When Paul Little was 19 he became addicted to prescription pain pills. Now as medical director of an addiction hospital, he helps teens recover from substance abuse and makes sure his own two daughters understand the dangers of drug use by testing them often.

By Paul Little, M.D.
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Jason* was just 14 years old when he started abusing prescription pain pills, stealing them from his parents and grandparents. By age 16, he was using heroin. Soon, he was cutting the heroin with fentanyl, and nearly died from an overdose. It was the wake-up call he needed to seek help for his extensive addiction and destructive behavior.

Stephanie* also began using drugs as a young teen, getting them from friends at parties and at school. Now at age 18, she’s expecting her second child while undergoing intensive rehabilitation therapy to overcome the demons of addiction.

Illicit drug use is a parent’s worst nightmare, and it’s a problem I know all too well. Not only do I see teens like Jason and Stephanie every day in my work at an addiction treatment hospital in Aliso Viejo, California, but I also lived through addiction. Following a routine surgery, I became addicted to prescription pain pills while working as a physician in the U.S. Air Force.

Thanks to my wife and my commanding officer, I was fortunate to get the treatment I needed. But the situation cost me my Air Force career, earning me an “other than honorable” discharge, and forcing me to call my mom on Mother’s Day to tell her I’d been admitted to rehab. That was 19 years ago, and while it was a tough journey, it inspired me to make it my life’s work to help others recover from substance use.

I’ve seen the turmoil substance use causes in a young life. I was determined to help my own daughters avoid the same fate.

Talking About Drugs With Kids

When my wife and I began hearing rumors of drug use among kids at our daughters’ schools, we sat down and had a frank discussion with our girls, then ages 12 and 16. They knew of classmates who used pills, and even some who used heroin—even in middle school.

One night, I casually brought it up at the dinner table: “What would you think if we drug tested you?” They looked at each other, both smiled and responded: “Sure.”

They were actually eager to do it out of novelty, which put me at ease that they had nothing to hide. But rather than treat it like an inquisition, we approached it like a science experiment. We explained how the test kits worked and walked through the process together, analyzing the results and discussing what a “positive” result would look like and what it would mean. I tested them randomly once or twice more through their teen years, and we never had an issue.

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Tips for Testing

If you’re a parent considering a drug test for your child, it’s important to know the right approach makes all the difference in maintaining a healthy relationship and a drug-free child. Here are some tips:

  1. Start with a conversation. Ask your child about issues with drugs at school, or if they’re aware of kids who use drugs. Talk to them about how dangerous it is to try drugs, to get involved with people who do, and how quickly things can spiral out of control.
  2. Keep the conversation going. Make sure kids know they can come to you if they’re concerned about a friend, or if they have been offered drugs or have taken drugs and don’t know what to do. Make it clear you won’t punish them simply for asking. They may be scared and looking to you for help, so don’t panic. Bring up the idea of testing and see how they react.
  3. Don’t spring it on them. Don’t wait up for them to come home late one night and hand them a urine cup. Conduct the test when it’s a normal day, not in a moment when you’re suspicious and will come across as accusatory.
  4. Get them involved. Explain that you’re not trying to “catch them” doing anything wrong, but you’re trying to protect them and keep your home safe. Buy the test kit together, talk about the different types of substances it detects and discuss the risk of false positives. Perhaps even discuss an incentive program, with rewards for clean tests.
  5. Keep an eye on their behavior. If you notice changes—they become isolated, depressed, stay out later, seem chronically tired, are frequently late for school or activities, school performance declines, etc.— it’s time for an intervention. Confront them about the behavior, explain that you’re worried and bring up the idea of a test.
  6. Involve their doctor. If you’re not comfortable conducting the test at home, or if you suspect there’s already a problem, make an appointment with your child’s pediatrician. He or she can explain the medical risks of substance use, conduct more in-depth testing, and serve as an independent third-party to the discussion, to prevent a you-versus-your-child confrontation.

To those who think drug testing their kids is invasive and undermines trust, I say: 1) not if you approach it correctly and 2) it’s better than finding out too late that they have a problem. Building a solid relationship with your kids, along with honest conversations, is critical to helping them survive their teen years, and the issue of drug use is no different.

I recommend drug testing children beginning around age 12, or when they start middle school. I know it sounds very early, but you’d be surprised how many adolescent patients tell me they began using drugs at age 12 or 14. And, studies show the earlier drug use begins, the likelihood of it developing into dependence or addiction increases dramatically. Like any disease, early detection is critical.

My Child Tested Positive. Now What?

If your child’s test comes back positive, don’t panic. It’s natural to feel angry or frustrated, driven by fear, but that’s the last thing your child needs right now. First, recognize that it could be a false positive. Next, schedule an appointment with your pediatrician or family doctor. They can conduct testing to determine if, and to what extent, your child has been using drugs and whether treatment is warranted.

The good news is that substance use among teens has declined substantially, now at its lowest level in over two decades, with the rate among 12th graders down 30 percent over the last five years. Of course, that’s little consolation to parents who discover their child has a problem. As the saying goes, an ounce of prevention is worth a pound of cure, so talk to your kids before it’s too late.

*Names changed to protect privacy

Paul Little, M.D., is the medical director of Laguna Treatment Hospital in Aliso Viejo, California. Dr. Little is an advocate for family involvement in addiction treatment. In his spare time, Dr. Little enjoys reading novels, mountain biking, hiking, and spending quality time with his family.

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