Chapter 3

What You Need to Know About Drugs —

An Overview

I don't know the first thing about drugs!

This chapter provides an overview about drugs and their effects. The word “drugs” means all street drugs, prescription drugs found in the home or that can be purchased illegally, non-prescription drugs available in stores, household products such as inhalants, drug substances, tobacco and alcohol. Chapter 4, focuses on alcohol and tobacco, and Chapter 5 addresses other drugs including cannabis, the most common illegal drug.

We know it is important for parents to have reliable information about drugs and their effects. Some parents are so worried and alarmed that they falsely attribute normal behavioral changes during adolescence to involvement with drugs. Others glance at headlines about youth drug-use rates and drug-related deaths, but quickly disregard them because those tragedies happen to “other peoples’ kids".

The reality is that drug use can harm teenagers in several ways, such as:

Learning the facts about drugs and their effects can help you decide how best to support your teen during this period of his or her life.

To get started, take a short drug-awareness quiz

Take a look at each of the statements below and try to decide if they are true or false. Click on True or False to reveal the answer.

Cannabis can be addictive.
Alcohol is a drug.
Nearly all teenagers use alcohol.
Talking to my child about drugs will encourage him or her to use drugs.
Alcohol and tobacco can be as harmful as other drugs.
Second-hand tobacco smoke can cause cancer.

Marijuana can be as addictive as any other drug. The active ingredient in marijuana, THC, has a very powerful effect on the brain. This effect can trigger biochemical events that contribute to becoming addicted. People who use marijuana often feel like they need to use more and more to get the same effect.

Alcohol is a drug. Many people think it is not a drug because it is a legal substance in most countries around the world. However, it is one of the most accessible drugs available to youth, and using it can lead to harm to the user like all the other drugs.

Not all teens drink alcohol, but the majority do. And most of those who do will drink to excess and become intoxicated at some point. Alcohol remains one of the most abused substances for this age group, and parents need to think carefully about alcohol use and its consequences.

Telling children about drugs and consequences of drug-use lets them know you care about them and their future. Although schools provide these messages, your child benefits the most from hearing you talk to them. It tells them that they are loved, and that you care very much about them. Children expect to hear these messages from their parents, and parents need to repeat them often. It is of course important to consider when and how you talk to them about this sensitive topic.

Because alcohol and tobacco are so easy to get, teenagers use them more often. Both of these drugs make changes in the brain that may cause addiction, and have potential for major negative health effects. Whether an individual is addicted or not, use of either of these drugs may result in harm to the person.

Research shows that second-hand smoke can cause to cancer in adults, children and even pets. Second-hand smoke can also trigger asthma and ear infections in children. Smoking outside the home is usually not enough to prevent respiratory problems on those who are most sensitive. Clothes, hair and skin of the smokers bring residues of cigarettes inside the house, not preventing the problem entirely.

Youth is a risk-period for drug use to occur

Countries that have studied levels of drug use across the life span have reliably found that it is young people who use drugs more than any other age group. The reasons are numerous and complex, and may have something to do with youths’ curiosity, relative immaturity, and desire to be more like adults. Thus, the prevention-smart parent needs to be alert to the effects of drug use and must do their best to help prevent before and during their children’s adolescence.

Most first-time drug users are teenagers

Getting high, getting addicted – It’s all in the brain

Your brain is made up of billions of nerve cells. They communicate by releasing chemical messengers called neurotransmitters. Each neurotransmitter is like a key that fits into a special "lock," called a receptor, located on the surface of nerve cells. When a neurotransmitter finds its receptor, it activates the receptor's nerve cell. Here are a few examples of some of the neurotransmitters and what they do and/or regulate in the body:

Don’t worry about the technical names but look at the different things that happen in the brain through the neurotransmitters.

How people communicate

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How brain cells communicate

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Easy to Start, Hard to Quit

Recently, scientists have discovered that all drugs of abuse are able to attach to various normal receptors in the brain that raise the levels of the neurotransmitter called dopamine in the parts of the brain that produce feelings of pleasure and reward. Dopamine is sometimes called the pleasure molecule. Researchers now believe that this dramatic increase in dopamine may play a key role in all addictions and help explain why it is so hard for people to stop using drugs.

Don’t get doped by dopamine!

When a person uses a drug, dopamine is increased in their brain, and they will feel pleasure. Unfortunately, if the person takes the drug again and again, the brain’s dopamine system becomes worn out. When that happens the person feels down, and not their “normal self.” This emotional pain can lead the person to return to drug use because it provides temporary relief.

Soon the person needs to take even more of the drug to feel better, or to get high, and the body develops a tolerance for the drug. It is a vicious cycle, because when the person has not used for a while, they may suffer from restlessness, hunger, depression, headaches, and other uncomfortable feelings. These are called withdrawal symptoms because they happen when the drug is withdrawn from the body.

Eventually, as the person continues to use, they may get addicted. And once this happens it is difficult to quit. It may take several attempts to quit and it can be a painful process. However, there are millions of ex-addicted drug users who have “kicked” addiction and returned to a normal life.

How else are drugs dangerous?

Possible damage to the brain and to learning

Researchers are now beginning to explore how drugs affect the developing brain of the adolescent and how alcohol use by young people may pose significant and possibly permanent damage to the brain.

Alcohol abuse may damage the part of the brain that is responsible for memory. This memory structure -- the hippocampus – may be particularly sensitive to damage by alcohol. One study showed that teenagers who had extensively abused alcohol performed 10% worse on memory tasks compared to a non-alcohol-using comparison group of teenagers. (Brown et al., 2000)

Other drugs that are abused by youth, such as tobacco, cannabis and other illicit drugs are being studied in order to learn about their possible harmful effects on the young brain.

How else are drugs dangerous?

Increased risk for mental illness

There is no evidence that drug use is the single cause of mental illness. However, scientists are beginning to understand that early drug use may play an important role in mental illness. For a young person who has a biological risk for a mental illness, like depression, anxiety or schizophrenia, taking drugs can “tip the scale” toward developing that mental disorder. (Substance Abuse and Mental Health Service Administration, United States Department of Health and Human Services, 2005)

How else are drugs dangerous?

Social problems

Drug use can also affect how children learn, develop socially and the way they behave.

How teenagers deal with friends and parents, how they control emotions, and how they face every day challenges are just some of the important social skills that they begin to learn as a throughout adolescence and into their early twenties. These skills are vital for teens so that they become successful adults. Using drugs during these developmental years can harm their ability to learn these important skills.

Substance use can affect family relationships, friendships, our physical health, our emotions, our work performance and our use of money – all aspects of our life. It is difficult enough for young people to “balance” all of these areas of life. When a teenager abuses drugs, balancing these things just gets tougher. A lot of the time, using the drug becomes the most important thing, and all the other areas of life fall out of balance. When this happens to teenagers, their school performance may suffer – he or she stops attending classes regularly, or may quit activities he or she once enjoyed, such as sports or music. These changes in daily routines are often the first things a parent may notice if their teenage is using drugs, because school and after-school or recreational activities are major life areas during adolescence.

How else are drugs dangerous?

Medical problems and injuries

Teenagers are usually very healthy and strong. In most countries, the main cause of death and disease in this age group is related to external causes, or events that are triggered by exposure to risky situations. Because drug use impairs judgment, a teenager high on drugs is even more likely than other teens to be a victim of accidents and fatalities involving unwise decisions.

A great proportion of injuries and fatalities such as drowning, falls, pedestrians hit by cars, burns, fights and even homicides have some or all of those involved under the influence of some substance.

Surveys conducted by the Pan American Health Organization (PAHO) found that “underage drinking is a particular problem in the PAHO region, which has a large proportion of young people. Surveys show that teens in the region drink often, and their drinking leads to traffic injuries, suicide attempts, homicide and violence, sexual assault, and risky sex. According to World Health Organization (WHO) data for 2002, alcohol was a factor in at least 69,000 deaths of young people aged 15 to 29 in the Americas.”

In some countries, teenagers can drive cars or other vehicles such as farm equipment as early as sixteen years of age. Parents must be especially alert to the problem of drug use while driving if their teen has access to a vehicle. The combination of lack of driving experience among teenagers, and the use of drugs that impair thinking and coordination abilities can be deadly.

Signs My Teenager Might Be Using Drugs

It is important for you to watch for signs that your son or daughter may be using drugs. Remember, you are the expert on your teen; you know them best. You don’t need to be a “drug prevention professional” to know if your teen is experimenting with drugs. Over the next few pages we describe some of the well-known signs you should look for. (adapted from the Partnership for a Drug Free America)

Caution: There are no perfectly accurate observable signs of drug use in a person. Use these indicators with caution. Follow-up any concerns you have about drug use by your teenager with a conversation with him or her.

Signs My Teenager Might Be Using Drugs

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Signs My Teenager Might Be Using Drugs

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Look for visual evidence, too. Take a close look while you’re having that face-to-face conversation.

  • Pay attention to the eyes - they can reveal any substance use. If your teenager has been smoking cannabis, his or her eyes might be red and heavy lidded, with constricted or narrowed pupils.

  • If he or she has been drinking alcohol, the pupils will be dilated, and he or she may have difficulty focusing on you.

  • In addition, alcohol has the effect for some people of giving a red, flushed color to the face and cheeks.

There are also telltale signs of more serious drug use:

  • Intravenous drug use leaves track marks, usually on the arms, but occasionally other places like the legs.

  • Long sleeves in hot summer weather may be an attempt to hide something.

  • Snorting cocaine causes nosebleeds and eventually eats away at the septum inside the nose.

Finally, there are several signs of inhalant use, the practice of inhaling the fumes from household chemicals for a high.

These include: sores or spots around the mouth; paint stains on the body or clothing; a chemical odor; or a runny nose.

Signs My Teenager Might Be Using Drugs

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  • For the teenager who's looking for alcohol or drugs, the home can be a gold mine of resources. Many parents keep some sort of alcohol in the house. Your teenager may take this alcohol, hoping you will not miss it. One way this is done is by filling liquor bottles back up with water to bring them to the original level. If one or both of the parents smokes cigarettes, the teenager may take some from the pack (or take the whole pack).

  • There is the potential danger of your teenager taking prescription pills not prescribed for him or her; or abusing over-the-counter drugs from the medicine cabinet in the home.

  • In more severe cases of drug abuse, a teenager may steal to finance a drug habit. Be aware of missing money in your wallet, or missing valuables, like jewelry and heirlooms.

  • Always keep track of the alcohol, tobacco products and medicines in the house. If you notice anything missing, or alcohol tastes suspiciously watery, you should discuss your concerns with your teenager. In some serious instances, you may have to lock these up so your teenage can't get to them.

  • Let him or her know that you're aware of what goes on, and that you won't tolerate stealing. Stress the trust relationship.

Signs My Teenager Might Be Using Drugs

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For some older teens, cars are very important. If you suspect your teenager has been using drugs recently, see if the car has any clues to offer. Some teenagers are not too careful about cleaning the inside of their car.

  • Does it smell like marijuana smoke or alcohol fumes?

  • Are there any bottles, pipes, bongs, or other drug paraphernalia rolling around on the floor or hidden in the glove box?

  • The bedroom can also be a place with clues of drug use, such as drug equipment or clothes are that smell like marijuana or cigarettes.

  • If you find anything, discuss it with him or her immediately; tell your teenager what exactly you have discovered and why you are concerned.

Signs My Teenager Might Be Using Drugs

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It is very normal for teenagers to make new friends. But some friends may be a bad influence on your teenager. Perhaps these new friends are older and seem to be more promiscuous and independent, with less parental supervision and less interest in school; in your teen’s language, “cool”.

They might be making poor choices and getting involved in questionable activities. Maybe you suspect that the friends are drug users. Most teenagers will defend their friends. But keep your eyes and ears open so you can help protect your child from friends who could be a negative influence.

Signs My Teenager Might Be Using Drugs

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It is normal for many teenagers to show mood changes during this age period, but drug use can create dramatic mood changes.

When your teenager returns home from a night out with friends, be alert for unusual or extreme moods. Is he or she very loud and obnoxious, or laughing hysterically at nothing? Is she or he unusually clumsy to the point where he's stumbling into furniture and walls, tripping over his own feet and knocking things over? Or perhaps secretive, very sullen, withdrawn, and unusually tired for the hour of night? You shouldn't read too much into a slight mood change after he or she gets home from being with his friends, but you should be on the lookout for unusual or extreme behavior. If your child shows extreme mood changes that last at least a few weeks, something serious may be occurring. This is when you should reach out to him or her and try to find out what is going on.

Signs My Teenager Might Be Using Drugs

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Suddenly you find your normally honest child is lying to you. Their evening and weekend plans are starting to not make sense. Your teen is vague about where he or she is going, or the excuses do not work. Examples might be:

  • He can't describe the movie he supposedly just saw; the friend she's supposed to be out with just called looking for her;
  • He says that parents will be at the parties he’s going to but can't give you a phone number;
  • She gets home way past her curfew or estimated time, and she's got a seemingly endless string of excuses to justify her behavior.

When you ask about these things that do not look right, your teen responds that it's none of your business.

Signs My Teenager Might Be Using Drugs

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Your child used to care about school and was a good student, but now his or her grades start falling and you do not see an obvious reason for it.

Your teenager gives you a weak explanation and assures you nothing is wrong. But they may be skipping school and spending less time on his homework, or appear to be losing interest in other activities. You get calls from teachers, coaches, principals: Your teenager has been missing classes, activities, or practices; or shows up for activities but no longer shows much effort. The desire to use drugs can be so strong that it can take over as the top priority in your teenager’s life.

Adapted from How to Keep Your Teenager Out of Trouble and What to Do if You Can’t, by Dr. Neil I. Bernstein (2001, Workman Publishing, New York).

Remember not to overreact to the signs above. A lot of them are about teenagers growing up “normally”. A lot of them reflect our own behavior at times!

The prevention-smart parent is able to notice and check but does not jump to conclusions and reflects on how to address any issues of concern with their child.

Where Do Teenagers Get Alcohol and Other Drugs?

The stark reality is that most teenagers get most of their alcohol or other drugs from adults.

Providing alcohol to teenagers can be risky

Think long and hard if you are going to provide alcohol to teenagers. Of course it is best – and safest - if your child does not use alcohol. We realize that cultures vary considerably about how restrictive or permissive drinking may be for young people. And some parents may want to balance a strategy of remaining open about the realities of alcohol use with an allowance of some drinking in the home accompanied by adult supervision.

Also, it is unwise to buy alcohol for your teenager’s friends, or anyone under the legal age for alcohol. In some countries, if you give teenagers alcohol and they get hurt or hurt someone else, you can get sued for damages.

Where Do Teenagers Get Alcohol and Other Drugs?

No to tobacco

Never buy or give tobacco to your teenager or anyone else underage.

Protect your child from adults giving illicit drugs to your child

Never give a young person illicit drugs (including cannabis), and keep your child distant from drug-using adults.

Watch out for your prescription drugs

Keep safe and secure any prescription medication in your home, such as anti-depressant or anti-anxiety medication. These medicines can be powerful drugs to a teenager. If your child is on medication for an attention deficit disorder (ADHD), take steps to prevent him or her from selling the medication to other teenagers.

Keep track of your child’s friends

Teenagers also get drugs from their friends. Get to know your child’s friends as best as possible. Do what you can to prevent your child from spending time with his or her friends whom you do not trust and suspect might be influencing your child to use drugs.

Be familiar with the parents of your child’s friends. Introduce yourself to the parents of your child’s friends. Familiarity with these parents will help when you need to communicate with them about preventing drug use among your child and peers.


Either on your own, with other members of your family, with your children or trusted friends:

  1. make a list of how you/your home gives messages about drug use eg. availability of alcohol or medicines
  2. discuss the behaviors of your children which give you concern and try to decide why they behave that way
  3. decide what you feel about drug use and share that

What you need to know about drugs

This chapter has given a lot of information on the potential harms that drugs can cause and on the signs that may give cause for concern that your child might be involved in drug use. Being armed with information is useful and necessary but it is equally important for the prevention smart parent to think how they acquire and use that that information especially in talking to their children about drugs.

Read the information through again and make a note of the information you feel is important. This will reinforce your own learning and understanding.

Well Done!

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