SEEING THE PROBLEM

Many adults trivialize how bad these drugs really are. They say it’s just pot or booze, what’s the big deal? But it is a big deal when it involves children. -- Marc Fishman, M.D.

It isn’t that they can’t see the solution. It is that they can’t see the problem. -- G.K. Chesterton

Your child uses drugs -- you know that much.

Your child is in trouble with drugs -- you are also fairly certain about that fact.

But is the problem serious enough to require intervention and treatment? Does your child need professional help? How can you know for sure?

In this chapter we will help you see the problem by looking at the widespread effects drugs have on emotions, thoughts, personality, physical appearance, and general behavior. When kids use drugs regularly and/or in large amounts, their behavior is affected in certain characteristic ways. And when the brain and body become dependent on drugs -- literally, physically needing the drug to function normally – certain telltale symptoms emerge.

Because many of the signs and symptoms listed below can be attributed to adolescence itself, you will need to consider both the quantity of symptoms and progressive deterioration over time. Most healthy, high-functioning teenagers will not experience a large number of these symptoms -- even if they are having a tough time negotiating adolescence -- and, if they do, their problems will tend to improve as they mature and become increasingly capable of making reasonable, sound decisions. Drug-using kids, on the other hand, will spiral downward over a period of weeks, months, or years as drugs gradually eat away at their personalities, judgment, reason, motivation, sense of self, compassion for others, and love of life.

For me it was just a gradual erosion of my love, my love for everything from human beings to the planet to the animals on the planet. All of my love was slowly eroded because everything was replaced over a ten-year period with only one thing: using. -- Anthony Kiedis, musician, recovering drug addict

The A to Z of
Adolescent Drug Use and Addiction

Anxiety: Anxiety is universal in adolescents who use drugs regularly. Many drugs cause physical changes (increased pulse rate, sweating, rapid heartbeat) that contribute to anxiety, and all addictive drugs can cause feelings of apprehension, dread, fear, and paranoia, especially during withdrawal. Other symptoms of anxiety include irritability, emotional instability, mood swings, mental confusion, and panic attacks.

Nutritional deficiencies may be contributing to the adolescent’s anxiety. Alcohol is notorious for causing blood sugar ups and downs that contribute to symptoms such as irritability, mood swings, nervousness, and constant worrying. Adolescents who use stimulant drugs such as amphetamines, methamphetamines, or cocaine, tend to eat poorly due to these drugs’ ability to suppress appetite; when they do eat, they often feast on fat-laden and sugar-rich foods.

Bloodshot Eyes: Alcohol, marijuana, and inhalants cause tiny blood vessels in the eyes to swell and burst, leading to red, bloodshot eyes. Stimulant drugs interrupt normal sleep patterns, another cause of bloodshot eyes. Regular drug users often attempt to disguise their red eyes by wearing sunglasses, or they use eye drops to "get the red out."

Craving: Kids call it "feening" or "fiending," and like all the symptoms in this A-to- Z list, craving gets worse as drug use intensifies. In the beginning, craving is related to the benefits associated with using -- the adolescent desires the pleasure, euphoria, relaxation and/or stimulation associated with using drugs as well as the good times associated with drinking and partying with friends.

If the adolescent is addicted to drugs, craving becomes a true physiological need or imperative -- the adolescent literally, physically needs the drug because his or her brain cells have adapted to the presence of the drug and need it to function normally.

I can’t even talk about drugs without wanting them. Man, my hands are sweating. I’m dying here. I mean it. I need my drugs. It’s not even so much that I want them, because I want to quit using, I really do. It’s just that I need them. -- Kirby, sixteen

Denial: Adolescents deny that they have a drug problem for several reasons. First, "the problem" seems so minor, so easy to control, and so universal. "Sure, yeah, I drink a lot, but everybody drinks – what else is there to do in this town?

Many adolescents deny they have a problem in order to protect their right to keep using.

You don’t want to be addicted, so you don’t think about it. You don’t listen to people. You don’t want to admit it might be true. -- Mark, fifteen

Denial may also be is a natural, even logical reaction to labels such as "druggie," "drug addict" and "chemically dependent." Most people think of drug addicts as homeless, helpless drunks clutching their brown paper bags or heroin addicts nodding off in the corner of a seedy hotel room. Adolescents match the face staring back at them in the mirror with the stereotypical image of the drug addict and conclude, "Not me."

Look at me -- do I look like a druggie? I don’t drink in the morning. I don’t shoot up on heroin. I don’t need drugs -- I just love them.
-- Frank, seventeen

Emotional Highs and Lows: Emotions change rapidly and often take uncharacteristic forms. Adolescents who are normally shy and sensitive may become loud-mouthed and belligerent. Friendly, outgoing kids become hostile and paranoid. Intense emotional ups-and-downs involving depression, anxiety, fear, paranoia, and agitation are often associated with the withdrawal syndrome. Feelings of inferiority and incompetence ("I’m a failure," "I’m not normal") are also common. When the adolescent is forced to stop using for days or weeks at a time due to illness, family vacations, treatment, or incarceration, emotional highs and lows may increase and cravings for drugs may intensify.

Fear: As drug use continues, feelings of anxiety and fear gradually metamorphose to suspiciousness, dread, panic, and an overall sense of despair. Paranoia and hostility are particularly acute in adolescents addicted to methamphetamines or cocaine.

Gastrointestinal (GI) complaints: The gastrointestinal system -- basically all the organs involved in processing food and eliminating wastes -- is hit hard by drug use. Symptoms of GI distress may include indigestion, constipation, diarrhea, abdominal cramping, nausea, vomiting, and loss of appetite.

Hardheadedness: Adolescents who regularly use drugs are notoriously hardheaded

-- stubborn, willful, headstrong, and obstinate. Every conversation, it seems, ends in a fight. This is fairly typical adolescent behavior but with a twist, for even the simplest questions -- Are you ready for school? Did you do your homework? Have you returned your grandfather’s phone call? -- can lead to full-scale battles.

While we’re talking about hard heads, we need to mention the risk of head injuries. A high percentage of adolescents who use drugs regularly will experience a head injury – from motor vehicle accidents to skateboarding while high on acid or "shrooms," falling down the stairs when drunk, and violent fights fueled by drug-induced paranoia. (See chapter 4, pages -- for a discussion of head injuries.)

Headaches, often fierce and long lasting, are also common in kids who use drugs frequently or in large amounts.

Insomnia: Drugs interfere with normal sleeping patterns and can cause insomnia, restlessness, interrupted sleep, and vivid nightmares. In an attempt to fix the problem and catch up on sleep, adolescents may use calming or sedating drugs. Adolescents addicted to alcohol, inhalants, marijuana, or prescription painkillers or sedatives often use before bedtime, believing that the drugs help them sleep. They are much more likely, however, to experience a restless night due to withdrawal symptoms that occur as the drug is metabolized and eliminated from the bloodstream.

Joylessness: As drug use continues and escalates, feelings of gloom and doom begin to cloud every aspect of life. Relationships with family members, friends, teachers, and coaches are strained or broken, contributing to feelings of despair. Formerly cheerful and energetic behavior gives way to episodes of weeping, guilt, shame, grief, and depression, which become more frequent and more severe as drug use escalates.

Keeping to Oneself: Adolescent drug users begin to spend a great deal of time alone, locked in their rooms, engrossed in their computers or email accounts, or listening to music (often with headphones, to ensure complete isolation). As drug use escalates, the adolescent may become increasingly tight-lipped and secretive. Phone calls and Emails are jealously guarded. Doors are locked, even bolted. Attempts by parents to find out where the adolescent is going or whom he is hanging out with are met with outright lies and deception or angry commands to "mind your own business." (For an accurate, harrowing portrayal of this aspect of adolescent drug-using behavior, watch the movie Life as a House.)

Legal Problems: Kids in trouble with drugs are much more likely be suspended or kicked out of school, run away from home, lie, steal, assault others, take a car without parental permission, and drive without a license. Because adolescent drug users typically hang out with other adolescent drug users, they are much more likely to get caught drinking at parties, stashing drugs and/or drug-related paraphernalia in their pockets or backpacks, driving under the influence, getting a "dirty UA" (a urine test that indicates recent drug use), or smoking weed in their cars or backyard alleys -- or, as some adolescents claim, in the school parking lot or baseball dugouts. The list of possible offenses goes on and on.

Money Problems: Both legal drugs (alcohol and tobacco products) and illegal drugs are expensive. Take the drug nicotine, for example. Cigarettes cost about five dollars per pack. An adolescent who smokes ten cigarettes a day will spend about seventeen dollars a week, seventy-five dollars a month, or nine hundred dollars a year on cigarettes.

Alcohol isn’t cheap either, and most adolescents who drink, drink a lot. Not many adolescents -- addicted or not -- limit their partying to one or two bottles of beer.

Marijuana is expensive. A daily marijuana user may spend ten, twenty, fifty, or several hundred dollars a week on high-quality (chronic) weed.

Methamphetamines are relatively cheap, but they are also highly addictive and many meth addicts use other drugs to alleviate the nasty side effects. If you’re on a meth binge, you won’t be able to hold down a job, which is one more way to put a hole in your pocket.

Cocaine and heroin are relatively expensive, although the cost has been going down in recent years.

Prescription painkillers such as OxyContin and Vicodin can range between five dollars and one hundred dollars on the street. Ritalin tablets cost between two and twenty dollars when sold illegally on the street

When adolescents regularly use drugs, they go through cash fast. If they become addicted to drugs, they may have to use more of the drug to feel the same effects and/or to delay the pain and misery of withdrawal.

Where do kids get money for drugs? They sell their possessions (CDs, DVDs, laptops, video games, jewelry, clothes); they steal money from parents, friends, or relatives; or they start dealing.

Nervousness: When adolescents use regularly, they are often apprehensive, tense, restless, and jittery. Stimulant drugs such as cocaine, amphetamines, and methamphetamines are most likely to cause physical agitation when the user is high, and all addictive drugs can create cause jittery nerves during the withdrawal period. Even non-addicted users will have shaky hands, tense muscles, and feelings of anxiety and mental confusion after a heavy night of partying.

Oblivion: Adolescents in trouble with drugs are typically preoccupied, forgetful, and absorbed in their own thoughts. They are literally in their own little world. Careless with their own safety, thoughtless and inconsiderate of others, they seem to care less about what others do or think.

"The only thing that really matters is drugs -- getting them, using them, getting more of them," one former user explains. "Everything else fades into oblivion."

Promises Broken: "I promise I’ll cut back." "I promise I’ll stay out of trouble." "I promise I’ll study harder." Adolescents may sincerely make promises that they are then unable to keep because the addiction subverts their best intentions. That clash between wanting to do the right thing and being unable to follow through on a heartfelt promise often fills the adolescent with shame, guilt, and despair.

Quirky Behaviors: While adolescents have always been well known for their bizarre behaviors, hairstyles, and clothing styles -- remember the headbands, face paints, and wild outfits of the1960s? -- adolescent drug users tend to go to extremes. Strange or bizarre body movements or gestures including jittery hands and feet, constant lip licking, and scratching or picking at the skin are common. Sudden and dramatic changes in clothing or hairstyles also may be a sign of trouble.

Resentments: Drug use seems to breed resentment. Old friendships are abandoned in fury or exasperation. The slightest criticism is met with defensiveness and hostility. Grudges are held for weeks or months. Feelings of annoyance, antagonism, and bitterness seem ever-present.

And blame is big -- if it’s not the teacher, coach, parents, cops, or probation officers who are causing the problem, it’s "the system," the community, or the world itself. Blaming others takes the spotlight off the adolescent’s drug use, and kids can convince themselves that the real problem exists outside them. "I hate the world," says an eighteen-year-old who regularly uses marijuana, ecstasy, and hallucinogens. "And I hate all the hypocritical, dishonest, miserable people in it, which is just about everyone."

Shame: As relationships with family members and friends are strained or ruptured, the adolescent’s resentments are compounded by intense guilt and shame. While they may try to hide their inner feelings, kids in trouble with drugs often feel inadequate, abnormal, worthless, powerless, and out of control. They may believe they are no good and conclude that they are truly bad kids or lost causes, as they have so often been called. When they get high, they can mask these feelings for a short time, but inevitably shame returns, along with feelings of self-contempt and self-hatred. Mired in self-loathing, many adolescent drug users consider or attempt suicide.

Yet experiences of shame, which imply self-consciousness, can be positive, even redemptive, forcing the adolescent face to face with the conflict between the person he is and the person he wants to become. As philosopher Helen Merrell Lynd explains in her classic book On Shame and the Search for Identity:

Shame interrupts any unquestioning, unaware sense of oneself. But it is possible that experiences of shame if confronted full in the face may throw an unexpected light on who one is and point the way toward who one may become. Fully faced, shame may become not primarily something to be covered, but a positive experience of revelation.

Not every adolescent addicted to drugs will admit to feeling shame and some never feel remorse or regret about their behavior and its effect on people they love. That lack of conscience may be a sign of deeper emotional problems.

Tempter Tantrums: Temper tantrums are not uncommon among adolescents, but when drugs are involved, sudden violent outbursts are often unprovoked and may occur on a regular basis. The adolescent seems to be angry and annoyed all the time and is often difficult to reason with, restrain, or pacify.

Underachievement: This is one of the classic symptoms of drug addiction -- kids who once had great energy and potential suddenly can care less about school, grades, old friends, family relationships, or the future.

Adolescent drug users often stop studying, and their grades drop precipitously. They seem to be unconcerned with the future and are quick to renounce longtime goals such as going to college or finding a steady summer job. They sit passively and watch TV, listen to music, or play video games, and they refuse to become involved in hobbies, sports, or outside activities. All these behaviors may be symptomatic of drug use and addiction.

Violent Episodes: Certain drugs -- alcohol, cocaine, methamphetamines, and PCP, for example -- are more likely to make users aggressive and potentially violent. Research shows that alcohol is the drug most likely to cause violent behavior in users. Combining different drugs can also lead to paranoid, hostile, aggressive and violent behaviors.

Physical and emotional instability increase during the withdrawal period, often leading to violence against others or self-abuse.

Weight Changes: Rapid weight loss or sudden weight gain may be a sign of regular drug use. Adolescents who regularly use stimulant drugs such as cocaine, and methamphetamines tend to lose weight fast. Kids who regularly use marijuana tend to gain weight, for marijuana is relaxing and kids like to kick back even as they beat a path to the refrigerator to satisfy the munchies. Lack of interest in food, obsession with high-sugar or high-fat foods, and rapid weight loss or weight gain may be warning signs of drug use and possible addiction.

Xenophobia: Xenophobia is a fear or hatred of anything foreign or strange. Many adolescents tend to be distrustful of adults in general, but regular drug use often exacerbates suspicion and paranoia, pulling the adolescent inward, away from others, and creating a sense of alienation and animosity toward strangers or anything out of the ordinary.

Yearning: A craving for peace and serenity and a longing to be normal are common in adolescents who use drugs. This yearning can be filled in the short term by drugs and/or material possessions, but inevitably feelings of emptiness -- a void at the very center of their being -- returns. "At the innermost core of all loneliness is a deep and powerful yearning for union with one's lost self," writes Irish author Brendan Francis. No substance on this earth works as quickly and efficiently as drugs do to separate the body from the soul and the individual from the rest of society.

I never felt "normal" before I started drinking and smoking weed. I didn’t realize that until I started using and suddenly felt so much better. It was like a cloud lifted, like I was floating. I thought, this is the way life should be! So all you people who are trying to tell me that I have a problem with drugs -- you’re all wrong. It’s only when I’m sober that I feel bad. When I use —that’s when I feel on top of the world.
-- Christina, sixteen

Zoned: All addictive drugs alter brain chemistry to one extent or another, pulling users into a different reality. Adolescents high on drugs or in withdrawal from drugs may appear zoned out, spacey, distracted, and off in some other world.

Now that you have read through the A to Z list, go back and underline or highlight those descriptions that apply to your child. Looking at those highlighted sections, ask yourself: Is this normal adolescence, or is something else going on?

C. S. Lewis once wrote, "It is not until we know our own face that we can turn it towards the light." Understanding the ways in which alcohol and other drugs can create a one-size-fits-all mask that covers the adolescent’s body, mind, heart and soul marks an important first step in the journey to find appropriate, effective help for your child.