In the tabloids, Lindsay Lohan reigns as the poster girl for substance abuse. This week radaronline.com broke the news that the 24-year-old actress got out of her court-ordered inpatient rehab after just 23 days. But she is hardly an anomaly. According to the Substance Abuse and Mental Health Services Administration's most recent National Survey on Drug Use and Health, an estimated 23 million Americans of all ages needed treatment for a substance use disorder in 2008 alone. What should you do if you're worried that your child or your spouse may be at risk for an addiction problem — or may already suffer from one?
1. Know the statistics. Nearly three-quarters of high school students have tried alcohol, and more than a third have tried marijuana, according to the U.S. Centers for Disease Control and Prevention's most recent Youth Risk Behavior Surveillance survey. In the 30 days before the survey, 24.2 percent of students had five or more drinks in a row, 20.8 percent used marijuana, and 19.5 percent of high school students smoked cigarettes. Alarmed yet?
2. Figure out if a problem exists. See a doctor. And know symptoms. Alcoholism, for example, involves craving, loss of control, physical dependence, and tolerance, according to the National Institute on Alcohol Abuse and Alcoholism. Its site offers extensive information for young teens and on college drinking. And visit the Alcoholics Anonymous site, which asks people to see if they answer "yes" to four of 12 questions, including, "Has your drinking caused trouble at home?" Movies such as "Animal House" sometimes make it seem as though drinking is a boy deal. But alcohol may even be a bigger problem for women. Their bodies contain proportionately less water than men's, so they can wind up with a higher concentration in their bloodstream.
3. Catch problems early. To feel less like black sheep, kids with mood disorders and behavioral difficulties, in particular, may start hanging out with the wrong crowd. "Drugs become a coping mechanism or a sort of conduit to getting with the social group that's more accepting than their regular peer group," says Dr. Geetha Subramanian, a child and addiction psychiatrist in Bethesda, Md. Set limits and consequences, and reward good behavior. "You can't just tell a kid, 'don't smoke weed—you can die from it,'" she says. Be wary if a child starts to skip school or dramatically change clothing style. And take note of missing money, red eyes, unsteady gait, and cigarette smoking. (Tobacco is a gateway drug for marijuana.) Skip the home drug tests: kids can too easily figure out how to beat them, she says.
4. Don't let kids feel responsible for an adult's problem. "Make sure the kids understand it's not their fault," says Dr. Daniel Levy, a developmental pediatrician who sits on the American Academy of Pediatrics' committee on communications and media. "If it's a situation where it's intolerable, then the living arrangements have to change."
5. Prevent children from following in an abusing sibling's footsteps. Nip copycat behavior in the bud. Say, "'Look what happened,'" says Levy. "'Your sister was a great student, and she started smoking pot, and her grades fell, and she started doing bad things. Do you want that to happen to you? How are you going to change your behavior so you don't fall into the same trap your sibling did?'"
6. Be aware of prescription drug abuse. Alcohol and marijuana get most of the attention. But the National Institute on Drug Abuse notes that teens may get their hands on medications such as Vicodin, too. Click here for the story of a teen and his dad. In its kit for Drug Recovery Month (September), SAMHSA gives information about commonly misused substances.
7. Take action if necessary. Laws vary by state, but remember that you typically can't force anyone 18 or older to get treatment unless it's court ordered. Still, you and your doctor may decide it's vital. Visit the government's Substance Abuse Treatment Facility Locator, sponsored by the Substance Abuse and Mental Health Services Administration. You can also visit well-known addiction treatment programs such as the Betty Ford Center, Hazelden, and the Mayo Clinic. Check with your insurer about coverage. To find support groups for abusers, use the meeting finders on the Alcoholics Anonymous and Narcotics Anonymous sites.
8. Seek out social support. "Try not to hide," says Subramanian. Many families don't reach out because abuse is a taboo, and they don't want other kids or neighbors to know their child is smoking pot. Support groups for families include Al-Anon and Alateen, the National Association for Children of Alcoholics, and Families Anonymous.
9. Don't neglect other family members. "Siblings may have anger, may have some shame, may feel left out because the parents are focusing on this target individual who's getting all the attention," says Subramanian. "They may feel resentment." Know that how to handle the addiction problem may "polarize" a couple with different parenting styles.
10. Model good behavior. Don't smoke, abuse drugs, or drink too much yourself. The recommended guideline for daily consumption: no more than one drink for women or two drinks for men.
Have you dealt with substance abuse in your family, and if so, what worked?