How To Talk To Teens About Drugs
Why "Just Say Know" Needs To Replace "Just Say No"
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The Teen Overdose Crisis Is Real
Teen drug overdoses hit an all-time high in 2022, killing the equivalent of a high school classroom of youth each week, according to a new report in The New England Journal of Medicine. Drug overdoses and poisonings are now the third-leading cause of children’s deaths in the U.S., after firearm-related injuries and motor vehicle crashes.
On a recent episode of NPR’s Life Kit podcast, Nicole Cohen and Lee Gaines spend 22 minutes taking a fresh look at the question of “How To Talk to Teens About Drugs” (Give it a listen - it’s well worth your time!)
In this edition of Teen Health Today, I’ll be exploring the five suggestions proposed in the Life Kit episode and sharing resources parents, caregivers, and teachers can use to improve these conversations.
1. Get Familiar With The Current Drug Landscape
The LifeKit story starts with an interview with Ed Ternan, whose son Charlie died of a fentanyl overdose after taking a counterfeit Percocet pill. Ed and his wife Mary started the non-profit organization Song For Charlie to raise awareness about ‘fentapills’ — fake pills made of fentanyl.
Over the past year, Song For Charlie has partnered with experts from a variety of fields to create The New Drug Talk, a resource hub to help families discuss this issue. I’ve been glad to be able to contribute to this effort as a writer, editor, and content advisor.
This 30-minute video is one way to start this conversation with young people. Watch it together, and then talk about what you saw. Here are some post-viewing conversation starters:
“What story or fact did you find most surprising?”
“Why do you think teens rate fentanyl as less dangerous than cocaine or heroin, even though it’s much more deadly?”
“Why do you think some young people take pills they didn’t get from a pharmacist?”
“Do you see drugs at school?”
“Do you feel like you can talk to friends and family about fentanyl? If not, what would have to change?”
2. Learn About Harm Reduction And How It Can Be Used to Talk to Teens About Drugs
The LifeKit story includes an interview with Bonnie Halpern-Felsher, who runs the Halpern-Felsher REACH Lab at Stanford University. She shares this perspective on harm reduction:
The first tenet of harm reduction is that “the most important way to reduce your harm is not to use in the first place”.
The second is “if you are using, let's work on trying to either stop or cut back.”
When we only give the message of “don't” and we only give the message of “just say no,” not only are we not giving teenagers the tools to help them make healthy decisions at that moment, we also shame them and embarrass them. Then they don't want to come to you as a parent to admit that they have tried drugs because they don't want to disappoint you.
The REACH Lab is an AMAZING resource that makes lesson plans and intervention tools available for free to schools. The New England Journal of Medicine recommends one of them by name:
“Clinicians, educators, and parents can draw inspiration from the Safety First curriculum, which presents abstinence from drugs as the safest choice for adolescents but also provides information about risk reduction for those who choose to experiment with drugs.”
3. Start The Conversation And Keep It Going
Whether we are talking about drugs, dating, mental health, or any other sensitive subject, we want young people to feel safe to honestly share their feelings, ask questions, and voice their concerns. Don’t assume this will be a one-time talk. Instead, work to establish open lines of communication so this conversation can continue as a dialogue. Here are some tips from TheNewDrugTalk.org:
Take An Open and Calm Approach
As you talk to your child, try to avoid judgment, anger, or fear. Young people may pick up on your tone and tune out or react defensively. Be sure to make this a conversation and not a lecture.
Think of this first conversation as just opening the door – you don’t need to say it all in one go. Focus on setting the tone for open and ongoing dialogue, an environment conducive to mutual understanding and honesty. It is not about being right or having your stance immediately embraced.
It may be more effective to have 60 one-minute conversations than one 60-minute conversation. Bite-size conversations and information sharing can be very effective.
An open conversation will disarm the notion that this is a lecture. It will also provide a relaxed environment to discuss ideas without making them feel like they are being blamed or are in trouble.
Talk As a Family
If you have a partner, try to have a conversation with them and your child together so they see that you are on the same page and equally invested in sharing this knowledge and keeping them safe.
If you don’t have a partner, think about inviting another family over and having a conversation over dinner so they can understand this is a norm that other households share and will reinforce together.
Share your values and expectations clearly.
Plan in advance for how you might react to concerning information that the young person might share to make sure they still feel safe and welcome to open up.
What's The Right Time To Talk?
Pick a calm moment that is distraction-free. Young people sometimes prefer having conversations where they don’t have to sit face-to-face. Try talking while walking, driving, or doing other activities together.
You might want to talk after seeing drug use depicted in a TV show or before your child goes to a concert with friends.
Ask open-ended questions about what their peers are doing. Avoid lectures, and instead listen and share what you are learning. Remember your child may be reluctant to talk about this sensitive topic. Just keep trying!
What's The Best Opening Line?
It’s smart to start with a question like, “What have you heard about fentanyl?” This will help you understand what they know already, and also give you an opportunity to correct any misinformation. Then you have an opening to share what you know: “I’ve been reading up on fentanyl, and think it’s an important issue to talk about together”.
Acknowledge that there is a lot to learn and you want to share your knowledge and continue to learn together – things change quickly and together you can share the most up-to-date information with each other.
4. Be Honest
Sometimes young people ask questions like “Have you ever used drugs?” How you answer is a personal decision. It’s ok to say “I’d rather not talk about that” or “I don’t think today is the right day to get into my life history.” Here are some ideas from TheNewDrugTalk.org:
You might say “I promise to tell you one day, I just don’t feel ready to right now”. That way it doesn’t feel like you are shutting down the conversation, but also gives you time to consider your answer. If you do choose to share, think about how what you say can help you connect with your child and deepen their understanding of the issues involved.
You may want to talk about how the fact that fentanyl is present in so many illicit drugs today makes it more risky to experiment with drugs than it was in the past. You can talk about other things that have changed as well, saying something like “When I was growing up, we did not have the brain scanning technology that we do today. We didn’t understand how risky drug use during your teen years is. We were told not to use, but were not given science-based explanations about how it might affect us.”
Parents with a history of substance use sometimes say that they regret some of the choices that they made and they are trying to help their child avoid making similar mistakes.
5. Share Harm Reduction Strategies With Teens
Harm reduction is an evidence-based public health approach that acknowledges certain risky behaviors, like drug use, may persist despite their known dangers.
Rather than focusing solely on abstinence, harm reduction aims to minimize the negative consequences of such behaviors.
The Safety First Curriculum outlines safety measures for when students or their friends do choose to use drugs. Although designed for use in a classroom, parents can easily adopt the ideas for use in conversations at home. Safety first emphasizes messages like:
If you're using drugs, the healthiest choice is to stop using, or at least cut down on how much and how often you use.
Ideally, you're using drugs only as recommended by a doctor or a pharmaceutical label. But if you're not, don't take a lot of any drug. Wait and see how it affects you before taking any more.
Consider your mindset before using drugs. What you're thinking and feeling before and during substance use can affect your experience.
Consider the setting. Where and with whom you're using drugs can reduce your chance of injury or death.
Check the substance before you use it. Testing a drug for things like fentanyl can reduce the risk of harm. But even test strips aren't always 100% accurate.
Don't mix drugs. The effects from combining drugs may be stronger and more unpredictable than one drug alone, and even deadly.
Know how to respond in an emergency: Spot the signs of an overdose. Call 911. Place someone on their side to prevent choking. Administer the opioid reversal medication naloxone, often sold under the brand name Narcan.
Want To Know More?
Song For Charlie’s Laura Didier and I will be presenting on this topic at the SHAPE America convention in Cleveland in March - I hope you can join us!
I recommend following innovative educator, who just published a Substack summarizing all the work she did in 2023 to help improve drug education:
If you enjoyed this post, please forward it to someone else who might like it, and click the ❤️ or 🔁 button on this post so more people can discover it on Substack. 🙏🏼