What you need to know about your teen and substance abuse by Susan Giurleo, PhD

There is a lot commentary in the news about the opioid epidemic in our country at the moment.

While we often think substance abuse happens to “other people” the reality is, addiction is a disease and can impact  us and those we love.

As I read the news on the interventions being put in place to curb substance abuse and addiction I see a troubling trend. The people being consulted and speaking out are most often law enforcement and medical professionals. Unfortunately, mental health professionals are missing from the table. The conversations revolve around treatment and recovery, rather than prevention. When we neglect to take a hard look at prevention, we are letting our young people down.

There is a myth that addicts “use once” and get hooked. Research does not bear this out. Consequently, there are many things we can do to support  our teens in avoiding the pain and suffering of an addiction which develops over time.

The truth is, our teens are most likely going to try alcohol and drugs. They are “hard wired” to push limits, test rules, and their brains crave stimulation and a “high” feels good. Often we hear about peer pressure being the driving factor toward substance use. However, after 20 years of working with teens, I want to suggest that kids don’t use merely to be cool or fit in and break rules. They often use drugs and alcohol to numb an inner pain that they can’t soothe on their own.

This substance driven soothing can be more pronounced in young people diagnosed with ADHD, whose brains are constantly humming and who often find school and friendships challenging due to their impulsivity and lack of focus. Teens who have untreated ADHD are statistically more susceptible to substance abuse as they try to self-medicate the chaos in their brains and cope with the ongoing negative feedback they receive about themselves in the school setting.

Additionally, it is not coincidental that a culture that is over stressed, moves too fast, frowns on self-care and sees vulnerability as a weakness has an opioid epidemic. Collectively, we need to chill out. The pressure we put on ourselves and our kids to overachieve, always be “on,” meet ever higher and higher expectations leads us to a place where we need to medicate ourselves to function. And some people’s brains are wired to get addicted to that medication.

Substance abuse prevention checklist

If we are being realistic, chances are your teen will try alcohol and/or drugs in his/her teen years. Experimentation in and of itself is not a major problem and is a normal part of these developmental years. But for some kids, experimentation leads to more chronic use and possible addiction. Here is a checklist of ways to support your child in hopefully preventing a bigger substance use problem.

  • Allow room for emotions. Teens are moody. They have very high and very low emotions. Often their emotional lives are confusing to adults. No matter how illogical their emotions appear to be, allow them to freely express themselves and support them in coping with their big feelings. A teen who can openly express feelings will not feel compelled to numb their unprocessed feelings later on.

  • Talk about substance use in nonjudgemental ways. If we accept that teens will experiment with substances, we have have productive conversations with our kids about drug use and abuse. Often we parents become anxious about the idea that our kid may drink a beer or smoke a joint and we throw out ultimatums and consequences before our kids can even go to their middle  school party. A teen who feels that any mistake or experimentation will lead to harsh consequences will sneak their experimentation under the radar. You will sleep better at night not knowing if your child is using, but that doesn’t mean they are safe.

  • Be aware of how you speak about substance use, abuse and those who are addicted. We all hold prejudices about drugs and those who use them. And our kids are always listening to our beliefs and values. A compassionate, rather than a negative tone regarding substance abuse and addiction can support our kids in informing us when they feel they may be having difficulty with their own use.

  • If your child does use substances, talk about how it makes them feel. No teen wants to abuse substances. Be open to the idea they are self-medicating a pain rather than simply making a stupid decision.

  • Get treatment for your child’s ADHD. Often parents have good intentions when they don’t medicate their child with a psychostimulant. However, untreated ADHD is correlated with higher levels of substance abuse compared to teens who are appropriately treated with medication and psychotherapy.

  • Additionally, seek treatment if you suspect your child may have anxiety and/or depression. While moodiness can be expected, ongoing struggles with sleeping, eating, friendships,school performance/behavior can all be signs your child is struggling with a bigger mental health issue. Also, keep in mind that depression in young people can appear to be anger and irritability rather than sadness, especially in boys.

  • If you are concerned seek help and support for your child and yourself. Early treatment of substance abuse is an important step toward preventing a chronic addiction. Parents need help,too. Seek out your own therapist and/or a support group.


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