How to Talk to Kids about Drugs, Alcohol and Addiction Inoculation

This podcast focuses on the conversations that need to occur around drugs and alcohol, substance abuse and addiction inoculation. How can we raise healthy kids in a culture of dependence? Dr. Robyn Silverman speaks with educator, Jess Lahey, about what makes the difference- and how we can make a difference.

Special Guest: Jessica Lahey

All children, regardless of their genetics, are at some risk for substance abuse. According to the National Center on Addiction and Substance Abuse, teen drug addiction is the nation’s largest preventable and costly health problem. Despite the existence of proven preventive strategies, nine out of ten adults with substance use disorder report they began drinking and taking drugs before age eighteen. Some room to grow that particularly refer to us, in relation to this podcast; According to Columbia University’s Center on Addiction and Substance Abuse (CASA), between 75-87% of parents talk at least a little about nicotine, alcohol, and marijuana, but just 50-60% talk about other drugs such as heroin, amphetamines and abuse of prescription medications—so we can make a difference with bringing this topic to the forefront. What do we say? What can we do to help create a supportive, open environment where substance abuse and the stressors surrounding it are not hidden in a closet where drinking and drug use can be triggered and take hold? For this conversation, we have Jessica Lahey on, who has been with us before when talking about failure—and this time, on addiction and addiction inoculation.

Jessica Lahey is a teacher, writer, and mom. She writes about education, parenting, and child welfare for The Washington Post, the New York Times, and The Atlantic and is the author of the New York Times bestselling book, The Gift of Failure: How the Best Parents Learn to Let Go So Their Children Can Succeed. She is a member of the Amazon Studios Thought Leader Board and wrote the curriculum for the Emmy-nominated Amazon Kids’ The Stinky and Dirty Show. She lives in Vermont with her husband, two sons, three dogs and two cats. Her new book is entitled The Addiction Inoculation: Raising Healthy Kids in a Culture of Dependence.

Important Messages:

  • Rehabilitation for kids when it comes to alcohol and drug addiction is different than it is for adults- tools are the same but applied differently.
  • Understanding what substance abuse looks like in adolescence and what we have to do to inoculate our kids as much as possible, and there are two prongs here, from getting started (because there are issues around substance use and the adolescent brain) and preventing substance abuse in their lifetime.
  • The brains of children and adolescents function differently than those of adults and the younger kids are when they start using drugs and alcohol, the more damage they can do to their brains, the more likely they are to develop substance use disorders as adults.
  • Risk-factors: Genetics (50-60% contributor), adoption, trauma, stress, toxic stress, little t trauma, big T trauma, adverse childhood experiences as outlined by the CDC and Keiser Permanente (ACEs quiz). Also see book: The Deepest Well- expands on list. Affect emotional state- and also epigenetics. How our genes express themselves. Genetics, Trauma, trauma, adoption, aggression towards other children, social ostracism, early academic failure. The earlier we intervene on these things, the better. Intertwined.
  • Substance use in adults- very different than for kids- kids brains still developing, connecting, so substances make a big difference in kids. (see Pollack and psychedelic use). There are risks to drugs and alcohol for adults but nothing like what they are for kids.
  • Risk vs Prevention. The heavier the risk side, the heavier the prevention side will need to be. Can’t be ashamed about it- that won’t help you be proactive.
  • Careful not to gaslight your children- and tell them what they are seeing and feeling in their own home is not what they should be feeling- that’s a real problem. Being told that what you are perceiving is not what you are perceiving- is really damaging.  Emotionally damaging. Trouble dealing with trust.
  • Do your parents ever talk to you about drug and alcohol abuse?
  • It’s like the sex conversation- it’s not just one conversation. Start early. Go with the developmental flow. Normalize. The easier it becomes.
  • “Not my kid.” Barrier to conversation.
  • Sobering statistics: Addiction exists in all ethnicities, socioeconomic groups…and kids consume over 10% of alcohol sold in this country. In any given month, 8% (8th gradres) and 33% (12th graders) of American middle and high school students drink some alcohol, 10% take some illegal drug, 18% drink enough to count as a binge, 8 percent drive after drinking, and 1 in 5 have ridden with another person who has been drinking. Research reveals a steady increase in the numbers of kids who become addicted between the ages of 12 and 18 and their first use? Typically happens in 7th or 8th grade. How can we “tip the scales” and amplify protective factors that can help put our kids on the healthy side of these statistics.
  • Reframing: The truth about the data. Kids perception- if you ask kids, the kids around them, “everyone does it,” but only 24% of kids have had a sip of alcohol by the end of 8th grade, the answer to that statement is an emphatic “no.” Only a quarter of kids are doing it!
  • Real information- giving honest, true info- how to refuse it, who’s doing it, that helps with inoculation against other high risk behaviors as well. So if you give information on who is drinking, drug abuse and how to refuse it, you can protect against early sex, throwing yourself off of a garage into a pool, etc. Generalizable.
  • Refusal skills- inoculation theory- not only does it increase their feelings of self-efficacy about their ability to refuse these things- they are also, in the end, more likely to use these refusal skills, and the more likely they are to talk to their parents about the fact that they use these refusal skills. It opens up communication, it increases the chances that they will refuse, and it helps them to feel in control of their ability to refuse.
  • Always need an exit strategy at a party. Help kids.
  • Scripts- what can you say to refuse. “I can’t, I’m taking an antibiotic,” “I’m Asian, and I have this genetic predisposition to…” “My mom is an alcoholic and so alcohol is not my thing.”
  • Over-estimate the amount of drinking in their own minds- how much do you think your friends drink? How upset their college roommate would be if they were invited to a party with no alcohol.
  • *If you’re a boy- you are more likely to increase your alcohol use to adhere to the erroneous perceived norm.
  • If you are a girl, you are more likely to withdraw socially if you don’t want to be a part of it.
  • Colleges are not offering alcohol-free events- because they overestimate the importance of alcohol and underestimate who would come. Continue to propagate this myth.
  • There is hope- real information. What alcohol does do in adolescent and adult brain, substance abuse and their brain- give them control so it’s their’s. They can have increased self-efficacy.
  • Just delay to age 18- substance abuse is only at 10%. Early 20s even better as this is when the brain is done with most of its development. Middle school- 50%, 10th grade- 17%, 18 years- 10%.
  • The National Center on Addiction and Substance Abuse (CASA) reveals that the more dinners per week that kids have with their families, the less likely they are to drink. Specifically, 33% of kids who eat 0-2 times per week with their family use alcohol, but for those who eat dinner 5-7 times per week with family, that statistic is cut in half.
  • Family time together very important (doesn’t have to be dinner). Dinner emblematic of time together.
  • Start early- social emotional programs with health components. What do we put in our bodies? What don’t we put in our bodies? Why do we spit out the toothpaste and don’t swallow? Why don’t we eat the tide pods? The soap? Why does this prescription bottle have mommy’s name on it and not daddy’s? Why can’t daddy just take mommy’s pills? Different bodies. Different amounts needed. Weights are different. These conversations can morph, later, into other discussions- like what’s in the medicine cabinet, what you can use in the medicine cabinet and what you can’t use. Not prescribed to you.
  • Vast number of parents know that if kids are going to use opioids, they are going to get their first from their own medicine cabinet or the medicine cabinet of friends.
  • Having these conversations early on can make it easier to have higher- stakes conversations as time goes on. What’s on the radio? What’s on TV? So many exposures.
  • Adolescents- don’t enjoy being manipulated.
  • What are they really selling here? Beer? Or the model friends in bikinis on a yacht? Sports advertising- worst offenders. FIFA- alcohol and sports marketing. Cartoons How portrayed? Elevates a happy time? Or something someone needs at the end of the day to cope with their lives?
  • Depending on how kids drinks- might become a problem. Not necessarily a situational thing.
  • Risk factor- friends if using. Productive conversation- what did you get out of this friendship? Instinct is to tell him to run. But get a lot out of these friendships. See story of Brian. What get from this relationship? What he offered to this relationship? It turns out that this relationship was a huge protective factor for Jess’ kid. Plus helped Brian- to stay in recovery and get help. Find openings. TV, advertising, Uncle Jerry needs a smoke- take these as natural places to talk.
  • How can we help encourage healthy peer groups and what do we do or say when we get wind of the knowledge that one of our children’s friends is involved with drugs, under-age drinking, partying and other risky-behavior: Instinct is say to run- a heightened risk-taker- this can also increase the risks others take around this kind of person. Instinct shut this down. Forecasting at age 7. Illogical- if they walk the same circles, a great way to push your child towards something is to forbid it. Helps to have the conversations and use these conversations without being obsessive about it. Evolving conversation.
  • Script: What do you get from this relationship? Using drugs/alcohol, less fun to be around, more stressful to be around, deep into the use/abuse, being friends/spouse—hard. What get out of relationship? “When you come home from being with this kid, you don’t seem as happy.”
  • Model: What healthy relationships look like. Has YOUR best interests in mind.
  • For example- friend- call ahead to make sure that there are non-alcoholic drinks available. Shows love.
  • “What if your friend wants you to use drugs/alcohol too?” Many peers want their friends to participate in drugs and alcohol too in order to keep them company and so that they don’t feel as bad about their own use. Easier to drink if people around you are drinking.
  • Close eye on relationship if a peer is a major risk-taker and if the friend is possibly using.
  • Question- What do you hope you get of a friendship?
  • Rules and expectations in households. Research clear- house rules- parents who give a consistent message- not until legal for you to drink- most of these kids don’t go on to have a substance abuse problem in their lifetime. The problem with permissive messaging around substance use are not doing their children any good favors. Party at your house? Illegal and poor message. A message- of a little of their own wine, a sip here or there, European kind of drinking—but can’t do this. Europe actually has the highest level of alcoholism in the world! France re-evaluating weekly guideline- how many drinks per week healthy?
  • Are you buying in big to the European myth? More likely to use and abuse substances in their lifetime.
  • Massive reconstructive situation in the brain- equal in comparison only to what’s happening in gestation and the first two years of life.
  • Health experts say- no safe amount to drink while pregnant, or to give a toddler, and same amount of brain plasticity in teens- shouldn’t have it either! Lower parts of brain hooking up to the higher parts of the brain. Prefrontal cortex. A lot going on here! Fatalistic “Teens are going to drink.”
  • The adolescent brain is equal to that level of brain plasticity- to vulnerability to things in the environment. So if we wouldn’t drink while we were pregnant and we wouldn’t give kids ages 0-2 alcohol, we also should be thinking about how normalized we have come to view drinking during adolescence. Uniquely vulnerable- this is what we need to bring up to our kids. Why are they so vulnerable when it comes to drinking? This is your ammunition.
  • Three pieces of info that we should be able to pull out of our back pocket? (1) Your brain is developing. And while there are things you can drink and consume when you are older that might not harm your brain- it does during adolescence. You process alcohol differently in your body when you are an adolescent. You are less likely to feel the negative effects or be able to discern how drunk you are. Less likely negative consequences- scary possible indicator of later problems.  Marijuana- not that risky- but in adolescence- receptors are in hippocampus where memories are formed- ability to retain info- if you have goals around a test or becoming architect- doing damage to that part of brain they need. Kids who smoke marijuana have much smaller hippocampi than those who don’t. Real consequences during adolescence. (2) Human nature- through pluralistic ignorance- to overestimate how much drugs and alcohol use matter to other people. Think other people care a lot. Probably overestimating. (3) I’m not telling you that you shouldn’t use drugs and alcohol because I’m some uptight -because I said so parent- I want you to feel like you are enough. (the drink Jess misses the most is the one that she drank before the social situation). Chris Heran. The first drink rather than the worst day. “I want you to know you are enough in your sober mind so you don’t need to resort to taking something so you can feel that you are enough.” Kids want to feel that they are enough- for their parents, for their friends. They deserve to be out there in the world as a presence.
  • If we want to raise healthy kids in a culture of dependence we MUST help them have a voice, help them feel good enough and give them a sense of self efficacy.
  • Solutions come from family- but also starts with the family. Clear eye of family use and abuse. Whether we use and how we use. Give kids impression that drugs and alcohol are used for self-medication, that’s a problem. Bring it all out of the shadows.

Notable Quotables:

  • “Substance abuse is a preventable disease or disorder.”
  • “We need to understand what substance abuse looks like in adolescence and what we have to do to inoculate our kids as much as possible, and there are two prongs here, from getting started (because there are issues around substance use and the adolescent brain) and preventing substance abuse in their lifetime.”
  • “Understanding the risks of drugs and alcohol on your kids is a good thing- it’s what you need to know about your children.”
  • “Genetics are the bullets you load into the gun and trauma is the trigger.”
  • “Viewing the risks can be empowering. You can’t be ashamed of it. You can’t feel guilty about it. If I just sit here and wallow about the fact that I gave our kids this horrible hand around their genetics, I’m not going to be proactive at all in terms of dealing with this stuff. Banish shame from this conversation. Banish guilt from this conversation.  I want us to pick up from where we are, acknowledge what’s going on with our family, substance abuse in our family, our own drinking habits, and move forward from a place of empowerment.”
  • “[The drug and alcohol conversation] is like the sex conversation. It’s not just one conversation. And the more often we have them, the easier they become.”
  • The cool thing about having real information is #1, giving kids honest, true information about how many people are doing it and how they can refuse it (inoculation theory is a powerful tool!), it turns out that when we protect kids against one high risk behavior, we protect kids against other high risk behaviors.”
  • “Having these refusal skills not only does it increase their feelings of self-efficacy about their ability to refuse these things- they are also, in the end, more likely to use these refusal skills, and the more likely they are to talk to their parents about the fact that they use these refusal skills. It opens up communication, it increases the chances that they will refuse, and it helps them to feel in control of their ability to refuse.”
  • “What we want is to raise kids for whom alcohol is no big deal. They can take it or leave it. We want kids who know how to drink moderately. The problem is we can’t teach moderate drinking in the way we think we can. Not only does permissive parenting and allowing your children to take sips of alcohol actually raise the chance of your child having a substance abuse disorder in their lifetime, the European myth is just that- a myth. Europe has the highest level of alcoholism in the world.”
  • “Brain reconstruction and cognitive development is massive during adolescence equaled only to what’s going on in the brain during gestation and the first two years of life. Just as the health experts say there is no safe amount of alcohol during pregnancy, there is also no safe amount of alcohol in a toddler. However, what we are talking about in the adolescent brain is equal to that level of brain plasticity- to vulnerability to things in the environment. So if we wouldn’t drink while we were pregnant and we wouldn’t give kids ages 0-2 alcohol, we also should be thinking about how normalized we have come to view drinking during adolescence.”
  • Kids want to feel that they are enough- for their parents & for their friends- that they deserve to be out there in the world as a presence.
  • “If we want to raise healthy kids in a culture of dependence we MUST help them have a voice, help them feel good enough and give them a sense of self efficacy so that they feel that they have earned their place in the world and they feel they can go out and do things and be effective.”

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