The Gateway Drugs
Few children and adolescents start a career of drug use by snorting cocaine or injecting heroin. The path usually begins with products from the corner store tobacco, alcohol or household products that are inhaled or with marijuana, which some mistakenly consider safe.
Tobacco the smoking gun
No drug habit has a greater negative impact on our national health than tobacco, which is implicated in more than four hundred thousand deaths in the United States each year. The list of disorders caused or aggravated by tobacco is staggering. Among these diseases are cancers of the lungs, mouth, vocal cords and other organs; chronic lung disease; asthma; ulcers; clogging of the vessels that supply blood to the heart and other organs, causing heart attacks, strokes, amputations and premature deaths. Babies and children who breathe smokers' exhaust at home are at risk for respiratory infections, asthma and sudden infant death syndrome (SIDS).
The vast majority of diseases related to tobacco take their toll later in life after subjects have had years of exposure. So why is adolescent tobacco use such a major concern?
Nicotine is extremely addictive. Nicotine's hook is set quickly and, once in place, is extremely difficult to remove. A few hits of nicotine produce a unique combination of relaxation and alertness, and withdrawal produces unpleasant physical and psychological symptoms. As a result, fewer than 10 percent of smokers can limit their habit to five cigarettes or fewer per day.
Almost every long-term smoker first lights up during adolescence. Nearly 30 percent of any high school graduation class are regular smokers, as are more than 70 percent of their peers who dropped out of school. Over the past two decades, the average age at which tobacco use begins has dropped from 16 to 12. The younger one becomes nicotine dependent, the more cigarettes will be smoked as an adult.
A huge amount of money is spent every year to make smoking appear glamorous and exciting. The tobacco industry's annual multibillion-dollar advertising budget is supposedly intended to encourage adults to switch brands, but the cartoon characters, sexy young couples, macho men and liberated women in cigarette ads have clearly been shown to influence children and adolescents. Heavy visibility of these ads at sporting and cultural events also sends definite signals that tobacco is hot stuff. Warnings issued in health-education class pale in comparison. In one survey of high school smokers, more than 95 percent were aware of health risks, but 70 percent claimed they were not concerned enough to stop.
Cigarettes keep very bad company. Smoking is associated with significantly poorer school performance and a higher likelihood of sexual activity. Because the use of alcohol and marijuana is significantly greater among adolescent smokers, tobacco is identified as a "gateway" drug one that increases the odds of using even more dangerous substances. It is the last of these points that should sound the alarm for parents of adolescent smokers. If your teenager is smoking cigarettes, he is seven times more likely to be using illicit drugs and eleven times more likely to be drinking heavily than his nonsmoking counterparts.
Smokeless (chewing and snuffing) tobacco, which has been made highly visible (and glamorized to some degree) by users who are professional athletes, is not a safe alternative to cigarettes. Surveys show that about 12 percent of male high school students currently use smokeless tobacco. Usage rates are even higher in many Native American populations. Chewing tobacco is clearly associated with damage to the gingiva (the soft tissues surrounding the teeth) and with aggressive cancers of the mouth. Furthermore, both chewing and snuffing deliver powerful jolts of nicotine. A 1993 report from the National Institutes of Health indicates that a typical dose of snuff contains twice the amount of nicotine in a cigarette, while a wad of chewing tobacco contains 15 times that amount. Needless to say, addiction to these substances is very common, as are withdrawal symptoms when use is stopped.
Alcohol the most dangerous gateway drug
In all 50 states, it is illegal to sell alcoholic beverages to anyone under 21. This is no accident, because for teenagers alcohol is a gateway to a lot more than other drugs.
Alcohol causes more deaths among adolescents than any other substance. Alcohol is involved in one third of all traffic deaths for young people aged 15 through 19. Overall, driving under the influence is the leading cause of death for people between the ages of 15 and 24. Alcohol also frequently plays a role in adolescent deaths from other causes: homicides, suicides, drownings and motorcycle and bicycle accidents.
In addition, alcohol plays an important role in adolescent crime, sexual promiscuity and date rape. According to research compiled by Mothers Against Drunk Driving (MADD), 95 percent of violent crime on college campuses is alcohol related, and 90 percent of reported campus rapes involve alcohol use by the assailant, the victim or both. In one study cited by MADD, 60 percent of college women diagnosed with a sexually transmitted infection were drunk when they became infected.
Another sobering reality about drinking is the early age at which it frequently begins.
According to the American Academy of Pediatrics, about one in five fifth-graders has already experienced alcohol intoxication. Four out of ten sixth-graders say they feel pressure from other students to drink. More than 50 percent of eighth-graders and eight out of ten twelfth-graders have tried alcohol at least once. One in four eighth-graders and half of all twelfth-graders have used alcohol within a given month."
More alcoholic products that specifically appeal to kids are hitting the marketplace. Wine coolers are increasingly popular with younger drinkers, as are a new wave of alcoholic concoctions billed as "thirst quenchers," often containing lemon or other fruit flavors.
A significant number of drinkers (about 20 percent) develop full-blown alcohol addiction and struggle with it for years. Ironically, the person who prides himself on the ability to "hold his liquor" is at the greatest risk for alcoholism. If large quantities of alcohol must be consumed to produce intoxication, he is demonstrating a tolerance for alcohol something all alcoholics have in common and addiction is likely to develop. Tolerance of alcohol and the risk of addiction are thought to be genetically predisposed and usually run in families. Adolescents with family members who have had alcohol-abuse problems must be warned that they are at higher risk for becoming addicted to alcohol if they ever start drinking.
Marijuana inhaled intellectual impairment
Parents who experimented with marijuana during the 1960s may not be terribly concerned about this drug. But what kids are smoking today bears little resemblance to what flower children were inhaling three decades ago. The average batch of marijuana in the 1960s contained 0.2 percent delta-9-tetrahydrocannabinol (or THC for short), its main mood-altering chemical. Today's vintage contains at least 5 percent THC, or 25-times the old concentration, which along with four hundred other assorted chemicals adversely affects the brain, lungs, heart, gonads (ovaries or testes) and immune system. In preteens and young adolescents, heavy use of marijuana can also impair growth and development.
Most kids who use marijuana or take THC capsules experience a sense of euphoria, relaxation and calm. Some feel it enhances perception. The reality is that it impairs intellectual function, specifically concentration, memory, judgment and motor skills. Short-term fallout can include injuries and death from motor-vehicle accidents or other trauma as well as sexual misadventures resulting from loss of inhibition and rational thinking.
Long-term users are known for an "amotivational" syndrome in which goals and self-discipline and the activities that require them (especially school performance) literally go up in smoke. During the teen years a child should be learning how to think and act more maturely, but frequent marijuana use can halt that process. Worse, it introduces kids to the harrowing world of illegal drugs and the criminals who produce and distribute them.
Inhalants cheap (and dangerous) thrills
This form of substance abuse is particularly hazardous because:
The materials involved are inexpensive and readily available in any garage or hardware store. Model glue, contact cement, gasoline, lacquers, paints, toiletries, cosmetics and dozens of other aerosol and volatile products can have mind-altering effects if inhaled deeply. Substance inhalers are generally very young. The age of peak use is typically 12 to 14, with first experiences as early as six to eight years of age. Most adolescents who have experimented with inhalants do so before their second year of high school, and nearly 20 percent of eighth graders have tried some form of inhalant .
The potential effects are disastrous. The most serious byproduct of chronic use is permanent damage to the brain and nervous system, causing loss of intellectual function and coordination. In addition, a variety of products can be lethal during or after inhalant use. One study of inhalant deaths revealed that over 20 percent occurred among first-time users. One consequence known as sudden sniffing death syndrome can occur when a user is surprised or suddenly frightened during the act of inhaling. Many inhalants temporarily increase the sensitivity of the heart muscle, and an abrupt adrenaline surge in response to being startled can provoke a lethal irregular heart rhythm.
Depending upon the substance used, several deep inspirations bring on a sense of euphoria frequently with hallucinations as well as stimulation and loss of inhibition (which may lead to other dangerous behavior). Drowsiness and sleep may follow.
Like other drug users, inhalant abusers may display erratic behavior, poor self-care and declining school performance. Parents may notice specific clues such as the aroma of the inhalant (which can persist in the breath for several hours), stains and odors in clothes and an unusual stash of products (such as gasoline or aerosol cans) in a child's room. An adult who discovers children or adolescents in the act of inhaling should avoid surprise tactics or a sudden confrontation that might cause a startle reflex, since this could precipitate a sudden lethal heart-rhythm disturbance.
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Other Things to Consider
Related Topics
Relationships: Blended Families, Parents and Adult Children
Transitions: Preparing for Adolescence, Empty Nest
