by Deni Carise

It’s boutonniere time. Prom and graduation season bring great excitement, but also anxiety. Every year, parents tell me they worry about the drinking and drugging that often accompany these milestones.  How should I talk to my teen, they ask, about staying safe? Luckily, there are numerous ways to approach a conversation with your teen, depending on your relationship with him or her--and your concerns.

It’s true that substance misuse, particularly underage drinking, is pervasive among teens. One in four twelfth graders report having five or more drinks in a row in the past two weeks (the definition of binge drinking). And it only takes one unlucky experiment with alcohol to produce detrimental consequences, including car crashes, sexual assault, and unplanned pregnancies. Furthermore, alcohol consumption can have long-term, deleterious effects on the still-developing teen brain.

However, rather than just harping on these facts, parents and educators should focus on addressing high school drinking and drugging before it starts by intervening. It does start early. A recent study in the Archives of General Psychiatry examined data from a national survey of more than 10,000 American teens ages 13 to 18. Researchers found that the 15 percent of U.S. high school students who abuse drugs and alcohol began using them at 14 or 15. This finding reinforces earlier research. Another study found that over the course of adolescence, the proportion of kids who drank in the past year rises ten-fold, from seven percent of 12-year-olds to nearly 70 percent of 18-year-olds. It follows that binge drinking also increases with age: about one in six tenth graders binge drink, compared to one in 14 eighth graders. These statistics speak to the need to address experimentation with alcohol, identify high-risk kids, and intervene early. 

Why wait for teens to experience the consequences of substance abuse, if we can develop effective screening, prevention, and intervention methods before they set foot on the dance floor at the prom?

Our clinical team at Phoenix House and researchers at the Philadelphia-based Treatment Research Institute (TRI) and the University of Pennsylvania (UPENN)  have developed a revolutionary software system to assess teens’ and pre-teens’ risk of substance use or abuse.

This computerized screening tool asks kids to answer various questions about their alcohol/drug use, risky behavior (such as riding with drivers who use drugs or alcohol), and future goals. When clinical staff go over these questions with kids, they also have a chance to ask additional questions about why that teen may be experimenting with drugs. Do they experience social anxiety? What kind of pressure are they under? Do they have a tendency to withdraw from groups? Based on their answers to these questions, the system generates a summary document with suggestions for treatment providers. If a child appears to have a healthy, drug-free lifestyle, suggestions will include reinforcing good behavior. If the assessment indicates ongoing, regular use, a counseling session and possible referral to treatment will be recommended. The tool provides suggested protocols for these two scenarios, and everything in between.

We recently began a pilot program at a middle and high school on Long Island, using software to screen kids and provide recommendations. Our aim is to screen every student. We will then test the pilot’s effectiveness by comparing the results of a school-wide risk assessment survey taken at the beginning of the school year to one taken at the end. One young man says, "The project has helped me in so many ways.  It showed me how drugs affect me and the risk that I take if I take drugs.  It helps prevent a lot of accidents." 

We hypothesize that this tool will significantly reduce students’ risk of substance use and abuse by providing them with the support they need before a problem develops. Eventually, we hope to make this system available in schools across the country. This protocol could truly save lives. We know that if a child reaches the age of 21 without developing a Substance Use Disorder, he or she is unlikely to do so later on. Thus, screening and brief intervention protect young people in the short term and in the long term as well. 

If we can screen for substance abuse, why wouldn’t we? We should treat it like any other chronic disease.  We wouldn’t wait till a young person reaches the end of high school to identify and address their high risk of diabetes, or to treat their condition. Similarly, screening, risk reduction, and treatment for adolescent substance abuse should be routine.  Why wait to start the process of safeguarding our kids’ futures?  The real window of opportunity happens long before they buy their boutonnieres.

Here are some guidelines for talking to your teen before he or she starts experimenting

Or more guidelines for bringing up the topic once your teen has started.

Deni Carise Ph.D. is the Chief Clinical Officer of Phoenix House, a leading nonprofit provider of substance abuse prevention and treatment services which operates in 10 states. Carise also serves as a consultant, trainer and advisor for the United Nations Office on Drugs and Crime. She is an adjunct clinical professor at the Center for Studies of Addiction at the University of Pennsylvania. http://www.phoenixhouse.org

image by bronser used under a creative commons license.