Of all the answers offered at a recent conference on “How to Raise a Drug-Free Kid: The Straight Dope,” perhaps the one from Joseph A. Califano, chairman and founder of the National Center on Addiction and Substance Abuse (CASA), best summed up the advice to parents.
Califano closed the Nov. 17 meeting by recounting a discussion with his former law partner, Edward Bennett Williams, just days before his death in 1988. Asked the most important lesson he had learned in a lifetime spending rubbing shoulders with luminaries like Ben Bradlee, Frank Sinatra and Hugh Hefner, Williams simply responded, “Always leave a light on in the window for your kids.”
In other words: “Be a parent.”
The underlying theme to the daylong conference, and work such as CASA's annual reports on the importance of family dinners, is that just having parents isn't enough to prevent adolescent alcohol and other drug problems. Parents need to consistently interact with their children in order to be effective drug-prevention agents.
“Parents have profound power, but they need to engage,” said conference presenter Ross B. Brower, M.D., assistant professor of clinical health and an attending physician at the Weill Cornell Medical Center in New York.
The “Nine Facets of Parental Engagement” in Califano's latest book, which lent its title to the conference, provides a 'how-to' checklist for parents:
- Be there: Get involved in your children's lives and activities.
- Open the lines of communication and keep them open.
- Set a good example: Actions are more persuasive than words.
- Set rules and expect your children to follow them.
- Monitor your children's whereabouts.
- Maintain family rituals such as eating dinner together.
- Incorporate religious and spiritual practices into family life.
- Get Dad engaged — and keep him engaged.
- Engage the larger family of your children's friends, teachers, classmates, neighbors and community.
Opening the conference, keynote speaker Nora Volkow, M.D., stressed that the brains of children and adolescents are still forming, and that their “developmental trajectory” can be greatly influenced by external stimuli — especially that provided by parents.
“Kids are making choices using criteria we as adults don't remember, because we don't think that way anymore,” noted conference speaker Cynthia Kuhn, Ph.D., professor of pharmacology and cancer biology at the Duke University Medical Center and co-author of a pair of books on youth and drugs. “Parents, you're their frontal cortex, because they don't have one yet.”
First and foremost, parents need to lead by example, said Brower. “Through your behaviors and actions you are constantly communicating to your children,” he said. Parental actions like their own drinking, smoking and drug-using habits are the main lessons parents deliver, “enhanced by the occasional conversation,” he said.
Parents shouldn't be intimidated by the idea of 'The Big Talk' — in fact, they shouldn't even plan to deliver an anti-drug speech to their children unless there's an immediate crisis to confront, experts say. “It should be a series of small conversations,” said Steve Pasierb, president and CEO of the Partnership for a Drug-Free America, who took part in a panel discussion on “How to Harness the Power of Parenting.”
Pasierb wryly noted that “the current generation of parents is the most drug-experienced in history.” From a parenting perspective, the key is to use personal knowledge about drugs in a teachable moment without turning conversations into a confessional about their own drug history, experts said. “Parents are afraid to discuss their own past,” said Pasierb. “Be honest, but you don't owe them the blow-by-blow details.”
Many parents “are in favor of their kids being “drug-free-'ish,'” especially where alcohol use is concerned,” noted Pasierb. Experts warned against facilitating teen drinking by hosting parties for underage drinkers, or looking the other way when evidence of drug use pops up.
Still, they said, parents should set realistic expectations, and the science cited by Volkow demonstrates the value of delaying first use of alcohol and drugs as long as possible as a bulwark against development of serious addiction problems.
“It's a fine line you walk as a parent,” said Brower. “The expectation is zero tolerance, but you both know it's not going to be zero. But having the attitude that because it's inevitable you're going to relax and give in is not correct. You know there will be some use, but you need to always be pushing back in the opposite direction.”
Research also has shown that parents who are more permissive but involved in their kids lives are typically more effective in preventing drug problems than those who set strict rules but are absent. “Be authoritative, not authoritarian,” advised Kuhn.
On the other hand, experts at the conference stressed the folly of parents trying to be friends with their children. “Teens don't need more autonomy; they need more connections,” said Ralph I. Lopez, M.D., professor of pediatrics at the Weill Cornell Medical Center. “If you're a popular parent, you're doing something wrong.”
Lopez advised parents who suspect their children of drug use to insist on an at-home drug test. “You would be an idiot as a parent to say that's not an option,” he said. “If you don't take that step, you are a coward as a parent.”
Schools and Communities: In Loco Parentis
As noted in Califano's book, schools and communities can play a critical role in creating protective environments for adolescents. Mark D. Wilson, Ed.D., of Morgan County High School in Madison, Ga., and the 2009 Principal of the Year as named by the National Association of Secondary School Principals, tells the story of a six-year-old child who stole a car and tried to drive it to school because he was having problems at home. “He was going to school because it was a place of hope to him,” said Wilson.
As with parenting, however, the most effective school and community based prevention programs are those that maintain constant contact with kids. For example, Robert Morris, a health educator and head football coach at Phillips Exeter Academy in New Hampshire, is available practically 24/7 for students who take part in the Leaders from Exeter Abstaining from Drugs (LEAD) program.
“Kids who are substance-free make that decision over and over again, every weekend,” said Morris, who joined other educators on the conference's “Don't Let School Days Become School Daze” panel in stressing the need for building relationships with kids, establishing safe havens, and creating a “dinner-table equivalent” in school.
“You've got to be there all the time,” said Morris, who lives in a dorm with 60 boys. “There's a short window of opportunity. If it's 11 p.m. on a Friday night, they know they can see me and have a conversation.”
Founded in 1992, the CASASTART program in Bridgeport, Conn., has become an intergenerational effort. The long-running prevention program for youths ages 8-18 accepts referrals from school student assistance programs and works directly with families to improve the home and school environment. CASASTART mentors go far beyond drug counseling to teaching parenting skills and job skills, and giving family members their cellphone numbers to call in case of emergency.
“The original kids are now in their 20s and still work for us,” noted coordinator Irma Camacho of the Child Guidance Center of Greater Bridgeport. “We've pretty much formed a family in the schools.”
For parents, the take-home lesson from the conference may be this: Parenting is hard, and there are no shortcuts when trying to keep your kids safe from alcohol, tobacco and other drugs. Just ask conference panelist Linda Morgan, an Oklahoma City mother who sold her house to pay for her son's drug treatment.
Today, Morgan's son is attending college — he's even in a fraternity — and a mentor has pledged to pay for his education if he stays sober. As PDFA's Pasierb noted, if you put in the hard work as a parent, “you'll give your kids a gift for the rest of their lives.”