What you don’t know can put your child at risk. You may think you already know enough about the drug culture because drugs were around when you were growing up. You may have even tried marijuana when you were a teen.

Today, kids know more, are exposed to a greater variety of drugs and drug sources, from friends to music and the media. Drugs are often cheaper and easier to find for kids today. Educate yourself about the new drug culture and your kids. 

Types of Treatment Programs

Research studies on addiction treatment typically have classified programs into several general types or modalities. Treatment approaches and individual programs continue to evolve and diversify, and many programs today do not fit neatly into traditional drug addiction treatment classifications.

Most, however, start with detoxification and medically managed withdrawal, often considered the first stage of treatment. Detoxification, the process by which the body clears itself of drugs, is designed to manage the acute and potentially dangerous physiological effects of stopping drug use. As stated previously, detoxification alone does not address the psychological, social, and behavioral problems associated with addiction and therefore does not typically produce lasting behavioral changes necessary for recovery. Detoxification should thus be followed by a formal assessment and referral to drug addiction treatment.

Because it is often accompanied by unpleasant and potentially fatal side effects stemming from withdrawal, detoxification is often managed with medications administered by a physician in an inpatient or outpatient setting; therefore, it is referred to as "medically managed withdrawal.” Medications are available to assist in the withdrawal from opioids, benzodiazepines, alcohol, nicotine, barbiturates, and other sedatives.

Kleber, H.D. Outpatient detoxification from opiates. Primary Psychiatry 1:42-52, 1996.

Long-Term Residential Treatment

Long-term residential treatment provides care 24 hours a day, generally in non-hospital settings. The best-known residential treatment model is the therapeutic community (TC), with planned lengths of stay of between 6 and 12 months. TCs focus on the "resocialization" of the individual and use the program’s entire community—including other residents, staff, and the social context—as active components of treatment. Addiction is viewed in the context of an individual’s social and psychological deficits, and treatment focuses on developing personal accountability and responsibility as well as socially productive lives. Treatment is highly structured and can be confrontational at times, with activities designed to help residents examine damaging beliefs, self-concepts, and destructive patterns of behavior and adopt new, more harmonious and constructive ways to interact with others. Many TCs offer comprehensive services, which can include employment training and other support services, onsite. Research shows that TCs can be modified to treat individuals with special needs, including adolescents, women, homeless individuals, people with severe mental disorders, and individuals in the criminal justice system (see "Treating Criminal Justice-Involved Drug Abusers and Addicted Individuals").

Lewis, B.F.; McCusker, J.; Hindin, R.; Frost, R.; and Garfield, F. Four residential drug treatment programs: Project IMPACT. In: J.A. Inciardi, F.M. Tims, and B.W. Fletcher (eds.),   Innovative Approaches in the Treatment of Drug Abuse, Westport, CT: Greenwood Press, pp. 45-60, 1993.

Sacks, S.; Banks, S.; McKendrick, K.; and Sacks, J.Y. Modified therapeutic community for co-occurring disorders: A summary of four studies. Journal of Substance Abuse Treatment34(1):112-122, 2008.

Sacks, S.; Sacks, J.; DeLeon, G.; Bernhardt, A.; and Staines, G. Modified therapeutic community for mentally ill chemical "abusers": Background; influences; program description; preliminary findings. Substance Use and Misuse 32(9):1217-1259, 1997.

Stevens, S.J., and Glider, P.J. Therapeutic communities: Substance abuse treatment for women. In: F.M. Tims, G. DeLeon, and N. Jainchill (eds.), Therapeutic Community: Advances in Research and Application, National Institute on Drug Abuse Research Monograph 144, NIH Pub. No. 94-3633, U.S. Government Printing Office, pp. 162-180, 1994.

Sullivan, C.J.; McKendrick, K.; Sacks, S.; and Banks, S.M. Modified therapeutic community for offenders with MICA disorders: Substance use outcomes. American Journal of Drug and Alcohol Abuse 33(6):823-832, 2007.

Short-Term Residential Treatment

Short-term residential programs provide intensive but relatively brief treatment based on a modified 12-step approach. These programs were originally designed to treat alcohol problems, but during the cocaine epidemic of the mid-1980s, many began to treat other types of substance use disorders. The original residential treatment model consisted of a 3- to 6-week hospital-based inpatient treatment phase followed by extended outpatient therapy and participation in a self-help group, such as AA. Following stays in residential treatment programs, it is important for individuals to remain engaged in outpatient treatment programs and/or aftercare programs. These programs help to reduce the risk of relapse once a patient leaves the residential setting.

Hubbard, R.L.; Craddock, S.G.; Flynn, P.M.; Anderson, J.; and Etheridge, R.M. Overview of 1-year follow-up outcomes in the Drug Abuse Treatment Outcome Study (DATOS). Psychology of Addictive Behaviors 11(4):291-298, 1998.

Miller, M.M. Traditional approaches to the treatment of addiction. In: A.W. Graham and T.K. Schultz (eds.), Principles of Addiction Medicine (2nd ed.). Washington, D.C.: American Society of Addiction Medicine, 1998.

Outpatient Treatment Programs

Outpatient treatment varies in the types and intensity of services offered. Such treatment costs less than residential or inpatient treatment and often is more suitable for people with jobs or extensive social supports. It should be noted, however, that low-intensity programs may offer little more than drug education. Other outpatient models, such as intensive day treatment, can be comparable to residential programs in services and effectiveness, depending on the individual patient’s characteristics and needs. In many outpatient programs, group counseling can be a major component. Some outpatient programs are also designed to treat patients with medical or other mental health problems in addition to their drug disorders.

Hubbard, R.L.; Craddock, S.G.; Flynn, P.M.; Anderson, J.; and Etheridge, R.M. Overview of 1-year follow-up outcomes in the Drug Abuse Treatment Outcome Study (DATOS). Psychology of Addictive Behaviors 11(4):291-298, 1998.

Institute of Medicine. Treating Drug Problems. Washington, D.C.: National Academy Press, 1990.

McLellan, A.T.; Grisson, G.; Durell, J.; Alterman, A.I.; Brill, P.; and O'Brien, C.P. Substance abuse treatment in the private setting: Are some programs more effective than others?Journal of Substance Abuse Treatment 10:243-254, 1993.

Simpson, D.D., and Brown, B.S. Treatment retention and follow-up outcomes in the Drug Abuse Treatment Outcome Study (DATOS). Psychology of Addictive Behaviors 11(4):294-307, 1998.

Individualized Drug Counseling

Individualized drug counseling not only focuses on reducing or stopping illicit drug or alcohol use; it also addresses related areas of impaired functioning—such as employment status, illegal activity, and family/social relations—as well as the content and structure of the patient’s recovery program. Through its emphasis on short-term behavioral goals, individualized counseling helps the patient develop coping strategies and tools to abstain from drug use and maintain abstinence. The addiction counselor encourages 12-step participation (at least one or two times per week) and makes referrals for needed supplemental medical, psychiatric, employment, and other services.

Group Counseling

Many therapeutic settings use group therapy to capitalize on the social reinforcement offered by peer discussion and to help promote drug-free lifestyles. Research has shown that when group therapy either is offered in conjunction with individualized drug counseling or is formatted to reflect the principles of cognitive-behavioral therapy or contingency management, positive outcomes are achieved. Currently, researchers are testing conditions in which group therapy can be standardized and made more community-friendly.

Treating Criminal Justice-Involved Drug Abusers and Addicted Individuals

Often, drug abusers come into contact with the criminal justice system earlier than other health or social systems, presenting opportunities for intervention and treatment prior to, during, after, or in lieu of incarceration. Research has shown that combining criminal justice sanctions with drug treatment can be effective in decreasing drug abuse and related crime. Individuals under legal coercion tend to stay in treatment longer and do as well as or better than those not under legal pressure. Studies show that for incarcerated individuals with drug problems, starting drug abuse treatment in prison and continuing the same treatment upon release—in other words, a seamless continuum of services—results in better outcomes: less drug use and less criminal behavior. More information on how the criminal justice system can address the problem of drug addiction can be found in Principles of Drug Abuse Treatment for Criminal Justice Populations: A Research-Based Guide  (National Institute on Drug Abuse, revised 2012).

Want to Know More?— Some FAQs about Marijuana

What is marijuana? Are there different kinds?

Fact: Marijuana has adverse effects on many of the skills required for driving a car. Driving while high can lead to car accidents.

Marijuana is a green, brown, or gray mixture of dried, shredded leaves, stems, seeds, and flowers of the hemp plant (Cannabis sativa). Cannabis is a term that refers to marijuana and other drugs made from the same plant. Strong forms of cannabis include sinsemilla (sin-seh-me-yah), hashish ("hash" for short), and hash oil. There are many different slang terms for marijuana and, as with other drugs, they change quickly and vary from region to region. But no matter its form or label, all cannabis preparations are mind-altering (psychoactive) because they all contain THC (delta-9-tetrahydrocannabinol). They also contain more than 400 other chemicals.

How is marijuana used?

Most users roll loose marijuana into a cigarette (called a joint or a nail) or smoke it in a pipe or a water pipe, sometimes referred to as a bong. Some users mix marijuana into foods, or use it to brew a tea. Another method is to slice open a cigar and replace the tobacco with marijuana, creating what is known as a blunt. Marijuana cigarettes or blunts sometimes are dipped in PCP or mixed with other substances, including crack cocaine.

How many people use marijuana?

Before the 1960s, many Americans had never heard of marijuana, but today it is the most often used illegal drug in the United States. According to a 2009 national survey, more than 104 million Americans over the age of 12 had tried marijuana at least once, and almost 17 million had used the drug in the month before the survey.

Researchers have found that the use of marijuana and other drugs usually peaks in the late teens and early twenties, and then declines in later years. Therefore, marijuana use among young people remains a natural concern for parents and the focus of continuing research, particularly regarding its impact on brain development, which continues into a person's early twenties.

NIDA's annual Monitoring the Future Survey reports that among students from 8th, 10th, and 12th grades, most measures of marijuana use have decreased over the past decade; however, this decline has stalled in recent years as attitudes have softened about marijuana's risks. In 2009, 11.8 percent of 8th-graders reported marijuana use in the past year, and 6.5 percent were current (past-month) users. Among 10th-graders, 26.7 percent had used marijuana in the past year, and 15.9 percent were current users. Rates of use among 12th-graders were higher still: 32.8 percent had used marijuana during the year prior to the survey, and 20.6 percent (or about 1 in 5) were current users.

How does marijuana work?

When marijuana is smoked, its effects are felt almost immediately. This is because THC (marijuana's psychoactive ingredient) rapidly reaches every organ in the body, including the brain. The effects of smoked marijuana can last from 1 to 3 hours. If consumed in foods, the effects come on slower and may not last as long.

Marijuana works through THC attaching to specific sites on nerve cells in the brain and in other parts of the body. These sites are called cannabinoid receptors (CBRs) since they were discovered by scientists trying to understand how marijuana, or cannabis, exerts its effects. THC is chemically similar to a class of chemicals that our body produces naturally, called endocannabinoids, and marijuana disrupts the normal function of this system. CBRs are found in brain areas that influence pleasure, memory, thinking, concentration, movement, coordination, appetite, pain, and sensory and time perception. Because of this system's wide-ranging influence over many critical functions, it is not surprising that marijuana can have multiple effects—not just on the brain, but on a user's general health as well. Some of these effects are related to acute intoxication while others may accumulate over time to cause more persistent problems, including addiction.

What are marijuana's short-term effects?

The following are some effects that marijuana use can produce:

• Euphoria (high). THC activates the reward system in the same way that nearly all drugs of abuse do: by stimulating brain cells to release the chemical dopamine.
• Memory impairment. THC alters how information is processed in the hippocampus, a brain area responsible for memory formation, causing problems with short-term memory as well as difficulty with complex tasks requiring sustained attention/concentration. Prolonged use could therefore affect learning skills and academic achievement.
• Increased appetite ("munchies").
• Increased heart rate.
• Dilation (expansion) of the blood vessels in the eyes, making them look red or bloodshot.
• Adverse mental reactions in some. These include anxiety, fear, distrust, or panic, particularly in those who are new to the drug or who are taking it in a strange setting; and acute psychosis, which includes hallucinations, delusions, paranoia, and loss of the sense of personal identity.

What determines how marijuana affects an individual? How important is marijuana potency?

Fact: In 2008, marijuana was reported in over 374,000 emergency department visits in the U.S., with about 13 percent involving people between the ages of 12 and 17.

• Like any other drug, marijuana's effects on an individual depend on a number of factors, including the person's previous experience with the drug (or other drugs), biology (e.g., genes), gender, how the drug is taken (smoked versus orally), and the drug's potency. Potency—determined by the amount of THC contained in the marijuana—has received much attention lately because it has been increasing steadily. In 2009, THC concentrations in marijuana averaged close to 10 percent, compared to around 4 percent in the 1980s. This is based on analyses of marijuana samples confiscated by law enforcement agencies. So what does this actually mean? For a new user, it may mean exposure to higher concentrations of THC, with a greater chance of an adverse or unpredictable reaction. In fact, increases in potency may account for the rise in emergency department visits involving marijuana use. For experienced users, it may mean a greater risk for addiction if they are exposing themselves to high doses on a regular basis. However, the full range of consequences associated with marijuana's higher potency is not well understood, nor is it known whether marijuana users adjust for the increase in potency by using less.

Does using marijuana lead to other drug use?

• Long-term studies of high school students' patterns of drug use show that most young people who use other drugs have tried marijuana, alcohol, or tobacco first. That said, many young people who use marijuana do not go on to use other drugs. It is clear that more research is needed to determine who is at greatest risk. For example, the risk of young people using cocaine is much greater for those who have tried marijuana than for those who have not (though teen cocaine use is low overall). We also know from animal studies that when rats are exposed to cannabinoids their brain reward system becomes less sensitive, or responsive, to that drug, which means that they would need more of the drug to achieve the same effect. An important aspect of this effect is a phenomenon called cross-tolerance (the ability of one drug to reduce responsiveness to a different drug). This was only seen if the rats that were given cannabinoids were young (e.g., adolescent) at the time of exposure. Prompted by the results of this animal study, researchers are now examining the possibility that early exposure to marijuana (e.g., in adolescence) may induce changes in the brain that make a person more vulnerable to subsequent marijuana addiction or to the risk of becoming addicted to other drugs, such as alcohol, opioids, or cocaine. It is important to point out, however, that research has not fully explained any of these effects, which are complex and likely to involve a combination of biological, social, and psychological factors.

Does smoking marijuana cause lung cancer?

• We do not know yet. Studies have not found an increased risk of lung cancer in marijuana smokers, as compared with nonsmokers. However, marijuana smoke does irritate the lungs and increases the likelihood of other respiratory problems through exposure to carcinogens and other toxins. Repeated exposure to marijuana smoke can lead to daily cough and excess phlegm production, more frequent acute chest illnesses, and a greater risk of lung infections. Marijuana also affects the immune system, although the implications for cancer are unclear. Moreover, many people who smoke marijuana also smoke cigarettes, which do cause cancer, and quitting tobacco can be harder if the person uses marijuana as well.

Since marijuana is addictive, does it produce withdrawal symptoms when someone quits using it?

• For many years, this was a subject of debate; but researchers have clearly characterized a set of symptoms that many long-term users experience when they stop using the drug. The symptoms are similar in type and severity to those of nicotine withdrawal— irritability, sleeping difficulties, anxiety, and craving—which often prompt relapse. Withdrawal symptoms peak a few days after use has stopped and dissipate within about 2 weeks. And while these symptoms do not pose an immediate threat to the health of the user, they can make it hard for someone to remain abstinent.

Are there treatments for people addicted to marijuana?

• Currently, no FDA-approved medications exist for treating marijuana addiction, although promising research is under way to find medications for treating withdrawal symptoms and alleviating craving and other subjective effects of marijuana. Behavioral therapies are available and are similar to those used for treating other substance addiction. These include motivational enhancement to engage people in treatment; cognitive behavioral therapies to teach patients strategies for avoiding drug use and its triggers and for effectively managing stress; and motivational incentives, which provide vouchers or small cash rewards for sustained drug abstinence. Unfortunately, treatment success rates are rather modest, indicating that marijuana addiction, like other addictions, may need a chronic care approach that varies treatment intensity in line with the person's changing needs over time.

What are other risks related to marijuana that my child should be aware of?

• Here are a few that you or your child may not have thought about:

As with most drugs, marijuana use compromises judgment, which can mean a greater likelihood of engaging in risky behaviors and experiencing their negative consequences (e.g., acquiring a sexually transmitted disease, driving while intoxicated, or riding with someone else who is intoxicated and getting into a car crash).

In addition to psychosis, chronic marijuana use has been associated with an array of psychological effects, including depression, anxiety, suicidal thoughts, and personality disturbances. One of the most frequently cited is an "amotivational syndrome," which describes a diminished or lost drive to engage in formerly rewarding activities.

Whether this disorder occurs unto itself or is a subtype of depression associated with marijuana use remains controversial, as does the causal influence of marijuana. However, because of the endocannabinoid system's role in regulating mood, these associations seem plausible. More research is needed to confirm and better understand these linkages.

Marijuana use during pregnancy may adversely affect the fetus. Animal research suggests that the endocannabinoid system plays a role in the control of brain maturation, particularly the development of emotional responses. In humans, the data are less conclusive—in part, because it is difficult to disentangle the drug-specific factors from the environmental ones. For example, pregnant women who use marijuana may also smoke cigarettes or drink alcohol, both of which can affect fetal development. Nevertheless, research suggests that babies born to women who used marijuana during their pregnancies may have subtle neurological alterations and, as children, can show diminished problemsolving skills, memory, and attentive processes. Although, the extent to which these effects reflect marijuana use or other drugs is unclear.

How can I tell if my child has been using marijuana?

• Parents should be aware of changes in their child's behavior, such as carelessness with grooming, mood changes, and deteriorating relationships with family members and friends. In addition, changes in academic performance, increased absenteeism or truancy, lost interest in sports or other favorite activities, and changes in eating or sleeping habits could all be related to drug use—or may indicate other problems. See textbox for a more detailed list of warning signs.
• If someone is high on marijuana, he or she might:
• seem dizzy or uncoordinated;
• seem silly and giggly for no reason;
• have very red, bloodshot eyes;
• have a hard time remembering things that just happened;
• be in possession of drugs and drug paraphernalia, including pipes and rolling papers;
• have an odor on clothes and in the bedroom;
• use incense and other deodorizers;
• use eye drops;
• wear clothing or jewelry or have posters that promote drug use; or
• have unexplained use of money.

Starting the Conversation

As this information has shown, marijuana can pose a particular threat to the health and well-being of children and adolescents at a critical point in their lives—when they are growing, learning, maturing, and laying the foundation for their adult years. As a parent, your children look to you for help and guidance in working out problems and in making decisions, including the decision not to use drugs. Even if you have used drugs in the past, you can have an open conversation about the dangers. Divulging past drug use is an individual decision, but having used drugs should not prevent you from talking to your child about the dangers of drug use. In fact, experience can better equip us to teach others, including drawing on the value of possible mistakes.

Fact: Marijuana is addictive. About 1 in 11 people who try it, and 25-50 percent of those who use it every day, become addicted to marijuana.

Greater acceptance of marijuana use, compared with use of other illicit drugs, continues to underlie divergent opinions about its dangers, illegality, and potential value. Indeed, the ongoing public debate about smoking marijuana to ameliorate a wide range of ills—from pain and nausea to anxiety and sleep disturbances—may complicate your discussion. However, as you have read, marijuana also has liabilities and as a medicinal formulation is not ideal. It contains numerous other compounds with unknown health effects; plus, smoking as a delivery method clearly is not optimal for lung health. Scientists continue to investigate the medicinal properties of THC and other cannabinoids to better evaluate and harness their ability to help patients suffering from a broad range of conditions, while avoiding the adverse effects of smoked marijuana.

Fact: Marijuana users may have many of the same respiratory problems that tobacco smokers have, such as chronic cough and more frequent chest colds.

Meanwhile, marijuana use can be particularly dangerous for adolescents and can alter the trajectory of a young life, diminishing a person's full potential. And that is reason enough to have this sometimes difficult conversation with your children. We hope this booklet can serve as a catalyst and helpful guide to beginning the dialogue and, more importantly, continuing it and keeping the channels of communication open.

Other Useful Resources

There are numerous resources, many right in your own community, where you can obtain information to help you talk to your children about drugs. Consult your local library, school, or community service organization. You may also contact the governmental organizations listed below.

Fact: Marijuana affects the brain and leads to impaired short-term memory, perception, judgment, and motor skills.

National Institute on Drug Abuse (NIDA)

NIDA's mission is to lead the Nation in bringing the power of science to bear on drug abuse and addiction. This charge has two critical components. The first is the strategic support and conduct of research across a broad range of disciplines. The second is ensuring the rapid and effective dissemination and use of the results of that research to inform policy and improve practice.

NIDA offers an extensive collection of publications, videotapes, and educational materials to help parents talk to their children about drug use. For general inquiries, contact NIDA's public information office at 301-443-1124 or visit the NIDA Web site at www.drugabuse.gov. For more information on marijuana and other drugs, visit http://www.drugabuse.gov/drugs-abuse/marijuana and www.teens.drugabuse.gov. All NIDA publications are available free of charge through the NIDA DRUGPUBS Research Dissemination Center (http://drugpubs.drugabuse.gov; email drugpubs@nida.nih.gov; or phone 1-877-NIDA-NIH or 1-240-645-0228.

Substance Abuse and Mental Health Services Administration (SAMHSA)

SAMHSA provides valuable information on its Web site, including resources for finding substance abuse treatment. Its treatment locator (http://findtreatment.samhsa.gov/) can help you find a drug abuse or alcohol treatment program near you. Visit http://www.samhsa.gov for more information on drug abuse prevention and treatment policies, programs, and services.

National Institute of Mental Health (NIMH)

NIMH provides numerous resources covering a variety of mental health disorders, which often co-occur with drug abuse and addiction. Visit www.nimh.nih.gov to access the latest research findings and other helpful mental health information.

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

NIAAA conducts and supports research across many scientific areas, coordinating with other institutes on alcohol-related issues, which frequently intersect with other drug abuse/addiction problems. Visit http://www.niaaa.nih.gov/ for information on a variety of alcohol-related topics.

Medicines Two Choices for You

The Cause of Addiction

Appreciate that a child's first drug is refined sugar. This is always due to the side-effect of taking antibiotics and being exposed to the other Digestive System Disruptors, resulting in Leaky Gut Syndrome and not restoring balance to the digestive system.  Dr. Huntoon has properly addressed this for over 30 years and has helped individuals beat their addictions to both alcohol and drugs. And it starts with cleaning up the Digestive System.

So many, including those in the "addiction" profession do not realize that all addiction begins with the sense of taste in which 80 % of your taste buds are devoted to the taste of sweets. As a result, when a child's self-esteem is threatened in any way and they begin to feel low self-esteem, there is an 80 % chance your child will reach for something sweet to satisfy the imbalance within their self-esteem. 

Once a child has developed this addiction, it is not a great leap to continue to want to "escape" their stress and not knowing how to deal with it, to more stronger escaped. The first of these is usually smoking or smoking marijuana. It can also be the adult form of sugar, alcohol. Any and all of these may become the drug of choice for the child and if some of the choices and situations the child experiences as a result of those choices can lead to stronger drugs. Please keep that in mind when looking at this situation.

Marijuana: The Facts Parents Need to Know

The National Institute on Drug Abuse (NIDA) are pleased to offer two short booklets for parents and children to review the scientific facts about marijuana:

(1) Marijuana: Facts Parents Need to Know and (2) Marijuana: Facts for Teens. Although it is best to talk about drugs when children are young—since that is when drug use often begins—it is never too late to start.

Marijuana remains the most abused illicit substance among youth. By the time they graduate high school, about 44 percent of U.S. teens will have tried marijuana at least once in their lifetime. Although use among teens has dropped dramatically in the past decade (to a prevalence of about 15 percent for past-month use in 2010), this decline has stalled and, in fact, may now be on the upswing. Recent survey data show that daily marijuana use is up among students in 8th, 10th, and 12th grades, compared to the year prior. A principal reason is that today's teens have come to view marijuana as less dangerous than before—even among 8th-graders, whose marijuana use increased across past-year, past-month, and daily measures. These statistics were taken from the 2010 Monitoring the Future Survey, which has been tracking teen attitudes and drug use since 1975.

Survey results show that we still have a long way to go in our efforts to prevent marijuana use and avoid the toll it can take on a young person's life. NIDA recognizes that parents have an important role in this effort and can strongly influence their children's attitudes and behaviors. However, the subject of marijuana use has become increasingly difficult to talk about—in part, because of the mixed messages being conveyed by the passage of medical marijuana laws and calls for marijuana legalization in certain States. In addition, many parents of today's teens may have used marijuana when they were younger, which could make talking openly and setting definitive rules about its use more difficult.

Talking to our children about drug abuse is not always easy, but it is crucial. You can also get involved in your community and seek out drug abuse prevention programs that you and your child can participate in together. Sometimes, just beginning the conversation is the hardest part. I hope these booklets can help.

Nora D. Volkow, M.D.
Director
National Institute on Drug Abuse

Alcohol

Ethyl alcohol, or ethanol, is an intoxicating ingredient found in beer, wine, and liquor. Alcohol is produced by the fermentation of yeast, sugars, and starches. It is a central nervous system depressant that is rapidly absorbed from the stomach and small intestine into the bloodstream. A standard drink equals 0.6 ounces of pure ethanol, or 12 ounces of beer; 8 ounces of malt liquor; 5 ounces of wine; or 1.5 ounces (a "shot") of 80-proof distilled spirits or liquor (e.g., gin, rum, vodka, or whiskey). NIDA does not conduct research on alcohol; for more information, please visit the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and theCenters for Disease Control (CDC).

Parents and others may be interested in the following signs and symptoms of drug use provided by The National Youth Anti-Drug Media Campaign:

• Alcohol:  

Odor on the breath. Intoxication/drunkenness. Difficulty focusing: glazed appearance of the eyes. Uncharacteristically passive behavior or combative and argumentative behavior. Gradual decline in personal appearance and hygiene. Gradual development of difficulties, especially in schoolwork or job performance. Absenteeism (particularly on Monday). Unexplained bruises and accidents. Irritability. Flushed skin. Loss of memory (blackouts). Availability and consumption of alcohol becomes the focus of social activities. Changes in peer-group associations and friendships. Impaired interpersonal relationships (unexplainable termination of relationships, and separation from close family members).

• Cocaine/Crack/Methamphetamines/Stimulants:  

Extremely dilated pupils. Dry mouth and nose, bad breath, frequent lip licking. Excessive activity, difficulty sitting still, lack of interest in food or sleep. Irritable, argumentative, nervous. Talkative, but conversation often lacks continuity; changes subject rapidly. Runny nose, cold or chronic sinus/nasal problems, nose bleeds. Use or possession of paraphernalia including small spoons, razor blades, mirror, little bottles of white powder and plastic, glass or metal straws.

• Depressants:  

Symptoms of alcohol intoxication with no alcohol odor on breath. (Remember that depressants are frequently used with alcohol.) Lack of facial expression or animation. Flat affect. Limp appearance. Slurredspeech. 

Note: There are few readily apparent symptoms. Abuse may be indicated by activities such as frequent visits to different physicians for prescriptions to treat “nervousness”, “anxiety”, “stress”, etc.

• Ecstasy:  

Confusion, blurred vision, rapid eye movement, chills or sweating, high body temperature, sweating profusely, dehydrated, confusion, faintness, paranoia or severe anxiety, panic attacks, trance-like state, transfixed on sights and sounds, unconscious clenching of the jaw, grinding teeth, muscle tension, very affectionate.  Depression, headaches, dizziness (from hangover/after effects), possession of pacifiers (used to stop jaw clenching), lollipops, candy necklaces, mentholated vapor rub, vomiting or nausea (from hangover/after effects). 

• Hallucinogens/LSD/Acid:  

Extremely dilated pupils, warm skin, excessive perspiration, and body odor are symptoms. Distorted sense of sight, hearing, touch; distorted image of self and time perception, mood and behavior changes, the extent depending on emotional state of the user and environmental conditions. Unpredictable flashback episodes even long after withdrawal (although these are rare). Hallucinogenic drugs, which occur both naturally and in synthetic form, distort or disturb sensory input, sometimes to a great degree. Hallucinogens occur naturally in primarily two forms, (peyote) cactus and psilocybin mushrooms.

Several chemical varieties have been synthesized, most notably LSD, MDA, STP, and PCP. Hallucinogen usage reached a peak in the United States in the late 1960s, but declined shortly thereafter due to a broader awareness of the detrimental effects of usage. However, a disturbing trend indicating resurgence in hallucinogen usage by high school and college students nationwide has been acknowledged by law enforcement. With the exception of PCP, all hallucinogens seem to share common effects of use. Any portion of sensory perceptions may be altered to varying degrees. Synesthesia, or the “seeing” of sounds,and the “hearing” of colors, is a common side effect of hallucinogen use.

Depersonalization, acute anxiety, and acute depression resulting in suicide have also been noted as a result of hallucinogen use.

• Inhalants:  

Substance odor on breath and clothes, runny nose, watering eyes, drowsiness or unconsciousness, poor muscle control. Prefers group activity to being alone. Presence of bags or rags containing dry plastic cement or other solvent at home, in locker at school or at work. Discarded whipped cream, spray paint or similar chargers (users of nitrousoxide). Small bottles labeled “incense” (users of butyl nitrite).

• Marijuana/Pot:  

Rapid, loud talking and bursts of laughter in early stages of intoxication. Sleepy or dazed in the later stages. Forgetfulness in conversation, inflammation in whites of eyes; pupils unlikely to be dilated, odor similar to burnt rope on clothing or breath. Brown residue on fingers, tendency to drive slowly – below speed limit, distorted sense of time passage – tendency to overestimate time intervals. Use or possession of paraphernalia including roach clip, packs of rolling papers, pipes or bongs. Marijuana users are difficult to recognize unless they are under the influence of the drug at the time of observation. Casual users may show none of the general symptoms. Marijuana does have a distinct odor and may be the same color or a bit greener than tobacco.

• Narcotics/Prescription Drugs/Heroin/Opium/Codeine/Oxycontin:  

Lethargy, drowsiness, constricted pupils fail to respond to light. Redness and raw nostrils from inhaling heroin in powder form. Scars (tracks) on inner arms or other parts of body, from needle injections. Use or possession of paraphernalia including syringes, bent spoons, bottle caps, eye droppers, rubber tubing, cotton and needles. Slurred speech. While there may be no readily apparent symptoms of analgesic abuse, it may be indicated by frequent visits to different physicians or dentists for prescriptions to treat pain of non-specific origin. In cases where patient has chronic pain and abuse of medication is suspected, it may be indicated by amounts and frequency taken.

• PCP:  

Unpredictable behavior; mood may swing from passivity to violence for no apparent reason. Symptoms of intoxication, disorientation, agitation and violence if exposed to excessive sensory stimulation. Fear, terror, rigid muscles, strange gait, deadened sensory perception (may experience severe injuries while appearing not to notice). Pupils may appear dilated. Mask-like facial appearance, floating pupils, appear to follow a moving object. Comatose (unresponsive) if large amount consumed, eyes may be open or closed.

• Solvents, Aerosols, Glue, Gasoline:
• Nitrous Oxide – laughing gas, whippits, nitrous
• Amyl Nitrate – snappers, poppers, pearlers, rushamies
• Butyl Nitrate – locker room, bolt, bullet, rush, climax, red gold

Slurred speech, impaired coordination, nausea, vomiting, slowed breathing. Brain damage, pains in the chest, muscles, joints, heart trouble, severe depression, fatigue, and loss of appetite, bronchial spasm, sores on nose or mouth, nosebleeds, diarrhea, bizarre or reckless behavior, sudden death, suffocation.

If you have increased your monitoring of your child and you suspect that he or she may be using drugs or alcohol, it’s time to have a conversation about substance abuse. In a caring, gently way, let your child know that in your family you have a policy of no drug use. And know that you should have this conversation not just once in your child’s life, but often. If you continue to spot the signs and symptoms of drug use, you may want to take your child to the doctor and ask him/her to screen for the use of illicit substances. This may involve a urine or blood drug screen. There are also over-the-counter drug tests available in some pharmacies. However, the analysis will have to be done by a professional.

Content provided with permission from The National Youth Anti-Drug Media Campaign.

The best solution is awareness and then addressing the problem. The choice of treatment and solution is an individualized one. What a parent can do is become aware of the signs and take the appropriate action. Working with a Holistic Chiropractor can help you and your family be and stay healthy.

Teen Drinking and Drug Use

How can you tell if your child is using drugs or alcohol? It is difficult because changes in mood or attitudes, unusual temper outbursts, changes in sleeping habits and changes in hobbies or other interests are common in teens. What should you look for?

Watch List for Parents 

• Changes in friends
• Negative changes in schoolwork, missing school, or declining grades
• Increased secrecy about possessions or activities
• Use of incense, room deodorant, or perfume to hide smoke or chemical odors
• Subtle changes in conversations with friends, e.g. more secretive, using “coded” language
• Change in clothing choices: new fascination with clothes that highlight drug use
• Increase in borrowing money
• Evidence of drug paraphernalia such as pipes, rolling papers, etc.
• Evidence of use of inhalant products (such as hairspray, nail polish, correction fluid, common household products). Rags and paper bags are sometimes used as accessories
• Bottles of eye drops, which may be used to mask bloodshot eyes or dilated pupils
• New use of mouthwash or breath mints to cover up the smell of alcohol
• Missing prescription drugs—especially narcotics and mood stabilizers

You can also look for signs of depression, withdrawal, carelessness with grooming or hostility. Also ask yourself, is your child doing well in school, getting along with friends, taking part in sports or other activities?

These changes often signal that something harmful is going on—and often that involves alcohol or drugs. You may want to take your child to the doctor and ask him or her about screening your child for drugs and alcohol. This may involve the health professional asking your child a simple question, or it may involve urine or blood drug screen. However, some of these signs also indicate there may be a deeper problem with depression, gang involvement, or suicide.

Be on the watch for these signs so that you can spot trouble before it goes too far.



Content provided with permission from The National Youth Anti-Drug Media Campaign.