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Help parents to help the next generation

The later a person starts to use substances, the better their chances in life – and parents are essential in preventing life-long consequences.

Parents are a wonderfully powerful influence in their teenager’s lives. The National Council on Alcoholism and Drug Dependence found that teens who learn about the risks of alcohol and drugs from their parents are up to 50% less likely to use illicit substances – however, only about three in 10 teenagers report learning about the dangers of substance abuse from their parents.

A serious and consistent finding in the NCADD and similar studies is that drug and alcohol initiation during adolescence is linked with greater problems across the user’s lifetime: the earlier the initiation, the more severe and pervasive will be the adult deficits of failure to grow and develop. In the US, the tendency to early initiation is trending and persistent. This suggests a potential accumulation of consequences in the years to come.

As some of us know all too acutely, adolescence is a transitional period of time in the life cycle, visibly marking the change from childhood to adulthood. Separation and individuation from the family is facilitated and marked by the move from parental direction to peer association – and potential peer pressure. This transitional period does not eliminate the need for a parent. The parent is still essential – just not as central as s/he once was when every need was met by the ‘perfect’ parent.

The difference in perception by the adolescent and the parent of parental salience is responsible for missed opportunities to influence behaviours of adolescents. Adolescent rebellion is an essential part of separation and individuation; parental guidance of how rebellion is expressed saves pain and suffering across the lifetime. In fact, global rebellion is a healthier sign of development than rebellion narrowly focused on a single issue, such as marijuana policy.

What is the scale of this issue?

Let’s look at some statistics on a range of substances that teenagers can be tempted by.

E-cigarettes. In 2014 in the US, more teens used e-cigarettes in the past 30 days than any other tobacco product, and e-cigarettes have the lowest perceived risk for regular use than any other drug surveyed, including alcohol. In the UK, it is thought that 20% of children have bought or used e-cigarettes (http://www.biomedcentral.com/1471-2458/15/244). A major concern in the public-health community is that e-cigarettes could serve as a point of entry into the use of nicotine (http://monitoringthefuture.org/pubs/monographs/mtf-overview2014.pdf). They have been called the “alcopops of the nicotine world”.

Tobacco. In the US, 17% of young adults aged 18-24 years currently smoke cigarettes, and almost all adults who become daily smokers first started using cigarettes by 26 years of age. Tobacco use remains the single largest preventable cause of death and disease in the US (http://www.childstats.gov/americaschildren/beh4.asp). In the UK, it is estimated that each year about 207,000 children start smoking, and two-thirds of adult smokers started before the age of 18 (http://ash.org.uk/files/documents/ASH_108.pdf).

Prescription drugs. In the US, 17.8% of students had taken prescription drugs – such as Oxycontin, Percocet, Vicodin, codeine, Adderall, Ritalin or Xanax – without a doctor’s prescription one or more times during their life (http://www.cdc.gov/mmwr/pdf/ss/ss6304.pdf). In the UK, about 1.3million people are estimated to be dependent on prescription drugs (http://www.publications.parliament.uk/pa/cm201314/cmselect/cmhaff/819/819.pdf); no separate figures for adolescents are available.

Illicit drugs. In 2013 in the US, an estimated 2.8million people aged 12 or older used an illicit drug for the first time; this averages to about 7,800 new users per day. Over half of initiates were younger than 18 when they first used, and 70.3% of users reported the drug as marijuana (http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf). In 2013 in the UK, 16% of pupils had ever taken drugs, with cannabis the most widely used (http://www.hscic.gov.uk/catalogue/PUB15943/drug-misu-eng-2014-rep.pdf).

Alcohol. 18.6% of US students drank alcohol (other than a few sips) for the first time before age 13 (http://www.cdc.gov/mmwr/pdf/ss/ss6304.pdf). Alcohol is the most commonly used and abused drug among US youth – more than tobacco and illicit drugs. Alcohol is responsible for over 4,300 annual deaths among underage youth (http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm). In 2012 in the UK, 43% of school pupils (aged 11-15) said that they had drunk alcohol at least once (http://www.hscic.gov.uk/catalogue/PUB14184).

As mentioned earlier, adolescence is a period of great change, which should be marked by development and acquisition of competencies essential to fully function as an adult, self sufficient and independent of parents. Perhaps paradoxically, parental supervision and guidance is vital to the growth and development of adolescents along lines that support healthy individuation and separation.

Adolescents live and learn in environments where their peers are increasing in importance and expressing earlier onset of substance initiation. Parents have an essential role to play in whether adolescents are to be protected from pressure that promotes, rather than suppresses, initiation. Delaying their age of initiation is important to the prevention of harmful life-long consequences.