YOUTH AT RISK

Identification and intervention. Those were the themes at a community
panel on substance abuse awareness held at the Hamilton-Wenham
Regional High School on Feb. 6. Well over 60 people attended,
including parents and school personnel. According to Assistant
Principal Allison Collins, the host for the evening, the goal of the
presentation was to help parents support teenagers during transition
years. A panel of distinguished and experienced presenters addressed
risk factors, intervention strategies and the warning signs of drug
and alcohol use in teenagers.

The event was organized by the Alcohol and Drug Abuse Awareness and
Prevention Team, a community organization comprised of teachers,
school administrators and guidance counselors, local emergency
services personnel, medical professionals, parents and community
members. ADAAPT meets once per month and sponsors a survey every
other year to collect data on youth risk behavior in the district.
According to Collins, the results from the March 2005 survey
indicated that 50 percent of high school students admitted to having
used alcohol, including 37 percent of the year's freshman class.
Some respondents indicated that they indulged in binge drinking
while 19 percent said they had tried marijuana and 7
percent admitted to recreational use of prescription stimulants and
painkillers. Between 2 and 3 percent of the respondents said they had
tried stronger illegal drugs. One in three of those surveyed
admitted to experiencing depression, with the highest percentage in
the ninth grade. Risk factors Substance abuse has some clear risk
factors. Dr. Jefferson Prince, director of child psychiatry at North
Shore Medical Center and a child psychiatrist with Mass.
General Hospital, addressed the relationship between substance abuse
and depression and other psychiatric disorders.

Recent research, Prince said, indicates that an individual's
neurobiology and genes play a role in how he or she experiences
pleasure. People who are likely to become addicted always "need more."

Prince also pointed out that, contrary to expectations, depression
does not necessarily precede substance abuse.

"Early substance use and sexual behavior," Prince said, "can
predispose people to depression, not the other way around."

Prince described some of the modifiable risk factors in teenagers
that parents should be aware of. "Cigarettes are a gateway drug," he
said. Tobacco trains the brain, Prince explained, to seek surges of
pleasure. Teens with attention deficit disorder often start using
cigarettes up to two years earlier than students without ADD.

Alcohol, Prince said, is the most common drug of choice and the most
easily obtainable. And he made the case that marijuana, contrary to
popular belief, is an addictive drug that seriously alters users'
perceptions of reality. Lynne Bishop, a clinical social worker with
Health and Education Services in Ipswich, identifiedmajor transition
times in a teenager's life as risk factors for substance abuse. As
teens grow more concerned and anxious about fitting in, the risk of
experimentation with drugs and alcohol increases. Prevention and
intervention Michael Appel, regional director of N.E. Addiction
Intervention Resources, works primarily with families that are in
crisis because of the substance abuse of a family member. He pointed
out that interventions usually happen with older teens, twelfth
graders and college students. And, he said, they most often happen in
conjunction with another event, such as attempted suicide, arrest or
academic failure.

"The hitting rock bottom theory is all very well," Appel explained.
"But it is probably possible to intervene earlier."

All of the panelists identified ways to prevent teenagers from
starting drug or alcohol use, to know when a child is using or at
risk and how to intervene. Prince recommended talking and listening
to kids and their friends in order to know them and their concerns.
It is harder to treat depression, he said, once substance use has
entered the equation.

Appel recommended setting boundaries for kids and seeking help early
for those exhibiting warning signs. He advised parents to let kids
know that some behavior is never acceptable.

"Families do have rights," Appel said, "not to be abused by other
family members who might be using drugs or alcohol."

Appel also advised parents to confront a teenager with their
suspicions. "If you think there's a problem," he explained, "there
is a problem." Parents, Appel said, should be aware of local
resources for intervention, treatment, medication, and support.

Bishop recommended that parents become what he called, "responsible
adults." In addition to keeping communication open with teens,
parents, he said, must stay connected with other parents for
information and support. Bishop said she believes that parents
should encourage teens to be part of a group or activity through
church, school, a job or sports to experience a healthy sense of
belonging. And, since she advises parents to model coping skills to
their kids, Bishop also reminded parents to keep track of themselves,
to know where to go when they feel overwhelmed.

Personal experiences Susan Ackerman, a local resident and parent of
a son diagnosed as an alcoholic and addicted substance abuser at age
15, and Paolo Carvalho, an 18-year-old in recovery, provided
information from personal experience. Ackerman said she had missed
the signs of her son's problems for two years and was blindsided by
his addiction when he was 15. She found Al-Anon supportive as an
alternative to isolation and negativism. Eventually, Ackerman had to
put her son into residential treatment and let him deal with his
issues. "Letting go," Ackerman said, "does not mean stopping
caring...success starts with acknowledging that there's a problem."

Carvalho said his problems started when he made the transition to
high school and was exposed to the older students. He said that once
he started using, he stopped listening to his parents. When his
addiction became out of control, Carvalho said, he lied to and stole
from friends and family to support his habit. He was afraid to tell
his family that he had a problem. "The best thing that happened to
me," Carvalho said, "was getting caught." Questions from the
audience focused on the early warning signs of substance abuse.
According to Prince, although some changes in behavior, sleep
patterns, interests and friends are normal, too many is not. Other
warning signs include changes in a child's schoolwork and grades,
exhibiting symptoms of depression and breaking rules.

"If a kid is not comfortable coming to a parent," Appel said, "then
there is a problem."

Bishop recommended that parents keep in touch with other adults who
might see their child on a regular basis and who can note any
changes. Students have an opportunity to become aware of warning
signs as well. The dangers of substance abuse are part of the
curriculum in all of the district's schools.