The recent spotlight on U.S. Olympic swimmer Michael Phelps for using marijuana got me thinking about what's going on with kids and drugs these days. I went searching for information about prevention and what parents can do to keep their kids safe and about the kinds of drugs kids are exposed to, who's using them and what science has to say about their effects.

What drugs are out there?

The landscape has changed somewhat since I was a teenager; but the usual suspects are still a concern. Drugs like cannabis (marijuana, hash), LSD, cocaine, heroin, methamphetamine and magic mushrooms are still around although their monikers have expanded somewhat. Parents need to keep their knowledge current in order to stay on top of things with their kids, so here's a review of some of the newbies.

Ecstasy

Ecstasy is also known as adam, AKA, E, euphoria, hug drug, M, M&M, MDM, 3,4-methylenedioxymethamphetamine, MDMA, X, XTC, the love drug, the party pill, hug,  and beans. Ecstasy acts on the brain to produce pleasant feelings and a sense of well-being, friendliness, empathy and closeness to others. But it also can lead to panic attacks, anxiety, decreased appetite, increased blood pressure and heart rate, sweating, thirst and dehydration, teeth grinding and jaw pain, nausea and vomiting. 

GHB - the 'date rape' drug

Also knowns as fantasy, G, gamma hydroxybutyrate, liquid ecstasy, liquid X, grievous bodily harm, organic quaalude, salty water, scoop, soap, easy lay, vita-G and georgia home boy. GHB dissolves in liquid, is odourless and tasteless, which means it can be slipped into drinks undetected. Its reputation as the "date rape" drug comes from the sedative effect it has on the victim, preventing them from resisting sexual assault. GHB makes people feel relaxed, euphoric, sedated and sleepy and causes people to lose their inhibitions.

Ketamine - another 'date rape' drug

Ketamine is a rapid-acting anesthetic used mainly by veterinarians and sometimes in human surgery. It is also known as a dissociative anesthetic because it can make a person feel a sense of detachment, as if their mind were separated from their body. The street drug is usually sold as a powder that can be dissolved in a liquid, snorted or smoked in a cigarette.

Who's using which drugs

We know a lot about the state of drug use among children and youth in Ontario from the Ontario Student Drug Use and Health Survey, a population survey of students in Grades 7 to 12 that began tracking information about their health, risk behaviour, attitudes and beliefs in 1977. 

Findings reported in 2007 show that alcohol is by far the most common drug used by Ontario kids, with 61 per cent of kids in Grades 7-12 reporting alcohol use in the past 12 months. This is followed by cannabis, at 26 per cent, and the non-medicinal use of opioid pain relievers such as codeine, Percocet, Percodan and Tylenol 3, at 21 per cent.

About six per cent of students report using solvents, stimulants and hallucinogens like mescaline and magic mushrooms. The least-common drug is GHB among this age group, at less than one per cent. Ecstasy ranks ninth at 3.5 per cent. LSD, methamphetamine, ketamine, ADHD drugs, crack, heroin, crystal meth and GHB come in under less than 2 per cent. 

These numbers reflect the average use in the past year among Grades 7 through 12. By grade 12, substance use creeps higher and includes mainly alcohol (61.2 per cent), cannabis (25.6 per cent), ecstasy (3.5 per cent) and cocaine (3.4 per cent). 

There is at least some evidence that cannabis use has fallen among teens in recent years.  A study of 15-year-olds in 30 countries showed declines in the U.S., Canada and some European countries from 2002 to 2006 (according to the February 2009 edition of the Archives of Pediatrics and Adolescent Medicine). It is not clear what has led to these declines, although some speculate that prevention efforts have had an impact. It has also been suggested that technology shifts have played a hand, with the rise in instant-messaging, email and cellphone use possibly reducing face-to-face contact and leading to fewer social contacts in the evenings. 

Before you get too excited, I will tell you that rates of cannabis use in the international survey were highest in Canada — in both 2002 and 2006. And lest you think cannabis to be the lesser of all evils when it comes to drugs, consider its long-term effects: irritated respiratory passages that can lead to bronchitis; the presence of the same toxic substances found in tobacco smoke that can cause cancer; lowered motivation, concentration and school and job performance. And if that doesn't give you pause, know that heavy use of cannabis may accelerate the onset of psychosis and the development of schizophrenia, a psychiatric disorder characterized by hallucinations, paranoia and delusions. 

The economic picture painted by a 2002 report by the Canadian Centre on Substance Abuse is equally grim. Substance abuse represents a significant drain on Canada's economy in terms of both its direct impact on the health care and criminal justice systems and its indirect impact on productivity as a result of premature death and ill health. Measured in terms of the burden on services such as health care and law enforcement, and the loss of productivity in the workplace or at home resulting from premature death and disability, the overall social cost of substance abuse in Canada in 2002 was estimated to be $39.8 billion.

What parents can do

Understanding why some young people use drugs is an important step toward prevention.  Some kids might bow to peer pressure and try drugs to feel like part of the crowd.  Curiousity and experimentation can also be a stimulus, as is the need to counter feelings of boredom, low self-esteem or stress. Remember that adolescence is a stressful period filled with change, and using drugs can make things seem better than they really are.

It is important to maintain a respectful and open communicative relationship, however difficult it may be at times. Parents also need to have clear and consistent expectations, routines and values.

Communicate your concerns without being judgmental. Stay interested in your teen's activities without appearing to intrude into their lives, however tough that may seem at times. Encourage your teens to talk about themselves and their life experiences, including how they feel about school, friends and other parts of their lives.

Teenagers are fragile in many respects, so it's important to express your unconditional love for them and let them know they have your support on all issues that might arise. 

Signs your teen is using

Signs that your teen is using drugs are difficult to detect because they often overlap with very common teenage behaviours such as changes in sleeping habits, hobbies and mood or attitudes. Keep an eye out for signs of depression, withdrawal, carelessness with grooming or hostility. Other signals might be changes in school performance, ability to socialize with friends, or reduced engagement in sports or other activities. Also be on the lookout for increased secrecy, increased money borrowing or "missing" money in the household and missing prescription drugs - especially narcotics and sedatives.

If you think you see some or many of these changes in your teenager, you might want to consult your family physician, pediatrician or your teenager's school counsellor.

To get help in Ontario, contact the Drug and Alcohol Registry of Treatment (DART). For more information and full description of illicit drugs visit the government's National Anti-Drug Strategy, which also has a downloadable brochure for parents called Talking With Your Teen About Drugs.

How to deal with teens who come home drunk or stoned

The Ottawa Police Service makes some helpful recommendations on what parents should do if their teen comes home drunk or stoned to which I've added my own thoughts. What to do that night:

DO - Try to remain cool and calm.

DO - Talk to them and try to find out what they have taken.

DO - Call a doctor or take them to the nearest hospital emergency department if they are seriously ill.

DO - Tell them, "We will talk about this tomorrow."

DO - Send them to bed and check on them often during the night.

DO NOT - Shout at, accuse or hurt them in any way. All this is quite useless and harmful when they are in this condition.

And, I would add, make it a policy that you will pick up your teen at any time of day or night, from anywhere, if they need help getting home.

What to do the next day:

DO - Talk to them immediately, in a calm yet firm voice. 

DO - Have them assume responsibility for their action, including clean-up if they were sick or if they partied in your home.

DO - Try to find out what happened and whom they were with.

DO - Let them know you will not accept their behaviour and you will be watching them closely in the future. Trust has been broken and needs to be rebuilt.

DO - Set up guidelines for behaviour with your child as well as curfews for going out with friends. Let them know you expect them to follow these guidelines.

DO - Talk to them about other activities so they can avoid taking drugs.

DO NOT - Have your discussion with them if you are too angry to talk about what happened; both of you might need a cooling off period, but don't leave it too long.

The prescription for drug abuse prevention reads as follows: listen carefully to your children and be attentive; role play how to say "no" to peer pressure regarding dangerous behaviours; provide age-appropriate information; establish a clear family position on drug use; discuss what makes a good friend; build self-esteem; and lastly, set a good example. Apply and repeat until grown.