My Teen Is Using Substances. How Do I Know When and If To Intervene?

In my work with parents, I get this question a lot.  Earlier in my career, the majority of the parents I worked with felt like they had an understanding of the drug culture and clear signs their adolescent may be using – bloodshot eyes, increased secretiveness or isolative behaviors, new friends, lighters or other drug use related paraphernalia  and of course, their teen coming home obviously under the influence.   Mostly they were worried their adolescent was “experimenting” with marijuana or alcohol.  Common responses were often  “let him sleep it off”, grounding or “let’s hope the hangover is bad enough she won’t want to do that again”.  I vaguely remember a similar comment from my own father.

But as Mr. Dylan sings, “the times they are a changin’ ”.  The current drug culture and substance use by adolescents is much more complicated in today’s world.  The variety, potency and availability of substances have all of us confused and overwhelmed.  The laws, consequences and social norms around substance use are changing daily and vary significantly from state to state, town to town, family to family, person to person.

There are numerous resources online that can educate you about drugs, the research, the trends, warning signs, etc.  I strongly encourage you to educate yourself.  A great website for information is the  National Institute on Drug Abuse’s DrugFacts: High School and Youth Trends.

I would never attempt to tackle the complexity of this issue within this short piece, but hope to add to the conversation.  For this conversation, let us talk about the deep and difficult issue of how you personally, as a parent, decide when your adolescent/young adult child has a substance use issue that needs addressing.  When do you know it’s gone too far?  It is such a slippery slope, it’s easy to “forget” what normal is, it’s hard to intervene on your child especially when “his explanation was logical”, “he apologized and said it was just this one time”, etc.  In my experience, helping parents feel in control of their situation, prepared and empowered to respond has been the most critical component to healthy, responsive, successful decision making on behalf of their children and one of the most rewarding aspects of my work.

When is it time for you to act? The answer is unique for each parent, teen and situation and is never simple.  I believe that parents must come to this decision on their own and with full commitment. Intervening and walking alongside your child during treatment (and beyond) requires no less, emotionally, spiritually, financially – you, your teen, your family, your lifestyle will be challenged on every level.   Many times I’ve seen situations fail or not achieve the desired or optimal results because parents were unready, unwilling or unable to make a firm decision or follow through (“all in”) when a decision was made to intervene on their child’s substance use.

As you ponder your own situation, here are some questions to help you find your own answer.

1. What are your personal beliefs and feelings regarding substance use?  Do you use drugs, alcohol or prescription narcotics yourself?  Do you have other process behaviors that may be considered addictions?  Gambling, shopping, smoking, sex, eating, working?  What is your personal perspective on substances and behaviors that we use to numb feelings, isolate, relax, feel better or “zone out”?
2. What is your personal history and exposure to addiction and substance use?
3. Do both parents agree on the above?  Are you philosophically aligned on this issue?  Where do you disagree?
4. What is your tolerance level for substance use from your child?  Is it ever ok for your adolescent to use substances?  How do you define “experimentation” or “typical behavior” as it relates to substance use?
5. What are the warning signs that your adolescent is exhibiting that might be of concern? List the evidence – suspension from school, rolling papers in the garbage can, bloodshot eyes, change in friends, etc.
6. What about the peripheral evidence that might be of concern- has your child been peripherally involved in substance use but you can’t prove his involvement directly?  Friends that are known to be using, brushes with the law or school authorities, odd or new behavior that “just doesn’t feel right” other situations that “weren’t his fault” or were “explained, minimized or excused” related to possible drug use.
7. What interventions have you already imposed?  Consequences, lectures, previous treatment, etc.  What worked, what didn’t?
8. Are you emotionally  capable of enforcing rules, if this leads to heightened resistance in the home? 
9. Are things getting better or worse? Is your child experiencing success or failures in other areas of their life; relationships with family and friends, school performance, recreational interests and activities, etc.  Are things “slipping” in any of these areas that may be an indicator of substance use?  If life remains manageable, is substance use alone a non-negotiable for your family?
10. Are you willing to talk about this issue out loud?  Is it ok if friends, neighbors, family, colleagues and others know that your adolescent is using drugs and may need outside help?
11. Have others talked to you about this issue or brought their concerns to you?  If yes, add these to either #5 or #6 above.
12. Are you willing to give up some parenting control and influence to others?  How uncomfortable are you willing to be?  Would it be ok for your child to be away from home for a time being? Miss family outings or events?  Change schools or living arrangements?  Would it be possible for your home to be substance free – including alcohol and prescription medications?  What about these questions makes you nervous or angry or relieved or???

In my work with parents, I recommend they write down their answers to these questions and share them with at least each other but ideally with me or another person that they trust, preferably someone objective and with experience in adolescent development and substance abuse.  Sometimes, having it down on paper and in front of you helps to see things in a new light.  As a part of the above exercise, I always ask parents to answer a final question, usually when we are together and reviewing their answers. 

      13. If your child had a problem with substances, how would you know for sure?  What evidence would be undeniable for you?

Oftentimes, parents will answer this final question with “see answers above” and they come to a realization that things are out of control or beyond their threshold of “acceptable”.  This allows for an easier transition to the next step conversation.  How can we work together to develop a plan that’s appropriate for your particular, unique situation?  Oftentimes, the clarity of the above exercise allows us to address their child’s situation with a clear head, open heart and focused on the facts.

For other parents, if they determine that they have not yet met their threshold, they feel more confident knowing that they will recognize when and if they do and together we can devise a plan for what to do should that day arrive.