Teens and drugs: 5 tips for talking with your kids

Parents of adolescents face a tough dilemma about substance use: we may want our children to be abstinent, but what do we do if they are not? The risks are high, as we've discussed in our blog about adolescent substance use and the developing brain. While parents can and should communicate clearly that non-use is the best decision for health, we simply can't control every aspect of young people's lives. There is no one-size-fits-all approach to successful dialogue with teens about substance use, but these principles may be helpful.

1.   Make your values and your rules clear

Parents sometimes use phrases like "be smart" or "make good decisions," though these terms may have very different meanings to different people. For example, a parent who says, "Be smart!" may think he is asking his child not to drink, while the child may interpret the instructions as, "Don't drink enough to black out." So, be specific. If you mean, "You can go out with your friends as long as you can assure me you will not use marijuana," then say it that way.

2.   Ask and listen, but resist the urge to lecture

As adults we very much want to impart as much wisdom as we can to help young people avoid the same mistakes that we made. But, it is probably more useful to draw out their innate curiosity and encourage them to seek out answers on their own. Consider beginning by asking a question like, "Tell me, what do you know about marijuana?" Teens who feel like their point of view is valued may be more willing to engage in a conversation. In response to what your child says, use nonjudgmental reflective statements to make sure she feels listened to, then follow up with a question. For example: "So you've heard that marijuana is pretty safe because it is natural. Do you think that is correct?" You don't need to agree with everything your teen says; you just need to make it clear you are listening. For more guidance on active listening skills, see this resource from The Center for Parenting Education.

3.   If your child has used substances, try to explore the reasons

Teens may use substances to help manage anxiety, relieve stress, distract from unpleasant emotions, or connect socially with peers. Being curious about those reasons can help him feel less judged. It may also give you a window into your teen's underlying struggles, help him develop insight into his own behavior, and point to problems that may need professional support. On the other hand, these conversations may be challenging for a parent to have with a child, and some young people have limited understanding as to why they use substances. For adolescents who are using substances regularly, we recommend an assessment by a professional who can support them in behavior change.

4.   Know when (and how) to intervene

Engaging with adolescents on the topic of substance use can be a delicate dance. We want to encourage openness and honesty, and we also want them to get clear messages that help to keep them safe. Teens who use substances recurrently and/or who have had a problem associated with substance use may be on a trajectory for developing a substance use disorder. It is a good idea for them to have a professional assessment. You can find a detailed list of signs and symptoms, as well as information about specific substances, on the website for the Adolescent Substance Use and Addiction Program at Boston Children's Hospital. If an assessment is warranted, you can start with your pediatrician, who can help refer you to a specialist as necessary.

5.   Be mindful of any family history of substance use disorders

Much of the underlying vulnerability to developing substance use disorders is passed down genetically. Exposure to substance use in the home is also a major risk factor. Both may affect children with a first- or second-degree relative (like a parent, grandparent, aunt, or uncle) with a substance use disorder. While we know from studies that the genetic heritability of addiction is strong, it is also complex, passed on through a series of genes and generally not limited to a single substance. In other words, children who have a relative with an opioid use disorder may themselves develop a cannabis or sedative use disorder. Honest conversations about unhealthy substance use, addiction, and the family risk of substance use disorders can help provide teens a good, solid reason for making the smart decision not to start using in the first place.