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Drugs and Child's


Few illnesses bring more fear to a parent than alcoholism and drug abuse. But unlike other disorders that can also be devastating to a child and his or her family, addiction feels particularly confusing - and somehow personal.

Where did we go wrong? How did she use all this time without us knowing? Where did he even get the drugs?

Okay, I’m ready to accept that what happened; so can I help, or am I going to make things even worse?

For other physical and mental illnesses, parents routinely turn to medical specialists for advice and expect guidance and typically follow the experts’ recommendations. The very process of charting a course of action with a doctor has significant therapeutic effects for both the child and the parents. Unfortunately, we have come to expect much less from the medical community when it comes to the prevention, diagnosis, and treatment of substance use disorders.

On one hand, we don’t trust that we know all that much about the illness itself. Both science and popular culture keep shifting their opinion on the “true” cause of addiction. In the 1960s and the 1970s, it was all about parenting; in the 1980 and the 1990s, we woke up to the monumental discoveries of genetics; and during the past decade, we have

been greatly attracted to co-occurring psychiatric disorders including posttraumatic stress disorder, bipolar disorder, attention-deficit hyperactivity disorder, and autism. Recently, family system considerations for both prevention and treatment have resurfaced, bringing us full circle to the world of our parents. Scientists now know that what causes one kid to get drunk and another to stay sober is rather complex. A number of interrelated biological, psychological, and social determinants affect the pleasure, reward, motivation, and memory brain neuronal circuitry leading to impairment in behavioral control, craving, and diminished recognition of significant problems in one’s life.

On the other hand, there are very few medical doctors with the appropriate training to address substance use among children and adolescents. The American Board of Psychiatry and Neurology has certified less than 250 psychiatrists in the subspecialty of addiction psychiatry over the past 10 years. Our texts will be straightforward answers to every parent’s questions about preventing, identifying, and treating substance abuse and dependence.



(6) Drugs & Child’s




Truth About Marijuana Being a Gateway Drug


What is self-medication?

There are certain situations where the primary reason that kids start smoking marijuana or using drugs is to make them feel better or as a means to cope-whether to forget family issues or school problems, or to treat depression, anxiety, or disordered thoughts; this is called self-medication. I have heard some kids say they were using marijuana to “dampen the voices.”


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(7) Drugs & Child’s



Natalia Yefimova

Natalia Efimova

How to Know If Your Children Do Drugs


How do you define/where do you draw the line between use, abuse, and dependency/addiction?

 Drug use occurs when one has used drugs with no resultant established pattern of habitual use, adverse consequences, or signs of dependence. Abuse and dependence is generally seen on a continuum with more criteria fulfilled for a dependence diagnosis.


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(8) Drugs & Child’s

Drug Addicted Children


Should I look for other conditions in addition to drug problems?

There are studies that track how often psychiatric conditions exist and what conditions usually go together. One study reported that 15-24-year-olds had the highest 12-month prevalence of any disorder, including substance abuse. Substance-abusing adolescents reveal high rates of coexisting mood disorders and behavior problems (conduct disorder). In a survey of adolescents in the community who abuse drugs, they are more likely to also suffer from mood problems. Individuals with severe problems with the law (such as those with antisocial personality disorder) have high rates of substance abuse. For adolescents with severe conduct problems and drug use, depression imparts risk far more severe than drug use alone. These adolescents abuse more drugs in combination, tend to have behavioral problems at an earlier age, and have increased anxiety and attention problems.

Adolescents with history of PTSD were found to have increased risk for cannabis use separate from the effects of deviant peers, genetics, race, male gender, socioeconomic status, or having a substance-abusing parent. Therefore, the significant interaction of these problems indicates that these conditions warrant very aggressive treatment.

I have a friend whose son has ADHD and is also receiving counseling for drug abuse. Was her son at a higher risk for substance abuse because of his ADHD?

The combination of ADHD and CD appears to be a more robust risk factor for later substance abuse than CD alone. Parents of children with CD alone have lower rates of alcohol and drug abuse than the parents of the conduct plus ADHD group. The parents in both of these groups had higher rates of children with substance abuse than the parents of children with ADHD alone. ADHD is found to occur in 30-50% of patients with co-occurring CD. ADHD was also shown to be associated with early onset of cigarette smoking. In addition, mood/anxiety disorders and conduct disorders, which are elevated in smokers, are also associated with ADHD. These conditions go along with each other to some extent.

Is there a relationship between bipolar disorder (manic-depressive illness) and drug abuse?

Adolescent-onset bipolar disorder is associated with higher risk for drug use compared to childhood-onset bipolar disorder. In fact, it ranks just slightly lower than conduct disorder (CD) in conferring that risk. When these two co-occur, recovery is more difficult, and both have to be treated aggressively.

 Do drugs cause problems with anger?

Drug use increases the risk for adolescents to get involved in fights. In some ways, drugs offer a reason for adolescents to act on their anger. Some get disinhibited by drug use.

You might have heard a story about a youngster known to be meek and quiet who then becomes violent while under the influence of drugs. It is also likely that drug use is intertwined with antisocial behavior where anger is channeled through gang activities (“jumping” other kids). On the other hand, some kids avoid acting on their anger and using drugs as a means to regain control or even numb their feelings. The use of drugs can also act as a way to deal with pent-up anger resulting from family problems, school problems, or even from boyfriend/girlfriend issues.

Irritability and aggression can be identified as behaviors for which medications are prescribed, especially if anger impedes benefits from psychosocial interventions. Individuals who act on their anger are at increased risk for later substance abuse. A derived scale, the Violence Proneness Scale (VPS) from the Drug Use Screening Inventory, is significantly predictive of aggressive behavior in young boys five to seven years later. The VPS established with 82% accuracy which male youths tested at age 16 did and did not give drugs in exchange for sex three years later. The VPS can be a very useful psycho educational tool for parents during initial evaluations in identifying and discussing future risks especially if no treatment is provided.

 There is a high rate of alcoholism in my family, so my child must be doomed to develop this condition, right?

This is a fatalistic sentiment expressed by parents every now and then. While there is a strong heritability for drug use, especially for alcohol use (up to 60%), this is still seen only as vulnerability: no complete causal relationship has emerged from studies. There are things that can be done before problems start. Your child can benefit from getting involved with extracurricular activities or sports. Spending quality time with your child as a family will be important in his or her upbringing. As parents, you can set living examples of leading a sober life. It takes courage to even talk about the presence of this risk factor in your family. Doing so affords a more open, honest, and candid conversation so that other, healthier choices can be made. His or her keeping sober friends that you also know decrease this risk. This will require your commitment, time, and effort as you and your child get involved with help.

Putting risks aside, are there any factors that can protect my child from substance abuse?

We know that certain factors have a greater chance of protecting children from using drugs-female gender; higher socioeconomic status; high academic aspiration or achievement; close and affectionate relationships with parents or family members; and absence of parental marital problems, chronic conflict, or alcohol abuse. In addition, family’s involvement with church confers protection.

Church activities allow for the youngster’s involvement in activities promoting social interaction with peers, moral development, and appropriate self-control. Treatment of co-occurring psychiatric conditions also decreases risk of future drug problems. It is therefore imperative that general difficulties observed early on in childhood be discussed with your primary doctors or pediatrician to establish need for further evaluation/referral and early treatment.

 Are there other characteristics that are likely to contribute to increased drug or alcohol use?

A risk profile was developed in a study to predict those who intended to use alcohol and those who did not among fifth and sixth graders. Rejection of parental authority was correlated with sixth graders more than with fifth graders. This is suggestive of a dwarfing importance of family role as adolescents get older and peer pressure becomes a more predominant factor. This is why parents should rely on really knowing who their children’s friends are.

It may be helpful to invite your children’s friends to your home as a means to know them and to get acquainted with their parents for networking. Try to avoid criticizing your child’s friends. Acknowledge that these friends are an increasingly important part of your child’s support system as he or she tries to define his or her own identity. Realize that your child also balances peer pressure as you encourage him or her to develop independent thinking.

Work with your child in playing out the consequences of choices so that he or she may avoid grave mistakes. P300 is brain surface electrical activity that is most strongly picked up in the parietal lobes. It is measured by an electroencephalogram (EEG), which is a procedure for which electrodes are attached at different parts of the scalp. P300 is involved in evaluating situations and decision-making processes. A blunted P300 is associated in adolescents with alcohol use and is found to be highly heritable. Its effects are found independent of the adverse effects of alcohol use.











(9) Drugs & Child’s

Child Drug Addicts Living Underground Ukraine Odessa


Are the reasons for starting to use drugs the same as those that one has for continuing drug use?

No. A number of reasons identified by kids to begin using drugs include curiosity, as a means to kill time or relax, or being pressured by friends, saying “My friends try it, so why shouldn’t I?” or “It’s cool with my friends.” Some kids deny the seriousness of trying drugs, saying, “It’s not a drug” or “I won’t get addicted to it.” This might progress to repeated use because of the drugs’ positive reinforcing effects (feeling good when high). A number of adolescents talk about the sense of belongingness that comes about when using drugs with friends and that this boosts their self esteem and morale. Continued use is again tied up with diminished perception of risk or harm and the fact that serious aftermath is not experienced until later on (adverse consequences are delayed). In cases of opioids (morphine or pains medications like Percocet [acetaminophen with oxycodone], codeine, or Tylenol 3 [acetaminophen and codeine]), one important reason for continuing to use drugs is to avoid uncomfortable withdrawal effects upon discontinuation of the drug.


Withdrawal - Uncomfortable or even painful bodily complaints and signs that exist after drug use is stopped. Occurs with dependence.

High - Street term for being under the influence of drugs.

I often hear about adolescents who get alcohol poisoning because they drink too much at once. Is this a common occurrence?

I have encountered a number of adolescents (females outnumbering males) who are referred through the emergency rooms for alcohol poisoning. This results from significant amounts of alcohol ingested in a short period of time by individuals who have not been regular drinkers. The adolescents that I have worked with reported using hard liquors like Hennesey, Bacardi, E and J, and Smirnoff. Compared to beer volume by volume, hard liquors require smaller amounts to achieve similar alcohol levels and therefore take less time to achieve toxic levels. Kids are also unable to pace their consumption. There are very few published studies, and even fewer involving Americans, that establish how common alcohol poisoning is. A European study (Kuzelova et al., 2009) looked at alcohol intoxication that required hospital admissions in children and adolescents. Covering a nine-year period, this study found that the average age of presentation is 15, and the number of children requiring admissions increased every year. The average alcohol concentration was 1.98 ±0.57 g/L, and this level increased in the last four years compared to the previous four years.. The severity of poisoning also increased in relation to blood alcohol levels.

Alcohol levels go beyond the legal limit of intoxication, which, depending on the state, ranges from 0.1 to 0.15 mg/dL. They had no recollection of events and had blacked out. A number of them had to be treated in intensive care units. A few of them also ingested otherpsychoactive agents like marijuana, which can be laced with cocaine, PCP, or embalming fluids. A few have disclosed using downers (benzodiazepines like diazepam,

Xanax [alprazolam], or Ativan [lorazepam]), which can significantly increase depressant effects when used with alcohol. Some of these individuals ended up losing their lives from significant respiratory depression or infection of the lungs due to aspiration related to decreased responsiveness.

 What is the alcohol equivalent to one drink?

One drink is equal to 12 g of ethanol, which is equal to 1.5 oz. of 80-proof liquor (40% ethanol) such as whiskey or gin, 12 oz. of regular beer (7.2 proof, 3.6% ethanol in the United States). Just one drink increases blood alcohol level of a 150-pound individual by 15–20 mg/dL. The body clears one drink in an hour at 20 mg/dL. Most (90%) of the alcohol is excreted through the liver by the enzyme alcohol dehydrogenase to acetaldehyde. This is then broken down to acetic acid and carbon dioxide (CO2 ) by acetaldehyde dehydrogenase.

 What is an acceptable pattern of drinking?

There is no acceptable pattern for adolescents. Moderate drinking by adults is acceptable. In adults, population studies point to the following as moderate drinking: up to two drinks in a day for males and up to one drink a day for females, and not as an average over several days. Every now and then, I encounter adolescents who report early drinking, as introduced by family membersduring dinners or by alcohol-using relatives. It may also be cultural. In a study by Mayzer and Zucker, early first drinking (EFD), defined as the first drink by 12 to 14 years of age, was associated with more delinquent behaviors than aggression. EFD was also disproportionately likely at both 3–5 and 12–14 years of age in children with high delinquent behaviors and was uncommon in those with low levels of delinquency. Alcohol consumption among young adults will continue to be an issue.

In the United States, a minimum of 21 years old is the legal requirement in all states for alcohol consumption. There are about 10.8 million underage drinkers in the United States.


Early first drinking (EFD) - EFD occurs when a person consumes his or her first drink between the ages of 12 and 14 years old.

 What is binge drinking?

Binge drinking is defined as the consumption of five or more drinks in a row for boys and four or more in a row for girls. Males are twice as likely to binge as females. Most people who binge drink are not alcohol dependent. Even for adults, approximately 92% of those who drink excessively report binge drinking in the month prior. Most (75%) binge drinking episodes involve adults over age 25 years. Binge drinkers are 14 times more likely to report alcohol-impaired driving than nonbinge drinkers. About 90% of the alcohol consumed by youth under the age of 21 years in the United States is in the form of binge drinking. The proportion of current drinkers who binge is highest in the 18-20-year-old group. Binge drinking begins around age 13, tends to increase during adolescence, and peaks in young adulthood (ages 18-22). Binge drinking during the past 30 days was reported by 8% of youth aged 12-17 and 30% of those aged 18-20.


Binge drinking - For adult males, it is the consumption of five or more drinks in 2 hours and for adult females, four or more drinks in 2 hours. For adolescents, equivalent amounts of alcohol consumed mean more toxic effects.


(10) Drugs & Child’s

Children Addicted To Opiate Drugs


What is the level of alcohol that is dangerous?

 Among persons under the legal drinking age (12–20), 15% were binge drinkers and 7% were heavy drinkers. Individuals who are drunk are more likely to drive after drinking, ride with drivers who have been drinking, not wear seat belts, carry weapons, get involved in physical fights, engage in unplanned/unprotected sex, and use illicit drugs.

The effects of alcohol have differing degrees of danger. One’s blood alcohol level (BAL) or blood alcohol content (BAC) should be an indicator of whether one is in danger from the alcohol itself or whether one might engage in dangerous behavior or be prone to having or causing an accident of some sort.

The following list shows the different bodily experiences at increasing blood alcohol levels:

• 0.02–0.03 BAC: Slight euphoria and loss of shyness; coordination is maintained.

• 0.04–0.06 BAC: Feeling of well-being, relaxation, lowered inhibitions, sensation of warmth, euphoria, minor impairment of reasoning and memory.

• 0.07–0.09 BAC: Slight impairment of balance, speech, vision, reaction time, and hearing; euphoria; reduced judgment and self-control. One with a BAC of 0.08 is legally impaired and for a number of states, it is illegal to drive at this level. You will probably believe that you are functioning better than you really are.

• 0.10–0.125 BAC: Severe motor incoordination, slurred speech, hearing and vision are impaired, euphoria. The BAC at which it is illegal to drive in West Virginia and Ohio is 0.10. • 0.13–0.15 BAC: Gross motor impairment and lack of physical control, blurred vision and loss of balance, anxiety and restlessness, severely impaired judgment and perception.

• 0.16–0.19 BAC: Uncomfortable mood predominates; nausea may appear. The drinker has the appearance of a sloppy drunk.

• 0.20 BAC: Disorientation. Assistance needed to stand or walk, possible inability to elicit pain if injured. Nausea and vomiting, possible choking with vomiting. Blackouts.

• 0.25 BAC: All mental, physical, and sensory functions are severely impaired. Increased risk of asphyxiation from choking on vomitus and of serious risk of aspiration.

• 0.30 BAC: Stupor, disorientation.

• 0.35 BAC: Possibility of coma. This is the level of surgical anesthesia.

• 0.40 BAC and higher: Onset of coma and possible death due to respiratory arrest.

I have treated adults who are able to carry a conversation and do not appear intoxicated even at a level of 0.25. This shows an extreme level of tolerance to alcohol.


Tolerance - A condition that is marked by the need for an increased amount of the drug abused to achieve the same high or attenuated reinforcing effects at the same amount. Occurs with drug dependence.

 Alcohol poisoning - is a medical emergency and should be called immediately.

 What signs and symptoms should I look for to recognize alcohol poisoning?

 What should I do if I suspect my son of alcohol poisoning?

 Alcohol poisoning is a medical emergency and should be called immediately. Symptoms of alcohol poisoning include alcohol on one’s breath; slow or irregular breathing (less than 8 breaths a minute or 10 or more seconds between breaths); cold, clammy, pale, or bluish skin (a sign that not enough oxygen is provided); unconsciousness; and vomiting. It is very important that the airways are unobstructed; you may need to position your son on his side to avoid aspiration of vomits. You may even have to support his breathing by mouth-to-mouth resuscitation.

I heard about the Amethyst Initiative. What is it?

 College presidents from about 135 of the nation’s best-known universities, including Duke, Dartmouth, and Ohio State, have called on lawmakers to consider lowering the drinking age from 21 to 18, saying current laws actually encourage dangerous binge drinking on campus. This was spearheaded by John McCardell, President Emeritus of Middlebury College, who questioned the 1984 federal highway law that financially penalizes states with a drinking age below 21. Amethyst came from the Greek words “a” (not) and “methustos” (intoxicated). Mythology states that Amethyst, a young girl, angered the god Dionysius after she got intoxicated with alcohol. She sought the help of Diana, who turned her into a white stone. After learning this, Dionysius felt sad and tears fell into his wine cup, which spilled onto the white stone and turned it purple. Amethyst is seen as an antidote against intoxication. In New Jersey, hearings were conducted to address this issue with Mothers Against Drunk Driving (MADD), and the directors of the state’s Division of Highway Traffic Safety and of Alcohol Beverage Control testified that legal drinking age laws saved lives. Since the drinking age was raised to 21 in New Jersey in the 1980s, there has been a 78% decrease in the number of 18- to 20-year-olds killed in drunken-driving crashes. This is solid evidence that the higher age requirement is, in fact, helping to prevent such accidents.

 What preventive measures are effective to deal with underage drinking?

 There are public policies that have been effective, including:

 1. Increasing price of alcohol

2. Increasing minimum age to purchase

3. Restricting access for retail alcohol sale

4. Regulating density or concentration of retail outlets

5. Regulating types of retail outlets

6. Restriction of licenses of retail outlets

7. Restricting service of alcohol (IDs)

8. Enforcing drinking and driving laws (random breath testing)

9. Setting BAC limits for drunk driving (0.05%–0.08%; for young drivers: 0.00%–0.02%, zero tolerance)

10. Implementing administrative license revocation laws

11. Implementing graduated driving licenses

12. Using automobile ignition interlocks

13. Restricting advertising

14. Placing warning labels on beverages

15. Implementing keg registration

16. Community interventions Practices with solid evidence include:

1. Increasing retail price of alcohol

2. Increasing minimum drinking age

3. Restricting hours and days of alcohol use

4. Zero tolerance policies for driving while under the influence of alcohol

5. Establishing limits on the retail sale of alcohol

6. Establishing lower BAC limits for driving


 Zero tolerance - A requirement that one’s blood alcohol level be 0%.



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