Just Say Wait To Teens

When it comes to adolescents and cigarettes, alcohol and marijuana, a psychiatrist and professor at NYU School of Medicine says: Be open, firm and realistic.
Positive reinforcement and communication are key, says Dr. Lis. Photograph by Jeremy Cai

By Dr. Lea Lis, MD

No one likes to be told no, especially teenagers in their rebellious years. So when I am asked how to parent a teenager when it comes to drugs and alcohol, I encourage a message of “just wait.” Parents are fighting a losing battle when it come to that old-fashioned, Nancy Reagan “just say no to drugs” approach. Our goal as a parent is to keep that brain as pure as possible until they are mature enough to understand the risks of drug use.

The first drug that is skyrocketing among teens are e-cigarettes like JUUL, which come in flavors like mint and mango. The nicotine in these has the addiction potential of heroin. They contain flavoring such as diacetyl, a chemical linked to a serious lung disease; volatile organic compounds such as benzene, which is found in car exhaust; and heavy metals such as nickel, tin and lead.

Recreational and medical marijuana is legal in many states, with more to follow. It seems that every other patient walking into my office is asking about CBD oil and its use for common mental health issues, such as anxiety. Teens may be underestimating the risks of marijuana as a recreational drug. THC, the psychoactive component of cannabis, is more concentrated in edibles than ever before, and can induce a psychotic, paranoid state in teens.

Marijuana is outpacing alcohol as a public health problem for teenagers. It affects the cerebellum of the brain, associated with motor skills, responsiveness and memory (not good for that biology test or college entrance exam).

What I hear most about the dangers of marijuana is “I don’t care.” Teens stop caring, don’t do their homework, don’t ask that girl/guy to prom, and do not learn valuable coping skills to manage anxiety.

Studies have revealed pot-smoking may have a permanent effect on teen brains, including shrinking brain volumes with reduced gray matter and increased damage to white matter. These have been seen on brain scans well into the adult years.

What should you tell your kids? Say that marijuana can be fun, and can be used safely, but not as a teenager. Encourage them to hold off, as they will have time for that later in life.

Positive reinforcement is the best way to keep your child from smoking marijuana. I recommend quarterly drug testing starting at age 14 (start earlier or test more frequently, if you are suspicious) for all teens. Kits can be purchased at the drugstore and are pretty accurate. If the test comes back clean, I would offer rewards such as special privileges, extra spending money, a shopping trip, or financial help buying a car. If the test is positive, I recommend taking away their phone and computer (aka the lifelines for most teens) until the test comes back negative. You must stop the addiction before it starts.

Alcohol is also a drug, and it can do the most damage of any drug. One problem with alcohol in teenagers is they already have impulse-control issues due to a condition called adolescence. Combine that with alcohol, and you get a recipe for disaster.

So what do we do about it? Talk about drinking alcohol in moderation with your teens, and be a good role model. It is important to expose them to the concept of moderation.

Be proactive and make sure you discuss the risks of drug use often. Use articles and videos as a starting point. The book The Teenage Brain by Frances E. Jensen, MD is a great resource for learning more about the subject. Talk to your kids about drug use. Don’t say never. Just say wait. Dr. Lea Lis, MD is a child and adolescent psychiatrist, and assistant clinical professor at NYU School of Medicine