Monthly Archives: October 2011

Q&A with Hazelden’s Dr. Joseph Lee: Adolescent Abuse of Synthetic Drugs

Join Together: What trends are you seeing in adolescent abuse of synthetic drugs? Which designer drugs are becoming most widely used?

Dr. Lee: Most often, Hazelden doesn’t see young people who are addicted primarily to synthetic drugs, but we do see a lot of experimentation. Of synthetic drugs, marijuana seems to be the most popular agent, with bath salts and hallucinogens used less frequently.

The majority of these young people who come in for residential care at Hazelden are admitted due to use of another substance, but many have tried synthetic drugs at some point. There are many cases, however, where synthetics became the primary drug of choice.

Join Together: Why is the increasing use of synthetic drugs so worrisome?

Dr. Lee: These drugs are particularly dangerous because amateur laboratories manufacture them and no one knows enough about the chemicals used to make these substances. There are a lot of chemicals marketed as synthetic cannabis that actually have different components. No one would really think about smoking a bath salt or potpourri on its own. The contaminants in these chemicals alone should raise concern. Each time someone uses a synthetic chemical, they have no way of knowing what they are putting into their body.

Reports from emergency room admissions and overdoses indicate that many kids are experiencing very serious negative reactions to synthetic substances, including heart problems, psychosis and agitation, and in rare cases, death. Personally, I have seen many kids develop psychotic symptoms that do not improve for months. Also, synthetic drugs are often manufactured to escape detection from standard urine drug screens.

Join Together: How are teens getting access to these drugs?

Dr. Lee: In the past, kids would buy these drugs from the same head shops where they get paraphernalia for marijuana and tobacco. Now, increasingly kids are going online to buy drugs to avoid getting caught.

It is tough to monitor the Internet for illegal drug sales because state and federal laws are not all-encompassing. If the state or federal government bans one substance, manufacturers can make a small change to the chemical so the new product is no longer illegal. This challenge mirrors the difficulty of regulating the sale of other drugs online.

Join Together: Which types of teens are most likely to experiment with synthetic drugs and why?

Dr. Lee: Anyone can experiment with synthetic drugs. However, there are at least three demographics that parents should be particularly aware of:

  • Young people are intrigued by synthetic drugs because they are experimental by nature at this age. Many don’t intend to get addicted, but decide to use drugs simply because their “friends are doing it, too.” There was a case in Blaine, Minnesota where kids ordered an ingestible, synthetic hallucinogen called “2 C-E” online and as a result of using it, one 19-year-old died and 10 more young people were hospitalized. This group may not have been addicted to drugs, but were “just” experimenting.
  • Young people who are already in trouble with the law and are being monitored use synthetic drugs because they are often undetectable by standard screenings.
  • Young people who seek peer-approval, perhaps a little more than what would be considered normal, are attracted to the idea that they can know more about synthetic drugs than others. This group receives a certain sense of authority and credibility among their network by being the person who is either well-connected or has an arcane knowledge of obscure drugs. They will often try chemicals that others might not try in order to demonstrate their mastery.

Overall, we are making a dangerous mistake by waiting for kids to show the signs of addiction before we educate children about synthetic substances. These drugs can have a severe, detrimental impact right away. Many kids have problems with synthetic drugs who are not necessarily addicted to anything else. Addiction is not a prerequisite for having a problem with synthetic substances.

Join Together: Are these drugs being used alone or together with other drugs? Are they a “gateway” to other types of substance abuse?

Dr. Lee: It is normal, though not healthy, for kids to experiment with substances. That is one of the differences between young people and adults with drug abuse problems. However, this behavior is dangerous because they might find that one drug is more rewarding than another. It’s just like ice cream: once they try and like chocolate ice cream, they wonder what strawberry ice cream tastes like. That’s really their approach.

Often times, the fact that kids mix chemicals together with alcohol, cigarettes or other substances multiplies the risk of having a bad reaction. We see many examples of overdoses with alcohol and pain medication, but it can also occur with other substances. Kids are often falsely reassured by the amount of potentially bad information they get from online and other resources.

The so-called “gateway hypothesis” is controversial. Researchers cannot prove that the use of one drug does something in the brain that encourages the use of other drugs. However, we do know that when you track young people who use alcohol, marijuana, and other substances before the age of 15, they are more likely to experiment with and use other substances later on. We also know that the earlier a child abuses drugs, the more likely they are to develop an addiction later in life.

Many of the kids who use synthetic substances also seem to have behavior problems or other mental health issues at a young age, so it is important for physicians to screen for those kids who display risk factors for addiction. But, we also see very high-functioning kids who succumb to addiction due to experimentation, so every parent and physician must be cautious.

Join Together: Are there any tactics you think would be effective in reducing the abuse of synthetic drugs?

Dr. Lee: Strong messaging about the dangers of synthetic drugs (and other drug and alcohol abuse) is very important for family members to use with their children at a young age. It is also equally essential that family members act in an open-minded and tolerant way with their children, so they feel comfortable coming to older family members with questions or problems.

It is true that parents who don’t have strong messages about not using drugs often have kids who use more. Parents who are firm with expectations and limits, but who are also available emotionally have the most success. This is called authoritative parenting.

Parents also wait too long to screen their kids for drug use, and specifically synthetic drug use. They need to have regular screenings with their pediatrician and other health professionals, beginning at an early age.

Parents should take a close look at their family history. If they have a predisposition to substance abuse, they need to pay attention for their children. Additionally, if they have an older child who uses substances, that increases the risk that the younger child will use drugs, as well.

There are many other things that parents can do to help their child and plenty of comprehensive resources for them to access in their community and online.

Joseph Lee, MD works at Hazelden’s Center for Youth and Families as a child and adolescent psychiatrist. Drawing upon his expertise in medicine, individual and family therapy, Twelve Step models, and the evaluation and treatment of adolescents, Dr. Lee works with teenagers and young adults from ages 14 to 25 who are struggling with addictions to drugs and alcohol. Please see more information on Hazelden’s website:


Parenting 101

September 2011

1.  My ex-husband is a heavy smoker and when our kids come home from a weekend with him they are disgusted by how they and their clothes smell – they’re more & more reluctant to spend time with him because of it.  When I mention it to him, he just scoffs at the notion.  What to do?

It is sadly common that issues like this one, between a divorced couple, become more about power struggles than about the ‘sensibility’ of the real issue.  Almost always these are a continuation of the ‘unresolved conflicts’ that the couple developed during their relationship period, and may have very little  to do with what the actual problem presents.

There are many realities all playing at once.  There is  dad’s reality that he wants time with his children.  And as far as he is concerned, his vices should never interfere with his right.  There is mom’s reality, who believes that her children’s health is at risk and feels it is her responsibility to take some kind of action. There is the children’s reality that they dislike the smoking so much that it’s interfering with their experience with their father.  And there is the social stigma that comes from the evidence that smoking is not only unhealthful, but second hand smoke can be seriously harmful to anyone who is exposed to it.    It is no accident that the last two decades have seen a tremendous increase in laws and regulations to prevent second hand smoke exposure.

The bottom line is  you need to do your best to try and keep your ex-husband from perceiving this situation as your agenda to get what you want.  The key here is his children.  While he may discount their opinions because they are children, he will eventually be persuaded by them if they continue to express their dissatisfaction about the smoking without criticizing him.  This is best done with ‘I’ statements.  I.E. “Dad, It makes me feel sick when I am inhaling the smoke that is in the house.  I can smell it on my clothes for days after I have been at your house.  I love spending time with you, but it’s difficult for me to deal with the cigarettes.”

Your children need to be fully supported in not being exposed to serious health hazards. If they  have tried to explain the situation to their father and he either ignores them or tells them he doesn’t care about their problem with his smoking, then  a family law attorney or the Los Angeles County Department of Children and Family Services can assist you with information on how you may pursue a smoke free environment for them, should you decide to pursue this further.

2.  We have two boys – 12 & 14 – and I’m very concerned about how aggressive some girls are.  They call and text at all hours, wear suggestive clothing, and many seem way too interested in “getting physical” for my comfort.  How do I deal with this without my boys tuning out?

Unless you want to risk taking on the entire peer population of your boys, we suggest you use some simple ‘limit’ setting that will provide them with a clear message from you.  Begin with limits on when the phone is to be used.  There should be blackout periods for phone usage beginning sometime around bed time, and extending until breakfast.  Other times may be during class, homework time, or possibly during ‘family’ time.  Whatever you decide should make sense and be reasonable.

Other guidelines you can provide your boys is that there is to be no ‘sexting’ – texting that has overt sexual references.  Check their texts from time to time.  Explain to your boys that until they are a certain age that it is not acceptable to have exchanges of touching of the genital areas.  By the way, if you have not spoken to your boys about sex, now is a perfect time. Be sure to talk about appropriate and inappropriate behavior between boy and girls.  The guidelines for this is pretty much the same as their school’s guidelines. Most schools do  have a ‘family life’ curriculum which covers academic sex topics, but it does not set guidelines or provide morals for which behaviors are appropriate and which are not.

As far as the girls wearing suggestive clothing;  much of it is the accepted fashion of today (blame our generation).  However, while many girls like to wear clothes that show off their physical features, there are very few of them that would wear something that exposes entire genital areas or all of their breast.  Unless you see something that really pushes the limits, it is best to focus on your boys.

The questions above are from parents who live in the South Bay. The responses have been provided by members of the South Bay Coalition whose expertise and experience lies in parenting, counseling, and/or substance abuse prevention. The South Bay Coalition is a non-profit partnership of agencies working to prevent substance abuse among our community’s youth. For local resources or more information, please visit our website or contact:

Parenting 101

August 2011

1.  We have two sons – 17 & 12 – the older is constantly ranting about his belief that drugs (especially marijuana) should be legalized.  He goes on and on about how using drugs doesn’t hurt anyone and how smoking weed is better for you than drinking, etc., etc.  I’m worried his attitude will spill over to our younger son.  Any advice on how to handle & dispel my older son’s beliefs will be much appreciated.

It would be rare for someone who did not indulge in Marijuana (or other drug) use to be so passionate about it being legalized or to make patently ridiculous statements like “using drugs doesn’t hurt anyone.”   While handling and attempting to dispel his beliefs is important, a far more important issue is very likely to be his substance use, and if it is active, any movement in his belief system is unlikely.  If you see any signs or symptoms of active drug use, please address those with an addiction professional ASAP.

The arguments about  the use of drugs in our society are extensive and complex. Unfortunately, there is no iron clad way to dispel your older son’s beliefs.  People using Marijuana are less prone to violent acts than drinkers of alcohol, but marijuana has far more profound negative effects on memory and motivation…and the back and forth could go on nearly endlessly.  We encourage you to look into the research and clinical evidence available on Marijuana, most easily available on the internet.  Some facts about marijuana use include:  it has been found that marijuana smoke contains  50 -70 percent more carcinogens than tobacco smoke!  Since users inhale the unfiltered smoke deeply and hold for a longer period of time, the lung tissue is irritated resulting in coughing, phlegm and increased risk of emphysema.  THC also has a negative impact on the immune system,  resulting in more frequent bouts with bacterial infections and respiratory illnesses. Since marijuana reduces memory retention and attention span, learning is compromised, resulting in decreases of accomplishment in the classroom or workplace. Chronic marijuana smokers  have a higher frequency of divorce and disruptive family life.

Begin a conversation with your older son on the grounds of looking at how we form our opinions and the importance of bias in both the presentation and interpretation of information.  Start with a genuine curiosity about how he has formed his beliefs about Marijuana and where he has gotten his information from.  If he is using Marijuana, he is unlikely to have either the ability or the inclination for a serious discussion about beliefs, bias and life – which leaves you with this standard parental response as your best option:  “while I can respect your opinions about marijuana or other drugs, the rules in our house will always be  that any illegal alcohol or other drug use is strictly prohibited, and,  any talk that promotes or encourages substance use is not allowed in the house.”  The same rules apply for the 12 year old.

If your older son is using, that will have a far more profound impact on your younger son than his verbally expressed beliefs. Older siblings are a tremendously powerful influence and most especially at the ages your sons currently are.  A concern that your question also raises is whether you are more focused on protecting your younger son and have almost given up on your older son.  A good family counselor with a strong knowledge and experience base in substance abuse could be an invaluable asset in addressing your situation.

2.  I suspect my 15 year old daughter is using marijuana – how can I tell?  What should I do?

You are fortunate in that Marijuana is one of the substances that  is easiest to find on a urine drug screen and can be found for many days after last use.  We strongly recommend testing.  Most often a parent’s suspicions do not arise until sometime after use has actually started. It is important that you have the test done by an entity with expertise in the drug testing process, like a local drug and alcohol treatment center,  rather than through a family physician.  A treatment center can help you make sure the test is valid, interpret the results,  and help guide you to appropriate help if the test is positive. It is important that you ask for a quantitative test, as if it is positive you will want to be able to look for increasing or decreasing levels of THC on future tests. There are many ways to cheat on drug tests and this information is readily available to even novice users. Your daughter needs to be unaware of the test until it happens. This is one of the few tests you do not want her studying for.  Be prepared for resistance on her part, which, if she is actively using, may be quite fierce. Avoid anger and judgment and make this an issue of protecting her health and safety.  Additionally, Whether she is using or not, you are sending a clear message that you are paying attention to her actions and you have no tolerance for any illegal use of alcohol or other drugs.  If your child does refuse, take it as a greater sign that she likely is using.  If she tries to guilt you into not giving the test by saying you need to just trust her, a good response would be:   “a clean test will provide me with the knowledge to trust you more!”

The questions above are from parents who live in the South Bay. The responses have been provided by members of the South Bay Coalition whose expertise and experience lies in parenting, counseling, and/or substance abuse prevention. The South Bay Coalition is a non-profit partnership of agencies working to prevent substance abuse among our community’s youth. For local resources or more information, please visit our website or contact:

Parenting 101

July 2011
1.   Our 14yr old daughter is becoming very difficult to handle.  She’s verbally abusive to everyone in the family and has been physical with me on a couple of occasions-nothing major just a shove.  Her younger brother is actually becoming fearful of her.  Not sure how to deal with this.  We’ve talked about counseling but she refuses to go.
Of course there could be many, many reasons for your daughter to be acting this way.  Without being familiar with your existing family system ( meaning, how your family deals with conflict, stress, and change) and also, without knowing if there has been any stressful or even traumatic incidents in her life, it is very difficult to provide a definitive answer.  But assuming that none of the factors above are playing a role in her thinking, it looks as if she is on her way, if not already there, to being a bully.  Bullying is a trait in children, most often learned from observing some adult model in their life that teaches them to get their way by pushing the limits as far as they think it is possible to do so.  A clear example of this is the ‘shove’ she gave you.  She was careful not to push you too far, but far enough for you to be emotionally responsive.  Her brother is an easy target for her to practice on.  She does not realize how much long-term negative effect it will have on their relationship because, even at 14, she is still a child.  We see bullying in many children and especially in smart kids who have a strong desire to get their way.  The more response, positive or negative, the more they engage in this behavior.

Even her refusing to go to counseling is a bullying tactic.  Our suggestion is that you schedule family counseling and require everyone to go.  Make sure you find a counselor who is familiar with bullying and will know how to help the entire family.

2. My 13 year old son is generally a pretty good kid – good looking, athletic, smart & funny.  Two issues concern me a) pretty much everything is a joke to him – he’s laid back almost to the point of lazy – and takes very little seriously; and b) he’s always been a big kid, but now I’m really concerned about his eating.  Sometimes it’s almost like he just can’t stop himself – I try to keep an eye on him but this worries me.
Sounds like a great many things are going on with your son, least of all would be a poor sense of self.  Even very smart, good looking, and athletically gifted kids are often attempting to prove something to themselves and to others.  ‘Disordered eating’ is a strong sign of a distorted sense of who he is, and what his worth is to others.  His laid back attitude could be his way of making sure he does not disappoint others, and especially himself. 

If his eating habits begin to negatively affect his good health, or his attitude begins to spiral down his progress in school, it is time to seek professional help – someone who specializes in children’s  issues.

The questions above are from parents who live in the South Bay. The responses have been provided by members of the South Bay Coalition whose expertise and experience lies in parenting, counseling, and/or substance abuse prevention. The South Bay Coalition is a non-profit partnership of agencies working to prevent substance abuse among our community’s youth. For local resources or more information, please visit our website or contact: