 of tobacco and filled suppressed immune system; apathy; increased cancer with marijuana), mixed risk; impaired judgment, memory, and concentration; with foods, or brewed loss of motivation, ambition, and interest. Withdrawal as tea. may cause headache, shakiness, sweating, stomach pains, nausea, restlessness, irritability, sleep difficulties, and decreased appetite.

Usually a white, Snorted or injected Euphoria, increased alertness and excitation, crystalline powder. into the veins after restlessness, irritability, increased blood pressure and Cocaine base (crack) dissolving in water heart rate, dilated pupils, insomnia, loss of appetite, consists of small, (powder); smoked and anxiety followed by mental and physical irregularly shaped alone or with exhaustion, sleep, and depression. High doses or chunks (or “rocks”) marijuana or tobacco prolonged use can cause paranoia. Long-term 16 of a whitish solid. (crack); used in inhaled use has led to a unique respiratory syndrome; combination with an chronic snorting of cocaine has led to the erosion of opiate, like heroin, in the upper nasal cavity. a practice known as speedballing.

Pill forms (including Usually by swallowing Increased motor activity, alertness, heart rate, and tablets and capsules) tablets, sometimes blood pressure; euphoria; increased sensitivity to but also distributed crushed and snorted, touch, increased energy, and sensual and sexual in powder and occasionally smoked arousal; unwanted effects include confusion, anxiety, liquid forms. (rarely injected). depression, paranoia, sleep problems, muscle tension, 14 Also available as a tremors, involuntary teeth clenching, muscle cramps, powder. Commonly nausea, faintness, chills, sweating, and blurred vision. taken with other May increase risk of long-term (perhaps permanent) substances, such as problems with memory and learning. alcohol and marijuana.

Regular meth is a pill Swallowed, snorted, Increased wakefulness, increased physical activity, or powder; crystal injected, or smoked. decreased appetite, rapid breathing and heart rate, meth resembles glass irregular heartbeat, increased blood pressure, extreme fragments or shiny anorexia, memory loss, severe dental problems. blue-white “rocks” of Chronic abusers exhibit violent behavior, anxiety, 14 various sizes. confusion, insomnia, aggression, hallucinations, mood disturbances, delusions, and paranoia that can cause homicidal or suicidal thoughts.

Typically a white or Injected, smoked, or Euphoric surge (or “rush”), followed by wakefulness brownish powder or a sniffed/snorted. and drowsiness, respiratory depression, black sticky substance constricted pupils, nausea, warm flushing of 14 known on the streets the skin, dry mouth, and heavy extremities. as “black tar heroin.”

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 53 SECTION 7

DRUG NAME(S) OTHER NAME(S)

K2/Spice is a mixture of herbs and spices, Bliss, Black Mamba, typically sprayed with a compound similar Bombay Blue, Fake Weed, to THC, the psychoactive ingredients in Genie, Spice, Zohai marijuana. Often sold in drug paraphernalia stores (“head shops”), tobacco or retail stores, and online, it is often sold as incense K2/Spice or “fake weed.”

“Bath salts” contain chemicals (synthetic Bliss, Blue Silk, Cloud stimulants) that are synthetic derivatives Nine, Drone, Energy-1, of cathinone, a central nervous system Ivory Wave, Lunar Wave, stimulant. Many of these products are sold Meow Meow, Ocean Burst, Synthetic Drugs Synthetic over the Internet, in convenience stores, and Pure Ivory, Purple Wave, in head shops. Red Dove, Snow Leopard, Stardust, Vanilla Sky, White Dove, White Knight, Bath Salts White Lightening

Inhalants are invisible, volatile substances in Gluey, Huff, Rush, Whippets common household products. They produce chemical vapors that are inhaled to induce psychoactive or mind altering effects. Inhalants are often among the first drugs young children use. Signs of use include paint or stains on body or clothing, spots or sores around the mouth, red or runny eyes or nose, chemical breath odor.

Inhalants

Dextromethorphan (DXM) is a cough CCC, Dex, DXM, Poor Man’s suppressor found in more than 120 over-the­ PCP, Robo, Rojo, Skittles, counter (OTC) cold medications. Abuse by Triple C, Velvet teenagers and young adults is of particular concern. High doses combined with alcohol Other or other drugs may cause death.

Cold Medications

Tobacco contains nicotine, one of the most Smoke, bone, highly addictive drugs used today. Teens butt, coffin nail, who smoke cigarettes are much more likely cancer stick to use marijuana than those who have never Tobacco (photo by Sjschen) smoked.

Alcohol is a drug that can interfere with Beer, wine, wine cooler, brain development in adolescents and malt liquor, booze teens. Alcohol poisoning, which can happen the very first time someone drinks alcohol, can cause serious brain damage or death. Drinking at a young age also makes Alcohol alcoholism more likely later in life.

For more information about these and other drugs, visit www.getsmartaboutdrugs.com.

54 U.S. DRUG ENFORCEMENT ADMINISTRATION • U.S. DEPARTMENT OF EDUCATION DRUG IDENTIFICATION CHART

DESCRiPTiON HOW CONSUMED MiND AND BODY EFFECTS SEE PAGE(S)

Typically small, silvery Usually smoked in Short term affects include plastic bags of dried joints or pipes; also paranoia, panic attacks, and leaves and marketed made into tea. giddiness; increased heart rate as incense that can and blood pressure. Long-term 15 be smoked. May effects on humans are not resemble potpourri. fully known.

Fine white, off-white, Usually ingested by Agitation, insomnia, irritability, dizziness, depression, or slightly yellow- sniffing or snorting paranoia, delusions, suicidal thoughts, seizures, panic colored powder; also but also taken orally, attacks, impaired perception of reality, reduced tablets and capsules. smoked, or put into a motor control, rapid heart rate (which may lead to solution and injected heart attacks and strokes), chest pains, nosebleeds, 15 into veins. sweating, nausea, vomiting, and decreased ability to think clearly.

Common household Breathed in through Slurred speech, lack of coordination, euphoria, and products such as the nose or the mouth dizziness, drowsiness, lingering headache, weight glue, lighter fluid, by sniffing, snorting, loss, muscle weakness, disorientation, inattentiveness, cleaning fluids, and or bagging (inhaling irritability, depression, unconsciousness, damage to paint. fumes from substances the nervous system and other organs, sudden death. sprayed or deposited inside a plastic or 9-11 paper bag); huffing from an inhalant- soaked rag stuffed in the mouth; or inhaling from balloons filled with nitrous oxide.

Cough syrup, pill Drinking liquid cough Mild stimulation, euphoria, hallucinations, confusion, forms (including preparations or inappropriate laughter, agitation, paranoia, tablets and capsules), powder formulas (now hallucinations, sensory changes (e.g., feeling of or powder. sold over the Internet), floating), loss of coordination, over-excitability, 11 or taking pills that are lethargy, slurred speech, sweating, hypertension. swallowed or crushed DXM products often contain other ingredients that and put into drinks. can cause liver damage, rapid heart rate, vomiting, seizures, and coma.

Dried, fermented Cigarettes, cigars, Addiction, heart and cardiovascular disease, cancer of leaves from the pipes, smokeless the lung, larynx, esophagus, bladder, pancreas, kidney, tobacco plant, tobacco (chew, dip, and mouth; emphysema and chronic bronchitis; can 7-8 usually brown. snuff). cause spontaneous abortion, pre-term delivery, and low birth weight.

Liquids in Orally. Addiction (alcoholism), dizziness, slurred speech, various colors. disturbed sleep, nausea, vomiting, hangovers, impaired motor skills, violent behavior, impaired learning, fetal alcohol syndrome, respiratory depression, and, at high 8-9 doses, death.

GROWING UP DRUG FREE: A PARENT’S GUIDE TO PREVENTION 55 Acknowledgments The Drug Enforcement Administration and the U.S. Department of Education want to thank the following persons for their review and helpful comments on the publication:

vivian Faden and Patricia Powell, National Institute of Alcohol and Alcohol Abuse

Jessica Cotto and Gayathri Dowling, National Institute of Drug Abuse

Rich Lucey and Steve Wing, Substance Abuse and Mental Health Services Administration