Substance Abuse in Children and Adolescents: Information for Parents and Educators

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1 Substance Abuse in Children and Adolescents: Information for Parents and Educators By Stephen N. Campbell, PhD Nova Southeastern University Substance abuse among American youth is a widespread problem. Despite indicators that use of illicit drugs and alcohol has declined over the past decade, a U.S. Department of Health and Human Services survey in 2002 (Johnston, O Malley, & Bachman, 2003) of 43, 700 adolescents in nearly 400 schools nationwide indicated that more than half (53%) have tried an illegal drug. If we count inhalants in the definition of illegal drugs, nearly one third of students have experimented with drugs by the time they reach eighth grade. And it isn t just marijuana 30% of the students surveyed reported using a drug other than marijuana by twelfth grade. The survey also showed that teenagers continue to experiment with alcohol and cigarettes. Again, although there is evidence that, over time, alcohol use among youth is declining, a recent national survey indicated nearly 11% of youth age were binge drinkers (U.S. Department of Health and Human Services, 2002). Parents and teachers need to recognize that substance abuse is a serious threat to the physical well-being of children and adolescents (such as danger to the brain and other vital organs) and their psychological functioning (such as impaired memory, judgment, ability to learn, and decline in academic performance). Children who use drugs and alcohol are also more prone to accidents, risky sexual behavior, violence, and thoughts of suicide. According to the U.S. Department of Health and Human Services (2003), 15% of 18 year-olds surveyed in 2002 reported driving under the influence of alcohol. In addition, another recent study found that high school students using marijuana on a frequent basis had much higher rates of delinquent and criminal behavior, including serious aggression, sale of illegal drugs, and carrying a handgun (U.S. Department of Health and Human Services, 2004). Causes of Substance Abuse Attitudes. Children and adolescents use drugs and alcohol for many reasons. Not only are the consequences of substance abuse a problem, but so are the attitudes teens have adopted toward substance use. For example, data from a Substance Abuse and Mental Health Services Administration report (2000) indicated that, as the number of young people who use marijuana has increased, the number who view marijuana as harmful has decreased. Most teens do not see any major risk trying marijuana once or twice. Researchers have suggested that changes in risk perception and knowledge may be due to a decrease in anti-drug messages in the media, an

2 increase in pro-drug messages through the popular culture, and a lack of awareness among parents about the prevalence of drug and alcohol use. Social, emotional, and family influences. Parents must understand why children and adolescents use drugs and alcohol. The desire to be accepted into a social group, peer pressure, and curiosity are common reasons. Children also use drugs to deal with depression, boredom, anger, and anxiety. However, research suggests that drug use by family members plays a strong role in whether children in the family start using drugs. It is important to keep in mind that parents are the first and most powerful influences in a child s life. As a parent, your child looks to you for help and guidance in making important decisions, including the decision not to use drugs. As a role model, your decision not to use illegal drugs will reinforce your message to your child. Prevention Strategies for Parents Preventing a child from using drugs and alcohol makes more sense than having to help the child to stop once he or she has started. It is more difficult to stop using drugs or alcohol when there is a psychological or physical dependence. One of the biggest deterrent to substance abuse is the fear of disappointing a parent. Therefore, prevention starts at home. There are a number of actions parents can take to create an environment where substance abuse is discouraged. Trust and Mutual Respect Develop a sense of respect and trust between you and your child. Spend time in activities together: Do fun things such as going to movies. Encourage participation in family decisions. Build trust and establish open lines of communication early. What you say and what you do must be consistent. Stay involved in your child s friendships and schoolwork. Communication Effective communication involves talking to and listening to your child: Communicate that you care: Children do not care about what a parent says to them unless they know that the parent cares about them. Actions are just as important as words. Your child can spot hypocrisy miles away. Do not preach: Discuss concerns without delivering a lecture. Have facts handy: Know what you are talking about and use brief examples to make your points.

3 Be a good listener: Listen to what your child has to say. Avoid interruptions. Ask questions for clarity, state what you think is meant, and verify that you understand correctly. This shows that you did listen, and what your child says is important to you. Do not judge: Try to understand what your child is saying without judging his or her motives, opinions, or conclusions. Use appropriate body language. Encourage your child to recognize and express his or her feelings: While you are talking to your child, it is important to let your child know you care not only about what he or she thinks but also about what he or she feels. Talking to Your Child About Drugs and Alcohol Be informed and give your child the facts about drugs and alcohol, and your expectations, unemotionally and straightforward: Scare tactics and exaggerated stories do not work: Children see and hear a great deal about drugs and alcohol at school. They see other children in the halls and on the playground who use drugs and alcohol. Children can see first-hand what is true and what is not. Clarify your standards and expectations: Make sure you let your child know where you stand and what your expectations are regarding the use of drugs and alcohol. Share appropriate information: Make sure the information about drugs and alcohol is developmentally appropriate to your child (your choice of words and the type of information should be at your child s grade/ability level). Teach your child about choices and consequences: For every choice there is a consequence. Stress the importance of evaluating the consequence before making the choice. Consider what may happen first and then decide if it is worth the cost. Interventions for Home and School Strategies for Parents Know the signs of substance abuse. You need to be aware of dramatic changes in your child s behavior (sometimes it is gradual; some children may use drugs and alcohol for a time and go undetected). Children may experiment with drugs and alcohol to fit in with their peers, but discontinue using after the experience. Some children continue to use drugs and alcohol and develop a psychological and/or a physical dependency. Look for the following warning signs: Depression, fatigue, withdrawal Poor grooming Hostility and deteriorating relationships with family and friends Changes in academic performance Increased absenteeism or truancy Lost interest in sports or other favorite activities Changes in eating or sleeping habits

4 Although these signs may be indicative of other problems, they are usually present among substance abusers. Within the home, be aware of the following signs: Drugs and drug paraphernalia such as pipes and rolling papers Odor on clothes and in the bedroom and/or the use of incense and other deodorizers Use of eye drops Talk with your child, family, friends, and school personnel. If you believe your child is using drugs and alcohol, talk with the child. A child who is confronted may deny any substance abuse, may confess and ask for help, or may confess an experimentation that has occurred but is now over. Talk with siblings and your child s close friends who you know do not use drugs or alcohol and see if they have concerns for your child. You can contact your school psychologist, social worker, counselor, or chemical-dependency specialist. Most school districts have professionals who can conduct a screening and help identify the need for referral for evaluation and treatment. Many treatment centers and some counselors in private practice will complete the initial assessment without charge and offer advice or referrals as necessary. Strategies for Teachers Model and teach healthy behaviors. Next to their parents, teachers typically are the most powerful role models for children and youth. You can provide a good model for students to follow as well as provide drug education: Talk to students about drugs and let them know how you feel about substance abuse. Help students develop skills and attitudes that will keep them away from drugs and alcohol. Incorporate drug education and prevention strategies in class presentations. For example, the biology instructor can discuss the impact using drugs has on the development of the prefrontal cortex, which is the part of the brain responsible for planning and reasoning and which is not fully developed until age 20. Intervene directly. Teachers may be the first to suspect a student is using drugs and alcohol. Obtain appropriate training on ways to identify students with substance abuse problems. Intervene if you believe a student is using drugs or alcohol and discuss substance abuse by students with school personnel (such as school nurse, school psychologist, principal). Warning signs of substance abuse that you might observe in your students include: Slurred or unintelligible speech Excessive sleeping in class Bloodshot eyes Many absences or truancy Significant drop in academic performance Other Sources of Help

5 Additional information can be found in local libraries and from health departments, mental health agencies, and youth groups. The school psychologist, guidance counselor, and school nurse are excellent resources at school. Most treatment facilities in your area can offer information and referrals. Videos, the Internet, books, and local support groups such as Narcotics Anonymous and Alcoholics Anonymous for teens are also good resources. Summary Parents and teachers are the most influential people in the lives of children. Consequently, it is crucial that parents and teachers respond proactively rather than reactively in preventing substance abuse in children by understanding the warning signs and acting appropriately and decisively. Resources Botvin, G. J., & Griffin, K. W. (2000). Preventing substance use and abuse. In K. Minke & G. Bear (Eds.), Preventing school problems Promoting school success: Strategies and programs that work (pp ). Bethesda, MD: National Association of School Psychologists. ISBN: Gerne, P. J., & Gerne, T. A. (1991). Substance abuse prevention activities for secondary students: Readyto- use lessons, fact sheets, and resources for grades Englewood Cliffs, NJ: Prentice Hall. ASIN: Johnston, L., O Malley, P., & Bachman, J. (2003). Monitoring the future: National results on adolescent drug use. Washington, DC: U.S. Department of Health and Human Services. Overview available: Levant, G. (1998). Keeping kids drug free: D.A.R.E. official parent s guide. Berkeley, CA: Thunder Bay Press. ASIN: Pagliaro, A. M., & Pagliaro, L. A. (1996). Substance use among children and adolescents: Its nature, extent, and effects from conception to adulthood. New York: Wiley. ISBN: Severson, H., & James, L. (2002). Prevention and early interventions for addictive behaviors: Health promotion in the schools. In M. Shinn, H. Walker, & G. Stoner (Eds.), Interventions for academic and behavior problems II: Preventive and remedial approaches (pp ). Bethesda, MD: National Association of School Psychologists. ISBN: South Carolina Department of Alcohol and Other Drug Abuse Services. (2001). The power of parents in a kid s world: A parent s guide to keeping children free from alcohol, tobacco and other drugs. Columbia, SC: Author. Available: html

6 Substance Abuse and Mental Health Services Administration. (2000). Summary of findings from the 1999 National Household Survey on Drug Abuse (DHHS Publication No. SMA ). Rockville, MD: Author. Available: U.S. Department of Health and Human Services. (2002). National Survey on Drug Use and Health. Washington, DC: Author. Available: 2k2results.htm U.S. Department of Health and Human Services. (2003). National Survey on Drug Use and Health: Quantity and frequency of alcohol use. Washington, DC: Author. Available: U.S. Department of Health and Human Services. (2003). National Survey on Drug Use and Health: Marijuana use and delinquent behaviors among youths. Washington, DC: Author. Available: MJdelinquency.htm Websites National Institute on Drug Abuse (NIDA) The National Youth Anti-Drug Media Campaign Substance Abuse and Mental Health Services Administration (SAMHSA) Stephen N. Campbell, PhD, is an Associate Professor in the Center for Psychological Studies at Nova Southeastern University, Ft. Lauderdale, FL National Association of School Psychologists, 4340 East West Highway, Suite 402, Bethesda, MD (301) Abuso de sustancias en niños y adolescentes: Información para padres y educadores Por Stephen N. Campbell, PhD Nova Southeastern University El abuso de sustancias entre los jóvenes estadounidenses es un problema generalizado. A pesar de los indicadores de que el uso de drogas ilícitas y alcohol ha disminuido en la última década, un Departamento de EE.UU. de Salud y Servicios Humanos de la encuesta en 2002 (Johnston, O'Malley, y Bachman, 2003), de 43, 700 adolescentes de cerca de 400 escuelas a nivel nacional indican que más de la mitad (53%) han probado una droga ilegal. Si contamos con inhalantes en la definición de las drogas ilegales, casi un tercio de los estudiantes han experimentado con drogas en el momento en que lleguen a octavo grado. Y no es sólo la marihuana-un 30% de los

7 estudiantes encuestados reportaron haber usado una droga aparte de la marihuana por duodécimo grado. La encuesta también mostró que los adolescentes siguen experimentando con el alcohol y los cigarrillos. Una vez más, aunque no hay evidencia de que, con el tiempo, el consumo de alcohol entre los jóvenes está disminuyendo, una encuesta nacional reciente indicó casi el 11% de los jóvenes de 12 a 17 eran bebedores empedernidos (EE.UU. Departamento de Salud y Servicios Humanos, 2002). Los padres y maestros deben reconocer que el abuso de sustancias es una seria amenaza para el bienestar físico de los niños y adolescentes (por ejemplo, peligro para el cerebro y otros órganos vitales) y de su funcionamiento psicológico (como el deterioro de la memoria, juicio, capacidad de aprender, y la disminución en el rendimiento académico). Los niños que usan drogas y el alcohol también son más propensos a sufrir accidentes, conductas sexuales de riesgo, la violencia, y los pensamientos de suicidio. De acuerdo con los EE.UU. Departamento de Salud y Servicios Humanos (2003), el 15% de 18 años encuestados en 2002 reportaron haber conducido bajo la influencia del alcohol. Además, otro estudio reciente encontró que los estudiantes de la escuela el uso de marihuana de manera frecuente tienen índices más altos de conducta delictiva y criminal, incluida la agresión grave, la venta de drogas ilegales, y portaba una pistola (EE.UU. Departamento de Salud y Servicios Humanos, 2004 ). Causas de Abuso de Sustancias Actitudes. Los niños y adolescentes consumen drogas y alcohol por muchas razones. No sólo son las consecuencias del abuso de drogas un problema, pero también lo son las actitudes de los adolescentes han adoptado con respecto al uso de sustancias. Por ejemplo, los datos de un Abuso de Sustancias y Salud Mental informe de la Administración de Servicios (2000) indicó que, como el número de jóvenes que usan marihuana ha aumentado, el número de personas que la marihuana vista como dañina ha disminuido. La mayoría de los adolescentes no ven ningún riesgo importante probar marihuana una o dos veces. Los investigadores han sugerido que los cambios en la percepción del riesgo y el conocimiento puede ser debido a una disminución de mensajes anti-drogas en los medios de comunicación, un aumento de la pro-droga mensajes a través de la cultura popular, y la falta de conciencia entre los padres acerca de la prevalencia de drogas y el consumo de alcohol. Las influencias sociales, emocionales y familiares. Los padres deben entender por qué los niños y adolescentes consumen drogas y alcohol. El deseo de ser aceptado en un grupo social, la presión de grupo, y la curiosidad son las razones más comunes. Los niños también utilizan drogas para lidiar con la depresión, el aburrimiento, la ira y la ansiedad. Sin embargo, las investigaciones sugieren que el consumo de drogas por miembros de la familia juega un papel

8 importante en si los niños en la familia comienzan a consumir drogas. Es importante tener en cuenta que los padres son la influencia primera y más poderosa en la vida de un niño. Como padre, su hijo se ve a ti por ayuda y orientación en la toma de decisiones importantes, incluyendo la decisión de no usar drogas. Como un modelo a seguir, su decisión de no usar drogas ilícitas refuerza este mensaje a su hijo. Estrategias de prevención para los padres Evitar que un niño el uso de drogas y el alcohol tiene más sentido que tener que ayudar al niño a dejar de una vez que él o ella ha comenzado. Es más difícil dejar de consumir drogas o alcohol cuando hay una dependencia psicológica o física. Uno de los mayores obstáculos para el abuso de sustancias es el temor de decepcionar a sus padres. Por lo tanto, la prevención empieza en casa. Hay una serie de medidas que los padres pueden tomar para crear un ambiente donde no se recomienda el abuso de sustancias. Confianza y respeto mutuo Desarrollar un sentido de respeto y confianza entre usted y su hijo. Pasar tiempo juntos en actividades: * Haga cosas divertidas como ir al cine. * Fomentar la participación en las decisiones familiares. * Desarrollar la confianza y establecer líneas de comunicación abiertas temprano. Lo que usted dice y lo que haces debe ser consistente. * Manténgase involucrado en las amistades de su hijo y el trabajo escolar. Comunicación La comunicación efectiva consiste en hablar con y escuchar a su hijo: * Comunica que usted se preocupa: los niños no se preocupan por lo que un padre les dice a menos que sepan que el padre se preocupa por ellos. Las acciones son tan importantes como las palabras. Su hijo puede detectar la hipocresía millas de distancia. * No predicamos: Hable de sus inquietudes, sin dar una conferencia. * Tenga a mano los hechos: Sabe lo que está hablando y el uso de ejemplos breves para hacer sus puntos. * Sea un buen oyente: Escuche lo que su hijo tiene que decir. Evite las interrupciones. Haga preguntas para mayor claridad, el estado lo que usted piensa que se entiende, y verificar que usted entienda correctamente. Esto demuestra que usted ha escuchado, y lo que su hijo dice que

9 es importante para usted. * No juzguéis: Trate de entender lo que dice su hijo, sin juzgar sus motivaciones, opiniones o conclusiones. Use un lenguaje corporal apropiado. * Anime a su hijo a reconocer y expresar sus sentimientos: Mientras que usted está hablando con su hijo, es importante que su hijo sepa que la atención no sólo sobre lo que él o ella piensa, sino también sobre lo que él o ella siente. Hablar con su hijo sobre las drogas y el alcohol Estar informados y dar a su hijo los hechos sobre las drogas y el alcohol, y sus expectativas, sin emoción y directa: * Tácticas de miedo y las historias exageradas que no funcionan: Los niños ven y oyen mucho sobre las drogas y el alcohol en la escuela. Que ven los niños en los pasillos y en el patio que usan drogas y alcohol. Los niños pueden ver de primera mano lo que es verdad y qué no lo es. * Aclare sus estándares y expectativas: Asegúrese de que su hijo sepa dónde se encuentra y cuáles son sus expectativas con respecto al uso de drogas y alcohol. * Compartir la información apropiada: Asegúrese de que la información sobre las drogas y el alcohol es apropiado para el desarrollo de su niño (a su elección de palabras y el tipo de información debe estar en grado de su hijo / nivel de habilidad). * Enseñe a su hijo acerca de las opciones y consecuencias: Por cada elección hay una consecuencia. Hincapié en la importancia de evaluar las consecuencias antes de tomar la decisión. Considere lo que puede pasar y luego decidir si vale la pena el costo. Intervenciones para el hogar y la escuela Estrategias para padres Conozca los síntomas de abuso de sustancias. Tienes que ser consciente de los cambios dramáticos en el comportamiento de su hijo (a veces es gradual, y algunos niños pueden utilizar las drogas y el alcohol por un tiempo y no se detectan). Los niños pueden experimentar con drogas y alcohol para encajar con sus compañeros, pero dejar de usar después de la experiencia. Algunos niños continúan consumiendo drogas y alcohol y el desarrollo psicológico y / o una dependencia física. Busque los siguientes signos: * La depresión, la fatiga, la retirada * Pobre de aseo * La hostilidad y el deterioro de las relaciones con familiares y amigos * Cambios en el rendimiento académico * Aumento del absentismo o ausentismo escolar

10 * Los intereses perdidos en los deportes y otras actividades favoritas * Cambios en la alimentación o los hábitos de dormir A pesar de estas señales pueden ser indicativas de otros problemas, que suelen estar presentes entre los toxicómanos. Dentro de la casa, tenga en cuenta los siguientes signos: * Las drogas y parafernalia de drogas, como pipas y papel de fumar * El olor en la ropa y en el dormitorio y / o el uso de incienso o desodorante de aire * El uso de gotas para los ojos Hable con su niño, la familia, amigos y personal de la escuela. Si usted cree que su hijo está consumiendo drogas y alcohol, hable con el niño. Un niño que se enfrenta puede negar a ningún abuso de sustancias, puede confesar y pedir ayuda, o puede confesar una experimentación que ha ocurrido, pero ahora ha terminado. Hable con sus hermanos y amigos cercanos de su hijo que usted sabe que no consumen drogas o alcohol y ver si tienen preocupaciones por su hijo. Puede comunicarse con su psicólogo escolar, trabajador social, consejero, o un especialista en química de la dependencia. La mayoría de los distritos escolares con profesionales que pueden llevar a cabo una detección y ayudar a identificar la necesidad de derivación para evaluación y tratamiento. Muchos centros de tratamiento y de algunos consejeros en la práctica privada se completa la evaluación inicial sin el consejo de la carga y ofrecer o referencias cuando sea necesario. Estrategias para los maestros Modelar y enseñar comportamientos saludables. Junto a sus padres, los maestros suelen ser los modelos más potentes para niños y jóvenes. Usted puede proporcionar un buen modelo para los estudiantes a seguir, así como proporcionar educación sobre las drogas: * Hable con los estudiantes acerca de las drogas y hacerles saber cómo te sientes sobre el abuso de sustancias. Ayuda a los estudiantes desarrollar habilidades y actitudes que les mantendrá alejados de las drogas y el alcohol. * Incorporar la educación sobre las drogas y las estrategias de prevención en las presentaciones en clase. Por ejemplo, el profesor de biología puede analizar el impacto de consumir drogas tiene en el desarrollo de la corteza prefrontal, que es la parte del cerebro responsable de la planificación y el razonamiento y que no se desarrolla completamente hasta los 20 años. Intervenir directamente. Los maestros pueden ser los primeros en sospechar un estudiante está consumiendo drogas y alcohol. Recibir una formación adecuada sobre las formas de identificar a

11 los estudiantes con problemas de abuso de sustancias. Intervenir si usted cree que un estudiante está usando drogas o alcohol y discutir el abuso de sustancias por los estudiantes con el personal de la escuela (como enfermera de la escuela, psicólogo de la escuela, el director). Las señales de advertencia del abuso de sustancias que se pudieran observar en sus alumnos son: * Dificultad para hablar o ininteligible * Sueño excesivo en clase * Ojos inyectados en sangre * Muchas ausencias o ausencias injustificadas * Disminución significativa en el rendimiento académico Otras fuentes de ayuda Información adicional se puede encontrar en las bibliotecas locales y los departamentos de salud, agencias de salud mental y grupos de jóvenes. El psicólogo escolar, consejero, y enfermera de la escuela son excelentes recursos en la escuela. La mayoría de las instalaciones de tratamiento en su área puede ofrecer información y referencias. Vídeos, Internet, libros, y los grupos locales de apoyo, como Narcóticos Anónimos y Alcohólicos Anónimos para que los adolescentes también son buenos recursos. Resumen Los padres y maestros son las personas más influyentes en la vida de los niños. Por lo tanto, es crucial que los padres y los maestros responder de manera proactiva en lugar de reactiva en la prevención del abuso de sustancias en los niños mediante la comprensión de las señales de advertencia y actuar apropiadamente y de manera decisiva. Recursos Botvin, G. J., & Griffin, K. W. (2000). Preventing substance use and abuse. In K. Minke & G. Bear (Eds.), Preventing school problems Promoting school success: Strategies and programs that work (pp ). Bethesda, MD: National Association of School Psychologists. ISBN: Gerne, P. J., & Gerne, T. A. (1991). Substance abuse prevention activities for secondary students: Readyto- use lessons, fact sheets, and resources for grades Englewood Cliffs, NJ: Prentice Hall. ASIN:

12 Johnston, L., O Malley, P., & Bachman, J. (2003). Monitoring the future: National results on adolescent drug use. Washington, DC: U.S. Department of Health and Human Services. Overview available: Levant, G. (1998). Keeping kids drug free: D.A.R.E. official parent s guide. Berkeley, CA: Thunder Bay Press. ASIN: Pagliaro, A. M., & Pagliaro, L. A. (1996). Substance use among children and adolescents: Its nature, extent, and effects from conception to adulthood. New York: Wiley. ISBN: Severson, H., & James, L. (2002). Prevention and early interventions for addictive behaviors: Health promotion in the schools. In M. Shinn, H. Walker, & G. Stoner (Eds.), Interventions for academic and behavior problems II: Preventive and remedial approaches (pp ). Bethesda, MD: National Association of School Psychologists. ISBN: South Carolina Department of Alcohol and Other Drug Abuse Services. (2001). The power of parents in a kid s world: A parent s guide to keeping children free from alcohol, tobacco and other drugs. Columbia, SC: Author. Available: html Substance Abuse and Mental Health Services Administration. (2000). Summary of findings from the 1999 National Household Survey on Drug Abuse (DHHS Publication No. SMA ). Rockville, MD: Author. Available: U.S. Department of Health and Human Services. (2002). National Survey on Drug Use and Health. Washington, DC: Author. Available: 2k2results.htm U.S. Department of Health and Human Services. (2003). National Survey on Drug Use and Health: Quantity and frequency of alcohol use. Washington, DC: Author. Available: U.S. Department of Health and Human Services. (2003). National Survey on Drug Use and Health: Marijuana use and delinquent behaviors among youths. Washington, DC: Author. Available: MJdelinquency.htm Websites National Institute on Drug Abuse (NIDA) The National Youth Anti-Drug Media Campaign Substance Abuse and Mental Health Services Administration (SAMHSA)

13 Stephen N. Campbell, PhD, es Profesor Asociado en el Centro de Estudios Psicológicos en la Nova Southeastern University, Fort. Lauderdale, FL Asociación Nacional de Psicólogos Escolares, 4340 East West Highway, Suite 402, Bethesda, MD (301)

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