A Prevention Primer For Parents and Caregivers

Andrew McKenna - Expert Content Editor

For simplicity’s sake, the terms parents and caregivers are used interchangeably throughout.


According to the Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics:

“In 2021, approximately 2.2 million youth ages 12 to 17 reported using illicit drugs and 2.2 million used alcohol in the past month, with approximately half of those youth reporting binge drinking. Each day, about 3,700 youth try marijuana for the first time ….”

A Common Theme

Ryan came home late on Saturday night, later than we expected him. He had told us that he was going to the high school to watch a basketball game. When he walked by my husband Daniel and me, sitting in the dimly lit living room watching a movie, we both could smell pot. We knew the smell from our college days—it seemed like a lifetime ago.

We both had tried weed a few times back then. I didn’t really care for it. Daniel liked it—it helped him relax and he smoked often back then. But after we both graduated, he stopped. His career was just starting, and we soon were married and started a family. Ryan was the youngest of three. His older sisters were off to college. Neither of them were partiers in high school. Wow, in the coming fall Ryan would be moving to the high school to start 9th grade.

My husband and I looked at each other in shock. Ryan had just turned 14 the previous month. He was a good kid, with lots of friends that we liked, he played sports and did well in school. In our minds, we didn’t think we would have to deal with the whole keg parties and marijuana thing until Ryan was older, at least a junior or senior in high school. What was happening? Ryan was still our baby.

We were nearly speechless. Until Daniel spoke up.

“Hey buddy. How was the game?”
“Wh … What?” Ryan asked.
“The game. At the high school?” I answered him.
“Oh, it was good. We lost.” Ryan said confusedly.
“Your future high school’s varsity team lost and that’s good?” His father asked with a laugh.
“Yeah. I mean no. I don’t know.” Ryan stumbled through his words

My husband and I again looked at each other. After 23 years of marriage, we came to be able to read each other’s minds. It wasn’t difficult in this situation—clearly Ryan was acting differently than we were used to.

“Well, I’m going to head upstairs and go to bed.” Ryan called from the kitchen. We could hear the refrigerator door close.

“Ok, honey. Good night.” I didn’t know what else to say. Should I call him in? Ask him questions about where he was? He seemed so defensive lately. I don’t want to cause an argument.

“Before you go up,” my husband said, “Come in here for a quick second. I want to show you something.” Daniel could always think on his feet. And he always seemed to be in control of situations. But he too, lately, was butting heads with Ryan.

About a month ago, Ryan had quit the baseball team, Babe Ruth League baseball, a sport he loved his whole young life. He just came home straight from school one day instead of going to practice, and told us he quit the team, that it wasn’t fun anymore. We didn’t sit down and talk about it; I guess we were thinking that it was his decision to make. Besides His father and I were tired from working, so we just let it go.

Since then, Daniel felt like Ryan wasn’t himself, that he was more secretive, always on his phone, leaving the house for short periods and returning only to go straight to his room. Just yesterday Daniel accidentally picked up Ryan’s phone thinking it was his own. As he looked at the screen he saw a message banner that said something like “I got the thing…call me”. Just as my husband realized it was Ryan’s phone, Ryan flew across the kitchen and snatched the phone from his father’s hand.

“Hey, what the frig, dad? Why are you looking at my phone.” Ryan walked away fast and seemed to be frantically deleting something.

“Huh? Oh, yeah ok, dad.” Ryan came walking into the living room, his arms full of food—a bag of chips, a bag of cookies, and a package of bologna. A strange combination for sure, even for a 14-year-old.

My husband reached over and turned on the light. Ryan stood in front of him as Daniel pulled a small pocket knife from his pocket and held it out. Ryan used to have a fascination with knives, especially old ones, collector’s items, or ones that told a story. In his room he had several books on antique knives.

“I came across this in a box in the attic. It was my grandfather’s and then my father’s, and eventually mine. Now it’s yours. Here son.” Daniel was pointing out the ornate ivory inlays on the handle, and the fact that the blade still held an edge. My husband explained that Ryan’s great grandfather had fought in Africa nearly a century ago and this knife he brought back as a gift for his young son. Ryan just stared, withdrawn, vacant—just as he has looked for the past month or so, maybe longer.

“That’s real ivory. Pretty cool, huh, Ryan?” but my husband wasn’t looking at the knife, he was looking at Ryan’s bloodshot eyes, the lackluster affect, the blank look like he was somewhere else, a far distance from the same living room where years earlier he would crawl around as a baby. The same space where he would later build forts with cushions and sheets. Those days seemed long past. Ryan had grown up fast.

“So, pretty cool, right buddy?” His father asked him again.

“Yeah dad, that is really cool.” Ryan answered as he stared at the pocketknife. No enthusiasm, no smile, just numb from whatever he had used.

There was like a long pause.

“Ok, well, that’s all. I just wanted to show it to you. Here, it’s yours, buddy.” My husband placed the knife in Ryan’s shirt pocket for him. Ryan mumbled thanks and turned towards the stairs, walking away with his arms full of food.

When he was out of earshot, I looked at my husband. Thoughts were racing through my mind. Nearly every day we would hear news stories about a fentanyl overdose—a friend’s child, or niece or nephew, aunt, uncle, friends of a friend’s loved one. People are dying—robbed of life by drug overdoses—and there seems to be no end in sight.

In the year ending 2021, 108,000 fatal drug overdoses occurred over a one-year period. That number isn’t an estimate, but overdose deaths that officials know about.

The short narrative above is based on a family that I recently worked with as a consultant. An adolescent using alcohol or other drugs can be a parent’s or caregiver’s worst nightmare. Especially with fentanyl—a game changer because of its lethality—now found in not only heroin and cocaine, but cannabis in all its forms, including gummies. In some cases, the amount of fentanyl sufficient to cause death, can fit on the tip of a pencil.

Parents and Caregivers Must Be Clear About Where They Stand

According to reliable research, parents and caregivers should make affirmative statements that they believe drugs, and alcohol at an early age (pre-21 years old) are extremely dangerous and that their children are not allowed to “experiment” with them. This would seem like a given, but it isn’t. Most household members don’t have conversations about drugs and alcohol. Because parents are seen as leaders and they must set expectations and make them clearly known.

Practice What You Preach

Parents and caregivers—even though they are adults—should set good examples for those in their care. Actions speak louder than words; abstinence or at a minimum healthy alcohol use is important for our young population to see. Children watch what the adults around them are doing, and often model that behavior late into their lives. If you’re a parent or caregiver who is concerned about their own alcohol (or drug) use, talk to your doctor and get their opinion. Perhaps cutting back is a healthy move for you, and taking positive action is the best example for our children to witness. No one is perfect. Being vulnerable and asking for help is a strength, not a weakness. Explain this to your children. Be a leader.

Be Present, Be Aware

In our scenario above, Ryan’s parents saw a key indicator that something was off with Ryan—abruptly quitting the baseball team, but missed a critical opportunity to communicate with Ryan. Youth who were once active in sports, clubs, or other interests like Ryan, who stop taking part in their normal activities involving peers and adults (coaches, teachers), are doing so for a reason.

If our loved-ones are in fact using drugs, being around teammates and coaches, for example, is an uncomfortable feeling. They can’t “enjoy” the high if they think people around them are noticing. The easiest remedy for this is to stop being around other people—isolating—and in Ryan’s case, this meant quitting the team. If on the other hand, Ryan wasn’t using drugs, stopping normal, enjoyable activities could be a sign of another challenge such as depression or anxiety. Either way, losing interest in normal activities is almost always a tell-tale sign that something is afoot, and parents and caregivers must investigate.

Social Media: Know What Our Children Are Doing

Every legal and illegal drug imaginable is readily available online now. Drug dealers are actively targeting our youth with easily access to heroin, fentanyl, cocaine, Adderall and other medications—fake and authentic—cannabis, benzodiazepines (e.g., valium, Xanax), you name it and it’s right there, sometimes with deliveries minutes away.

In our example above, if Ryan’s parents had known the 5-Ws of Ryan’s messaging activity and internet searches, perhaps they could have known the road Ryan was heading down. Of course, the challenge is real. First, many parents don’t believe they have the “right” to look into their children’s online activities. Some also feel that to look or inquire of their children will cause an argument or outright rebellion. Some parents don’t possess the knowledge to access their children’s technology.

These are all valid thoughts and obstacles to knowing what our children are doing. But none of them hold up when I get a phone call from a parent whose child just overdosed. If the overdose wasn’t fatal, the parents, caretaker, or friend is usually asking about treatment options. These are the calls that I pray for. These are the calls where I can help folks. It’s the calls—and I’ve taken a dozen—where the parent, caretaker, or friends tells me that their loved-one died that haunt me.

Every single one goes something close to this:

“I didn’t know! I had no idea he was using drugs.”

Or “I knew that something was going on. I should have done more.”

Watch, Look, Listen

The “doing more” includes making the difficult decision to look into what they are doing online, on their phones, who they are talking to, who they are spending time with, where they are spending their time. Many parents have a lot more power over their children than they often believe. It’s not easy by any means and my heart breaks for parents who have lost children to drug overdoses.

I cannot imagine for a minute the grief they must feel. In many cases these parents have tried everything—including going through their technology and playing “detective” as one friend of mine says. To those parents, I plead with them not to blame themselves, to seek grief counseling, clinical therapy, couples counseling if their spouse is involved, and perhaps most importantly, family counseling. No one is to blame for drug overdoses except for the dealers who target and market their poison to our most vulnerable population.

Love, Compassion, Understanding

No person that I’ve ever met suffering from addiction wants to continue using drugs or alcohol. Trying new things and experimenting are part of the human condition. The reasons some people chose not to try drugs are myriad and not the purpose of this article. But in my experience, I can say that in ninety-nine percent of cases, the decision to continue to use drugs after trying them for the first time is because they are escaping a feeling that is either painful, or just uncomfortable for them. Adolescence is rife with uncomfortable feelings. Insecurity, loneliness, hormone fluctuations, family problems, poor school performance, bullying, loss, relationships, and the list continues.

Establishing and maintaining strong communication with our children is a critical factor in preventing them from going down the dangerous path of drug use. Even perfect communication—which is rare—doesn’t guarantee anything. Watching our children’s behaviors, looking into their use of technology, and listening to their verbal and non-verbal cues is a course of conduct that parents can take if they’re willing to withstand the sometimes angry teenager, frustrated by their parent’s “nosiness.” However, in an equal number of cases, our children surprise us by their reactions by being open to our questions and concerns. Feeling loved and cared for in the often-scary world that our youth live in, is a good feeling, and one that they do not want to escape. You’re not alone. Ask for help.