What parents don't understand, can hurt their children in significant ways.

This happens occasionally. As I interview people right here in Buffalo, some for my private practice, some for treatment/therapeutic court, I hear this back story: A teenager tells me "My mom gave me a beer with dinner the other night" and relates this is a regular occurrence and has been so for some time. Or a dad that says "I smoked pot when I was a teen. I turned out fine and have no problem letting my kid do the same." Other parents have the idea that "all kids do it" and thereby allow their teens to smoke marijuana or drink alcohol or turn a blind eye to the behaviors.

In some cultures, and some in countries alcohol is routinely given to children and has been for centuries. This is well known and in many occasions has not led to severe problems or dysfunction. Here is what you have not heard. Today's heroin problem has taught us several things including this; there is a pattern that is predictable. When I interview a 20 something on his or her substance use history, the same answers are given over and over again. Heroin use comes after prescription medication abuse in at least 80% of the time. Opiates pain relievers are abused usually around the ages of 16, 17 sometimes a little later, sometimes a little earlier. Heroin use starts usually a few years later so around 20, 21ish. But almost always, in closer to 90% and higher alcohol and/or marijuana use starts BEFORE pills, before heroin. It is extremely rare that a young adult relates a history of staring to use heroin or prescription pills as a first drug in those earlier teen years. It does happen but in comparison to the norm, it is rare.

The use of substances such as alcohol and marijuana does not cause all users to develop problems and destructive patterns in their lives. These two drugs can be used recreationally by many with no apparent problems or consequences. However, they are almost always the precursors of heroin use and other severe addictive processes. We know from established research that the earlier a child is introduced to substances such as marijuana and alcohol the risk for addiction increases significantly. We also know that for some, the use of these socially acceptable drugs (one liquid and one that grows naturally from the ground) begins a process of unfolding, of developing concepts such as "I like getting high" and more subtle concepts such as "I have the ability to change how I feel by ingesting an outside substance and that is..... good." This very complicated process goes on to " it may be illegal but that is no reason to not use it" " the government tries to stop it and they are ridiculous" "the guy I buy it from is alright, he is very cool. he uses other stuff (and this becomes acceptable to try other "bad" or "illegal" things that are anticipated to be "good" or feel good just like pot and alcohol do). This process continues. It dissolves messages such as "drugs are bad or wrong" and "I should listen to adults and do the right thing". I am oversimplifying an extremely complicated process for the sake of brevity. The main point is, parents must be cautious in the messages they send to their children. The marijuana we smoked 30 or 40 years ago is much weaker than what is available now and heroin and other drugs are much more accessible than ever. If our goal is to avoid addiction and other serious concerns, the message must be underage use of all drugs, liquid, plant or otherwise is UNACCEPTABLE. This message must come very early (ages 5, 6 7) and continue throughout childhood. The human brain continues to develop to age 23 or so and the later the better when it comes to first use of substances.