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Teens & Substance Use

Daily Dose

Heroin Use Rising

1.15 to read

I continue to be alarmed with the news that heroin is becoming a more prevalent drug in our society. I was reminded of the reality of this just the other day when I saw a young adult (20 year old) patient of mine that I had not seen for awhile.  I remembered that during the end of his high school years his mother had called me about some issues he was having....but I never heard more and had not seen him for quite some time.

He came into the office as he was having cough and cold symptoms. While I was taking the history of his illness, I also started asking him how he had been and what he was doing now. He told me that he had just recently gotten out of rehab and was working part time and planning to start taking some college classes.  While he certainly was not the first patient of mine who had been to rehab, he was the first to tell me that he had been a heroin addict. I was “shocked” to say the least....heroin? One of my patients?

He was quite open as he told me he had started smoking marijuana in high school and then had gone on to experiment with other drugs including prescription narcotics, mushrooms and even meth. He was then introduced to heroin and as he told me , “it is readily available around here and in almost any high school in the Dallas/Ft. Worth area”. He also told me that heroin is cheaper than many other drugs, so may be a go to drug.  What really struck me was when he said “I cannot tell you the rush and euphoria you get with are addicted the first time!”. That statement turned out to be true for him.

At some time in the last 2 years he had also been arrested and sent to jail, but once out he continued to use heroin until he finally accepted help and went to rehab.  He had been clean for months and was continuing to work on staying that way.  I was so proud of him as well as his honesty in discussing his addictions. I pray that he may stay clean and sober, although he is smoking now...but as he said to me, “that discussion is for another appointment”. Agreed.

The face of heroin addiction is not like I had thought. It is now affecting a lot of this country and in suburban neighborhoods and schools. This is not only an inner city problem. If his statement, “I was addicted the first time” is true...then this is yet another discussion to have with our teens. 

While some teens “experiment” with alcohol and marijuana, there is no experimenting with heroin.  


Daily Dose

Marijuana Use in Teens

1.15 to read

While tobacco use is at an all time low among teenagers the use of marijuana is on the rise.  According to the annual 2012 Monitoring the Future Survey (which is administered annually to over 45,000 students grades 8-2 in both public and private schools) marijuana is the number 1 drug used by students in 8-12th grades.   

The 2012 survey showed that about 35% of high school seniors said they had smoked marijuana (pot, weed) in the past year, with daily use among seniors of about 7%.  Of some concern is the declining numbers of teens who view marijuana use as “risky”.  Only 20% of seniors thought that occasional uses was harmful and while more younger teens viewed marijuana smoking as risky, those numbers are also declining. 

While I have always talked to my adolescent patients about smoking I am now making sure that I am asking not only about cigarette use (which is almost gone in my practice) but specifically marijuana use as well, and anecdotally I can say that the numbers of older teens using “weed” is on the rise for sure. 

One of the concerns is that teens perception of marijuana use and harmful effects may be “squelched” due to the ongoing debate and legalization of medical marijuana in some states.  For many teens, “legal drugs” such as prescription painkillers and ADHD meds, even when used recreationally and inappropriately, are not as harmful.  Their perceptions are NOT accurate, and teen painkiller abuse is one the rise as well. 

Ongoing studies about daily marijuana use in teenage years has shown that marijuana contributed to lower IQ scores and impaired mental abilities.  There is growing concern that regular or daily use of marijuana may affect a teens ability to “achieve and/or excel” in school or jobs.   

Obviously, more data is needed, but among my teen patients with drug abuse issues, they will all admit to the fact that they started out “using” marijuana. I don’t have any patients that I can recall who started using meth or cocaine prior to having used marijuana (most fairly regularly). I still have concerns that for some people marijuanas seems to be a “gateway drug”.   

As the debate about legalizing marijuana continues it is becoming more important to discuss marijuana use with your teen and stay tuned for more studies on its effects (beneficial/detrimental).  Like so many issues, it doesn’t seem to be black and white.

Daily Dose

Teen Drug Abuse Declines But Abuse Continues

There is good news to report from a national survey of teens on drug use. The survey conducted from 2001 to 2005 indicated that there was a 20 percent decline in illicit drug use. The bad new is that teens are abusing different drugs than in previous years.

 Over 3 million adolescents each year begin using either over-the-counter (OTC) or prescription drugs inappropriately, and pain relievers are quickly becoming a "gateway" drug similar to marijuana. The other alarming statistic is that these drugs account for up to 22 percent of new substance abuse, and many teens report that these "prescription" drugs are readily available in their homes. During the last five years the parental medicine cabinet has become the easiest place to get "high" just like the liquor cabinet of old. Parents need to be as aware, if not more so, of locking up their medications as well as the liquor. Teens these days would prefer to abscond with their parent’s vicodin rather than a bottle of vodka. With so many adults now on multiple medications including medications for sleep, anxiety, pain relief, mood disturbances and even attentional issues the family medicine cabinet has a plethora of choices. Opiods are becoming a drug of choice and about 5 percent of high school seniors reported initiating Oxycontin use in the last year, while 10 percent report having tried Vicodin. I went to my own medicine cabinet and looked to see what we had available. There was left over pain medication from one son's wisdom teeth extraction, and another bottle from a different son's shoulder injury secondary to football. There were also several tablets of sleep medication that is sometimes used for travel and a half used bottle of cough syrup with codeine. Beyond that not much interesting; just vitamins and a few random bottles of Tylenol and Advil. I must admit, I would not know if any of the pain pills went missing, as I really had no idea they were even there. Many adolescents view the "miss-use" of prescription medications as being "safer" than illicit drugs. The misconception that prescription drugs cannot become addictive or lead to the use of other illicit medications is a common problem with teens. It is almost as if their immature brains do not process that these drugs, which were not prescribed for them, can be just as addictive and even deadly as illegal drugs. Many of my adolescent patients will report "borrowing" a friend or roommate’s stimulant like Ritalin or adderall to pull an "all nighter" and think nothing of this. They also have often reported using narcotics in combination with alcohol, without realizing that this could be deadly. They often don't even know what they took, as they will just say, "it was the blue pill a friend gave me, and they told me it would help me relax". As illicit drug use declines, the discussion with teens regarding abuse of OTC or prescription medications is a reality. Telling our teens about the inappropriate use of pain medications is as important as the discussions regarding marijuana and cocaine. As parents we must take inventory of our medicine cabinets, keep medications locked up, not just to prevent poisoning in younger children, but also to prevent potential drug abuse among teens. I know of several instances where adult friends have reported medications missing from their bathroom cabinets after their teens had friends over for an evening. I am heading to my own cabinet to do a little New Years throw away (remember to dispose of medications properly too!) That’s your daily dose, we’ll chat again tomorrow.

Your Teen

Teen Drug Use On The Rise, Again

Teen drug use is on the rise and parents need to take note.After nearly 10 years of declining numbers, teen drug use has reversed course and is rising among 9th-12th graders.

A  joint study published by the Partnership for a Drug Free America and the MetLife Foundation revealed the following: *teen alcohol use grew to 39% from 28% in 2008 * yearly and monthly marijuana us increased to 38% and 25%, respectively *75% of teenagers say they have friends who get high at parties, a 9% increase from 2008 The study revealed several reasons for the increase including less federal funding for drug-prevention programs in schools and the media. Inhalants like glue, nails polish remover, spray paints, and cleaning fluids pose a growing risk among teens.  These items are cheap readily available in a home and are used by younger teens to get a “quick high”. Over the past several years, studies have revealed that teen access to drugs, especially prescription medicines, is easier than ever. So what can parents do?  Be aware of any mood swings or behavior changes in your teen.  Make an effort to get know your child’s friends.  Eat dinner as a family.  Studies continue to prove that children who sit down to a family dinner do better in school and are less likely to get involved with risky behaviors.

Daily Dose

College Drug Overdose

1:30 to read

Colleges are gearing up for a new school year and already there has just been a death reported at a fraternity house at Texas A&M University.  This news hit close to home as the adolescent who died was from a Dallas suburb and several of my patients attend Texas A&M and were even in the same fraternity.  

The misuse of opioid medications is a national epidemic and the drug scene on college campuses seems to be increasing. The misuse of opioid medications includes drugs which have been obtained both legally (by prescription for pain management) and illegally. Many of the college students that I take care of have recently told me that these drugs which include oxycodone, hydrocodone, codeine, morphine and fentanyl are relatively easy to obtain in dorms, frat houses, classrooms, and on line via social media sites.  All of these opioids are chemically related and interact with opioid receptors in the brain to produce pleasurable effects and relieve pain. Some students reported that friends often offered to “share” their unused pain relievers and would even offer them for free! Unfortunately, unintentional drug overdoses due to opioids also continues to rise and has more than quadrupled since 1999. Adolescents just don’t seem to realize the power of these drugs!

In the case of the recent death in our area, the teen was found unresponsive and not breathing in the early morning hours after a fraternity party. It was thought that he had combined alcohol (probably excessive) with an opioid. The toxicology reports are pending….but the police reported they found marijuana (which seems to be almost everywhere) and other drugs including not only opioids but also MDMA (Ecstasy), LSD and other drug paraphernalia. 

Just like alcohol poisoning following binge drinking, opioids also cause respiratory depression and loss of consciousness   The combination of the two may be even more deadly, which could occur even if this was the first time the teen had used opioids. There is an antidote to opioid overdose, Naloxone (Narcan) which may be injected (or given intranasally) to counter the effects of an opioid drug overdose.  It is now available over the counter and my be life saving if given soon enough, by helping to reverse the respiratory depression and allow the person to be transported to a hospital for life saving care.

If you are just sending your child off to college or back to college PLEASE talk to them about alcohol and drugs and reiterate that the combination may be even be more deadly!!  Even one time use could be the last time….so tragic.






Your Teen

Kids Using Inhalants To Get High

More kids are using household products to get high.Take a look around your house. Do you have hairspray, furniture polish or air freshener?  Lock it up!  A recent study reveals children as young as 12 years old are more likely to use these products to get high than marijuana or alcohol.

The National Inhalant Prevention Coalition  released new findings showing kids are experimenting with everyday products and inhaling them to get high. Many of these products are accessible in a child’s home providing easy access to a quick buzz. Parents:  be aware of what common household products are in your home.  Talk with your children and explain to them just how dangerous inhaling these liquids and sprays can be. If you don’t think it can happen in your home, take note.  The National Institute on Drug Abuse says one in five 8th graders have tried inhalants.

Daily Dose

Marijuana Use

1:30 to read

The legalization of marijuana in a majority of states for both medical or recreational use is making marijuana use more and more prevalent. It  has also made it incumbent for pediatricians to have conversations with teenage patients (and parents) about the harmful effects of marijuana use. 


We are now in the in the era of legalization of marijuana, and I find myself having more and more conversations with teenage patients who “think that weed is acceptable and safer than alcohol”.  That statement alone is worrisome. In fact, I “hear” that many teens are using marijuana on a daily basis, and do not realize or are in denial about any long term deleterious effects of daily marijuana use.


“Marijuana is not a benign drug, especially for teens. Their brains are still developing and marijuana can cause abnormal and unhealthy changes” according to a just published clinical report from the American Academy of Pediatrics (AAP).


Studies have shown that teens who use marijuana on a regular basis may develop serious mental health disorders including addiction and depression. (Some teens are wrongly trying to  self-medicate their own anxiety and depression with a depressant).  Marijuana may also decrease memory and concentration, as well as causing attentional and problem solving issues.  Going to school “high” is just not conducive to academic success.


There are also studies that have shown that addiction may be related to daily marijuana use.  17% of people who use marijuana in adolescence may become addicted and that number may increase to 50% for teen who smoke marijuana daily. Daily alcohol use and marijuana use are both harmful but do effect the brain in different ways.  


But even knowing those statistics, teen surveys done by the U.S. Dept. of Health and Human Services found that there is decreasing concern for the risk of using marijuana once or twice a week among 12-17 year olds.


Parental use of marijuana is equally concerning. Parents not only expose their child to second hand smoke, but seeing parents using marijuana recreationally makes a child more likely to use marijuana themselves. Just like alcohol, being “high” on marijuana makes it difficult to parent and to provide a healthy home environment for a child.


Lastly, in my own years of practicing pediatrics I have seen more than a handful of teens who have had serious drug problems….they will all tell you their drug use did not begin with cocaine or meth or even heroin…..they all say it was marijuana that started them down the terrible path of drug addiction.


While there is a place for marijuana use in medicine for those with certain chronic conditions or for the management of reducing the side effects chemotherapy, marijuana use is not harmless and will never be.


Talk to your teens about drug use and specifically marijuana use…legalization does not make it safe. It is a slippery slope for sure.

Your Teen

Teens Are Taking Risks "Just For Fun"

News study says teens are engaging in risky behavior just for the thrill of it.Every parent of a teen knows, the teen years can be a rollercoaster ride. Parents find themselves telling their teens to slow down while driving, don’t engage in risky behaviors, and stay away from alcohol and drugs.  But why do teens engage in this behavior? A new study says:  it’s for the thrill of it.

A study published in the journal Cognitive Development found that teens, especially 14 year olds were the most likely to take risks because it is an escape. "The reason that teenagers take risks is not a problem with foreseeing the consequences. It was more because they chose to take those risks," Stephanie Burnett, of the University College London's Institute of Cognitive Neuroscience, explained in a university news release. This is the first evidence from lab-based study that adolescents are risk takers. Advice to parents?  Begin the dialogue early, when your child is in elementary school.  Clearly discuss your expectations and lay out the consequences of engaging in any risky behaviors.  The sooner you begin having these age-based conversations the better.


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