Tips for talking to teens about drugs and alcohol
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* Kim Krisberg

Like so many other things in life — and parenthood — helping teens make good decisions about drugs and alcohol comes down to one key overriding skill: good communication.

“Kids are already getting messages about drugs and alcohol, so if parents aren’t talking about it at all, that means they’re not part of that dialogue,” says Leslie Walker-Harding, MD, a member of the American Academy of Pediatrics’ Committee on Substance Use and Prevention. “Teens may not act like it, they might not say ‘thank you,’ but they are listening to you. So talk.”

Research shows that parents’ attitudes have a big influence on teen drug and alcohol use, whether it be marijuana, cigarettes or prescription medicines. For example, one survey found that teens who said they learned a lot or even a little from their parents or grandparents about prescription drugs were up to 42 percent less likely to abuse the drugs than teens who learned nothing. In another survey, 3 out of 4 teens said their parents have the biggest influence on their decision to drink alcohol.

In other words, teens are listening. The real question is what to say.

The National Institute on Drug Abuse encourages parents to start the conversation by asking themselves a few questions first. The institute’s “Family Checkup: Positive Parenting Prevents Drug Abuse” resource recommends five questions on communication, encouragement, negotiation, setting limits and supervision.

Questions include: “Are you able to communicate calmly and clearly with your teenager regarding relationship problems?” “Do you encourage positive behaviors in your teenager on a daily basis?” and “Are you able to calmly set limits when your teenager is defiant or disrespectful?” The idea is to promote parenting skills that lead to open communication at home and positive family relationships.

Results from the National Survey of Drug Use and Health show that drug, cigarette and alcohol use are often lower among young people who say their parents are supportive and regularly monitor their behaviors.

“It all boils down to extensive years of research in the field of prevention that show parental involvement in kids’ development is perhaps one of the most important protective factors in whether kids experiment with or go on to misuse drugs,” says Jack B. Stein, PhD, MSW, director of NIDA’s Office of Science Policy and Communications.

Stein says that establishing open communication early on will make it easier to talk about drugs and alcohol when the time comes and to pick up on worrisome behavior changes that warrant a check-in with your teen.

Exactly when to have the drug and alcohol talk with your teen will vary from family to family. If drugs and alcohol are being used in the home, it may be a good idea to talk before adolescence, Walker-Harding says. But overall, aim to have the conversation before middle school, when kids face a higher risk of experimentation, she says.

When it’s time to have a conversation with your teen, both Stein and Walker-Harding encourage parents to be active listeners, be as honest and authentic as possible, and set clear expectations and consequences. They should also acknowledge the gravity of peer pressure in a teen’s life, be nonjudgmental and avoid fear-based language. One tip is using “I” statements, such as “I hear you say you’re feeling...” or “I feel worried when...”

“Kids are going to be more likely to listen if parents are being authentic,” says Walker-Harding, who’s also chair of the Department of Pediatrics at the University of Washington School of Medicine. “But fear — fear has never worked.”

However, parents should be wary of offering first-person experiences, as it’s not always helpful or relevant. For instance, Stein noted, marijuana is much more potent now than it was years ago, so first-person stories might not represent the actual risks that teens face today.

When it comes to peer pressure, Walker-Harding says it’s not as simple as saying no. Instead, it’s about helping your teens feel confident in making their own decisions and sticking with it. In fact, give teens permission to make you — their parents — the “bad guy,” she says, as it can offer kids an easy out when confronted with pressure from their peers.

Most importantly, she tells parents not to give up.

“If the first discussion is just a disaster, don’t lose faith,” Walker-Harding says. “Keep doing it, it will get easier. Kids want to know these things from their parents.”

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/49/2/24/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/49/2/24/F1)

Photo by Aldo Murillo, courtesy iStockphoto

## Teen drug use by the numbers

The good news is that U.S. youth drug use is at its lowest levels in decades.

The 2018 Monitoring the Future report, which surveys drug use and attitudes among eighth-, 10th- and 12th-graders across the country, found that the percentage of high school seniors who used illicit drugs in the last year had declined by 30 percent in the past five years.

The exception was marijuana use, which remained unchanged from five years ago. Youth use of alcohol, cigarettes, heroin, prescription opioids, ecstasy and methamphetamines are at historic lows.

There is one area of particular concern — big increases in youth use of e-cigarettes. The trend, which can expose young people to harmful nicotine addiction, increased by about one-third over the span of just one year.

*   Copyright The Nation’s Health, American Public Health Association