I love working in therapy with parents and their kids because adolescence is a period in our lifespan development where there are visible and tangible inflection points for change. It’s a fertile time for growth, offering kids opportunities to learn about themselves and life; and for parents to improve their relationships with their kids and become more empowered as parents. It’s very challenging at times, for sure, but it’s gratifying to have the opportunity to have a significant positive impact with a struggling family.
I spent much of the last decade as a drug policy advocate, offering science-based information about substance use to families and how to access effective treatment. Viewing my work through the lens of drug policy offers me a window into some of the trends in problematic substance use in our country and informs me in my work with families.
The changing patterns of substance use, especially cannabis, are reflected by the shift in the types of calls I get from the (often very panicky) parents who call me for guidance. Before 2018, when medical cannabis was not yet available in my home state of Pennsylvania, many of the calls were from parents freaked out about their kid’s use of cannabis, much of the fear based on the now unsubstantiated “cannabis as gateway drug” myth.
Today, although parents coming to me are still very worried, their fear is tempered by an awareness that not only is teen cannabis use a manageable issue, but that, in some cases, cannabis seems to help their teens in ways that they couldn't accept a few years ago. Even so, parents continue to struggle in resolving the conflict they have between what they feel is best for their kids versus the drug war and rehab industry fear-based narratives about cannabis use.
Yes, cannabis can be habit-forming and addiction can develop in some. But many parents I work with now report that their teens use cannabis to help them sleep better and are in generally better moods, both conditions that may have resulted in more harmful prescriptions being deployed. They appreciate them being more cooperative, engaging, and acknowledge that using cannabis can significantly reduce their use of potentially more harmful drugs, such as opiates. However, cannabis is not without risk, especially for teens, and taking a harm reduction approach can be a gateway to conversation between parents and teens about hazardous and habitual use.
A harm reduction approach to parenting
As a psychologist, I embrace the principles of harm reduction, which is a public health philosophy based on respecting each person’s uniqueness, their right to make choices and making change through small positive steps. A primary harm reduction principle is our knowledge that human beings will always engage in behaviors that may carry risks--like driving, sex and using alcohol and other drugs.
Harm reduction principles nicely parallel psychological theories of normal adolescent development during which risk-taking and challenging limits and authority help teens establish independence and identity. Harm reduction approaches look to shift the focus from attempting to restrict or prohibit risky behaviors to reducing the negative consequences associated with them.
Harm reduction offers common-sense, time-tested effective parenting principles that can be used to help you cope more effectively with the challenge of a teen’s risky behaviors.
Fear and effective parenting don’t mix well. What we do know is that flexibility and being open to different approaches is the cornerstone to effective parenting and increases the likelihood of maintaining healthy connections with our teens and keeping them safer.
Consider the following harm reduction principles and how they can empower you to more effectively manage your teens’s substance use:
People use drugs for reasons
Our brains are hard-wired to move toward pleasure and away from pain. Substances help us relax, sleep, have fun, improve creativity, be more energized, and help us cope with physical pain as well as the emotional pain associated with more serious mental health issues.
Rather than starting from a warning about dangers, first reflect on your own reasons for using substances. Then focus on your teen’s own experience–how their behavior makes sense to them. This reduces judgment and invites and encourages a connection with you. Each teen has their own reasons for experimentation, which likely reflect common issues that most teenagers face, such as stress, depression, and pressures to “fit in.” Parents often forget that they were teenagers once facing the same challenges.
Meeting people “where they're at”
Understanding how your teens’s behavior makes sense to them will engage them in a supportive process of change by starting with their beliefs and attitudes about their own drug use. This is meeting them “where they're at.” It requires us to put aside our own attitudes and beliefs in order to listen. Listening encourages dialogue.
Teens in conflict with parents over drug use are often mired in distrust and defensiveness, having long ago tuned out lectures and warnings. Save your breath when launching into lecture mode. I’ve found in my work with teens that even when they continue to deny the extent of their substance use, many of them will admit that they want to regain fractured parental trust. Meeting teens here can be a good place to start.
Small positive steps
Change may be desired but it is also frightening and can sometimes feel overwhelming. Ambivalence is normal and so most people tend to resist changing all at once. Indeed, research shows that change occurs in predictable stages. Family problems usually take some time to develop and some time to resolve.
Small steps leading to small improvements in behavior—the experience of success—can give everyone some confidence and hope, which drives the process forward. Even a high-achieving teens’s self-esteem is vulnerable, so it’s important to voice appreciation and encouragement for any positive change they make.
No need to “hit bottom”
The notion that everyone who experiences hazardous or habitual drug or alcohol use has to “hit bottom” before they are ready for change is a myth with the potential to do great harm. Research shows that most people enter treatment or make positive changes in their substance use without hitting bottom.
‘Tough love’ embraces this myth and can damage or even destroy a teen’s life-sustaining connection to the only people who truly care about them. In the absence of violence or abuse in the home, kicking a teen out of a family could potentially be disastrous.
Parents learn about the ‘evils’ of enabling when support groups and counselors, in the interest in creating healthier boundaries, encourage us to directly confront our teens and not back down to the often-self-destructive manipulating that some teens will engage in.
Enabling unfortunately can become a badge of shame and failure that many parents wear when they repeatedly fail in their attempts to affect the course of their teen’s’s addiction or mental health problems.
Flexibility and Compassion
When confronted with drug use that’s worrisome, parents will frequently jump to a zero-tolerance approach, often accompanied by “lockdown” mode—grounding, no cell phone, no online access—in an attempt to eliminate all risk. Many teens, in their own wisdom, tell me a version of “If my parents think these punishments will stop me from getting high, they’re stupid!” Indeed, we can’t prevent a teen from using drugs if they’re determined to; and that fact, combined with zero tolerance’s zero flexibility, keeps anxiety high, often locking everyone into a destructive cycle.
Zero tolerance policies for teens who are going to smoke pot anyway forces them to lie and be more secretive about their use, escalating conflict even more. It will put teens in potentially more harmful situations and greatly limits parental response if their teen refuses to comply. On the other hand, opening up a discussion about the pros and cons of cannabis use from their perspective will help parents better understand why their teen uses cannabis and create opportunities for dialogue about what steps parents can take to effectively help them.
Certainly, our compassion can be sorely tested when we feel angry, hurt and raw in response to our teen’s destructive opposition. But we know that when parents connect with their teens and lead them with a light but stable hand, staying engaged but allowing independence, teens generally do better throughout life.
Human beings respond more favorably to harm reduction’s compassion and flexibility--characteristics essential to effective parenting.
Reality-Based Education
Teens want reality-based drug information given with honesty and the faith that they can make up their own minds. They prefer to learn from their friends, but whether they admit it or not, therapists’ and parents’ wisdom resonates with them because they appreciate that adults have already faced the same difficult issues.
You know your adolescents the best. If you need help in dealing with your teen, seek an adolescent specialist with knowledge of harm reduction and substance use–someone to collaborate with you to empower yourself and regain confidence.
Counseling can help you trust your instincts more to inform the difficult decisions you must make to establish healthy boundaries, thus balancing your family’s (and your own!) needs while providing a safety net for your struggling teen. We recommend checking out Know Drugs for more information and resource.
In part three of this series, we will provide some language and approaches for talking to your teen about cannabis from a harm reduction perspective. To learn more about my work or to reach out to me, head to www.barrylessin.com or follow me on Twitter!
