Parents of teenagers’ friends can have as much effect on the teens’ substance use as their own parents, according to a new study.

“Among friendship groups with ‘good parents’ there’s a synergistic effect - if your parents are consistent and aware of your whereabouts, and your friends’ parents are also consistent and aware of their (children’s) whereabouts, then you are less likely to use substances,” said Michael J. Cleveland, research assistant professor at the Prevention Research Centre and the Methodology Centre, Penn State.

In the study, 9,417 ninth-grade students were surveyed during the spring semester, and then again the following spring semester. The subjects came from 27 different rural school districts in Pennsylvania and Iowa, all participating in the Promoting School-university-community Partnerships to Enhance Resilience (PROSPER) study.

In ninth grade, the students were asked to name five of their closest friends. The researchers then identified social networks within the schools by matching up the mutually exclusive friendships. Overall, the team identified 897 different friendship groups, with an average of 10 to 11 students in each group.

At that time students also responded to questions about their perceptions of how much their parents knew about where they were and who they were with. They were also asked about the consistency of their parents’ discipline.

In the tenth-grade follow-up, participants answered questions about their substance use habits, specifically their use of alcohol, cigarettes and marijuana.

Researchers found parenting behaviours and adolescents’ substance-use behaviours to be significantly correlated that higher levels of parental knowledge and disciplinary consistency leading to a lower likelihood of substance use, whereas lower levels lead to a higher likelihood of substance use.

It was also found that behaviours of friends’ parents influenced substance use even when taking into account the effects of the teens’ own parents’ behaviours and their friends’ substance use, demonstrating the powerful effect of peers on adolescent behaviour

For example, if adolescents’ parents are consistent and generally aware of their children’s activities, but the parents of the children’s friends are inconsistent and generally unaware of their own children’s activities, the adolescents are more likely to use substances than if their friends’ parents were more similar to their own parents.

“The peer context is a very powerful influence,” said Cleveland. “We’ve found in other studies that the peer aspect can overwhelm your upbringing.”

According to the authors, this to be the first study where parenting at the peer level proved to have a concrete and statistically significant impact on child outcomes.

“I think that it empowers parents to know that not only can they have an influence on their own children, but they can also have a positive influence on their children’s friends as well,” said Cleveland. “And that by acting together the notion of ‘it takes a village’ can actually result in better outcomes for adolescents.”

The study was published in this month’s issue of the Journal of Studies on Alcohol and Drugs.

   Adopted children are twice as likely to abuse drugs if their biological parents did too, suggesting that genetics do indeed play a role in the development of substance abuse problems.However, trouble or substance abuse in the adoptive family is also a risk factor, according to a study of more than 18,000 adopted children inSweden.

This suggests that both environment and biological family history can influence a child’s likelihood of future drug use.”For someone at low genetic risk, being in a bad environment conveys only a modestly increased risk of drug abuse,” says lead study author Dr. Kenneth S. Kendler, professor of psychiatry and human genetics at Virginia Commonwealth University in Richmond. “But if you are at high genetic risk, this can put your risk for drug abuse much higher.”

 The findings should be reassuring to adoptive parents, and to people who are thinking about adopting, because they show the importance of a positive environment, experts say.  “A child who is adopted, just like a child who is biological, does carry a certain genetic risk, but this shows that the environment they’re being raised in and how their genetic risk interacts with that is probably much more important for the potential development of any disease, including substance abuse and dependence,” says Dr. Lukshmi Puttanniah, director of child and adolescent psychiatry at Lenox Hill Hospital in New York, who was not involved with the study.

 The study, published this week in the Archives of General Psychiatry, included 18,115 children born inSwedenbetween 1950 and 1993 and later adopted. Overall, 4.5% of adopted individuals had drug-abuse problems as identified by Swedish medical, legal and pharmacy records, versus 2.9% of people in the general population.

But 8.6% of those who had at least one biological parent who abused drugs had their own abuse problems versus 4.2% of adoptees whose biological parents did not have a history of drug abuse.

 Adopted children had roughly double the risk of drug abuse if their biological full- or half-sibling had similar issues. But the risk was about the same if their adoptive siblings — those who had no biological connection to them — had abused drugs.

In general, trouble in the adoptive family, such as parental divorce, death, criminal activity, and alcohol problems was linked to a higher risk of drug abuse in the adopted child. There are a number of things adoptive parents — and biological parents for that matter — can do to minimize the risk of their children experimenting with drugs and alcohol, say experts.

“If parents are responsible, are monitoring their children’s behavior, paying attention to them, spending time with them, that’s going to have a positive effect and protect them from going down the path of alcohol and drug abuse,” says Maria M. Wong, Ph.D., associate professor of psychology at Idaho State University in Pocatello.

 ”Knowing the medical history of children who will be adopted is always a good idea, however . . . genes are not destiny,” adds Dr. Wilson Compton, director of the division of epidemiology, services, and prevention research at the National Institute on Drug Abuse, which helped fund the study. “This study shows that in a healthy, safe, and secure environment with little exposure to drug abuse and other problems in the adoptive relatives, even children with multiple drug abusing biological relatives do much better than those whose adoptive families don’t provide such advantages.”

But the current study omitted some factors, some of which might be important to current and future adoptive parents.For instance, the researchers didn’t know when the adopted child joined his or her new family.

“Children who are adopted at age 5 are in a different risk category from newborns,” says Dr. Lisa Albers, director of the Adoption Program at Children’s Hospital Boston.

 And the study probably underestimates the number of drug users given that drug abuse was identified only if a person had had a brushwith the law, had been hospitalized or had a certain prescription history. That sets a “relatively high bar,” Albers says.  In any event, rates of drug abuse in theU.S.tend to be higher than inSwedenor other Scandinavian countries, says Kendler.  Also, researchers didn’t take into account changes in adoption in the last 50 years.

 For instance, many more children placed for adoption today have birth parents with a history of substance abuse compared with 50 years ago, says Albers.

On the other hand, the medical community has moved forward “light years” in its understanding and ability to handle other risk factors for substance abuse, such as ADHD, impulse control challenges, mental health concerns like anxiety or significant trauma, which may have occurred prior to the child coming into the family — all of which are risk factors for substance abuse, says Albers.

“If we have parents with a history of drug abuse, we can probably do better . . .. if we address the early signs that put the child at risk for drug abuse,” says Albers.

“Joining an adoptive family that is supportive even if you’re genetically at high risk is a very positive thing,” she adds.

Source:   www.health.com  5th March 2012

TORONTO, Nov. 2 — Methamphetamine can be detected in the hair of newborns whose mothers used the drug during pregnancy, researchers here have found.

Action Points

Note that this study shows that methamphetamine used during pregnancy can be found in the hair of neonates, suggesting it crosses the placental barrier with effects that are not completely understood.

Advise patients who ask that drug abuse during pregnancy can be detrimental to the fetus, with a range of physical and intellectual sequelae, as well as hazardous to the mother.

It represents the first direct evidence in humans that crystal meth, which is a growing drug-abuse problem in North America, can cross the placenta and affect the growing fetus, according to Facundo Garcia-Bournissen, M.D., of the Motherisk program at the Hospital for Sick Children.
Researchers at the program have been testing hair samples from parents and adults across Canada for several years, usually when there is clinical suspicion of drug abuse on the part of parents, Dr. Garcia-Bournissen and colleagues reported in the online issue of Archives of Disease in Childhood.
From June 1997 through December 2005, the database accumulated results of 34,278 tests for drugs in hair, representing 8,270 people. Nearly 60% (or 4,926) of these people were positive for at least one drug of abuse, the researchers said.
In a retrospective analysis, Dr. Garcia-Bournissen and colleagues examined the incidence of methamphetamine in hair samples:
• The first methamphetamine was found in hair in 2003, when six samples tested positive, with a slight increase in 2004, with eight cases.
• There were 372 cases in 2005 and the researchers said preliminary data for 2006 indicates that the surge has not stopped.
• The study identified 11 mother-neonate pairs in which each was positive for methamphetamine.
• Also, one newborn was negative, although the mother was positive.
The median methamphetamine values in the mother-baby pairs were 1.75 ng/mg for the mothers and 1.63 ng/mg for the newborns. Dr. Garcia-Bournissen and colleagues said.
The median concentrations were not significantly different, “suggesting that the transplacental transfer of methamphetamine is extensive,” the researchers said. On an individual level, maternal and neonatal drug levels correlated significantly (at P=0.003, using Spearman’s rho test, with r=0.8).
Interestingly, among the 171 subjects who were positive for methamphetamine and whose hair was tested for other drugs, 83.5% were positive for at least one other drug, usually cocaine, Dr. Garcia-Bournissen and colleagues found.
In contrast, among the 1,053 subjects negative for methamphetamine but positive for some other drug, only 38% were positive for more than one drug, they said.
“Positive exposure to methamphetamine strongly suggests that the person is a polydrug user, which may have important implications for fetal safety,” the researchers said.
The effects of the drug on the exposed child remain unclear, Dr. Garcia-Bournissen and colleagues noted, although there is some evidence that “children exposed in utero to methamphetamine are at risk of developmental problems, because of either the effect of direct exposure to the drug during pregnancy or growing in the environment associated with parental methamphetamine misuse, or probably both.”
Because the study was retrospective and anonymous, clinical information on the exposed infants is not available, the researchers said.

Source: www.medpage.today.com 2nd Nov. 2006

Children of drug addicts are suffering in desperation as shame and secrecy shroud the substance misuse in families, it was claimed today.

Youngsters whose parents take drugs are also more likely to have problems with substances, as well as their mental health, social skills and academically, a seminar heard. Joan O’Flynn, director of the National Advisory Committee on Drugs (NACD), said there is a need for more integration between addiction services, children’s services and medical professionals.

“Alcohol and drugs misuse by parents can impact negatively on a child’s experience of positive parenting and can create stressful family circumstances that impact on child development,” she said. “For many of the affected children, the effect of their parents’ substance misuse continues into their adult lives.

“For some, the impact can be multifaceted and persist not only into adult life but even into the lives of the next generation.” She added that stress, combined with the increased likelihood of the child being in care or homeless, leaves young people at a high risk of emotional isolation or social marginalisation.

Alcohol Action Ireland estimates between 61,000 and 104,000 children aged under 15 are living with parents who misuse alcohol. Director Fiona Ryan said: “Shame and secrecy shroud the issue of substance misuse in families with children living lives of quiet desperation.

“Alcohol Action Ireland has spent the past three years campaigning for children affected by parental alcohol problems to be seen and heard.” An NACD report – ‘Parental Substance Misuse: Addressing its Impact on Children’ – was launched at a seminar it jointly hosted with the Health Service Executive (HSE) and Alcohol Action Ireland, the national charity for alcohol-related issues.

The report reviewed all major international research on the impact of parental substance misuse on children and identified what steps can be taken in Ireland to reduce its impact.

It recommended additional research and data be collected to properly estimate the number of children whose parents have substance misuse problems. It also wants an assessment of which adult alcohol and drug treatment services are supporting parents and liaising with child support services. Women should also be educated on the adverse effects of consuming alcohol and drugs during pregnancy, it added.

Source: www.IrishExaminer.com 26th October 2011

TORONTO, Nov. 2 — Methamphetamine can be detected in the hair of newborns whose mothers used the drug during pregnancy, researchers here have found.
Action Points

• Note that this study shows that methamphetamine used during pregnancy can be found in the hair of neonates, suggesting it crosses the placental barrier with effects that are not completely understood.
• Advise patients who ask that drug abuse during pregnancy can be detrimental to the fetus, with a range of physical and intellectual sequelae, as well as hazardous to the mother.

It represents the first direct evidence in humans that crystal meth, which is a growing drug-abuse problem in North America, can cross the placenta and affect the growing fetus, according to Facundo Garcia-Bournissen, M.D., of the Motherisk program at the Hospital for Sick Children.
Researchers at the program have been testing hair samples from parents and adults across Canada for several years, usually when there is clinical suspicion of drug abuse on the part of parents, Dr. Garcia-Bournissen and colleagues reported in the online issue of Archives of Disease in Childhood.
From June 1997 through December 2005, the database accumulated results of 34,278 tests for drugs in hair, representing 8,270 people. Nearly 60% (or 4,926) of these people were positive for at least one drug of abuse, the researchers said.
In a retrospective analysis, Dr. Garcia-Bournissen and colleagues examined the incidence of methamphetamine in hair samples:

• The first methamphetamine was found in hair in 2003, when six samples tested positive, with a slight increase in 2004, with eight cases.
• There were 372 cases in 2005 and the researchers said preliminary data for 2006 indicates that the surge has not stopped.
• The study identified 11 mother-neonate pairs in which each was positive for methamphetamine.
• Also, one newborn was negative, although the mother was positive.

The median methamphetamine values in the mother-baby pairs were 1.75 ng/mg for the mothers and 1.63 ng/mg for the newborns. Dr. Garcia-Bournissen and colleagues said.
The median concentrations were not significantly different, “suggesting that the transplacental transfer of methamphetamine is extensive,” the researchers said. On an individual level, maternal and neonatal drug levels correlated significantly (at P=0.003, using Spearman’s rho test, with r=0.8).
Interestingly, among the 171 subjects who were positive for methamphetamine and whose hair was tested for other drugs, 83.5% were positive for at least one other drug, usually cocaine, Dr. Garcia-Bournissen and colleagues found.
In contrast, among the 1,053 subjects negative for methamphetamine but positive for some other drug, only 38% were positive for more than one drug, they said.
“Positive exposure to methamphetamine strongly suggests that the person is a polydrug user, which may have important implications for fetal safety,” the researchers said.
The effects of the drug on the exposed child remain unclear, Dr. Garcia-Bournissen and colleagues noted, although there is some evidence that “children exposed in utero to methamphetamine are at risk of developmental problems, because of either the effect of direct exposure to the drug during pregnancy or growing in the environment associated with parental methamphetamine misuse, or probably both.”
Because the study was retrospective and anonymous, clinical information on the exposed infants is not available, the researchers said.

Source: www.medpage.today.com 2nd Nov. 2006

In this Dutch study, promoting parental rule setting and classroom alcohol education together nearly halved the proportion of adolescents who went on to drink heavily. Rarely have such strong and sustained drinking prevention impacts been recorded from these types of interventions.

Summary

This Dutch study tested the long-term impact of the Örebro intervention (first developed and tested in Sweden) targeting parental rule-setting in relation to the drinking of their adolescent children, allied with classroom alcohol education. The parenting element entailed a brief presentation from an alcohol expert at the first parents’ meeting at the start of each school year on the adverse effects of youth drinking and the negative effects of permissive parental attitudes towards children’s alcohol use. After this parents of children from the same class were meant to meet to agree a shared set of rules about alcohol use. In fact, only half the schools did this; the remainder used the later mailing to send a checklist of candidate rules to parents for them to select from and return to the school. Three weeks after this meeting, a summary of the presentation and the result of the classroom discussion was sent to parents’ home addresses. Classroom alcohol education consisted of four lessons from trained teachers at the schools plus a booster a year later, using mainly computerised modules to foster a healthy attitude to drinking and to train the pupils in how to refuse offers of alcohol.
The 19 schools which joined the study were randomly allocated to the parenting intervention alone, to classroom alcohol education alone, to the combination of both, or to act as control schools which carried on with alcohol education as usual.
An earlier paper from the same study reported that relative to education as usual, among the 2937 (of 3490) 12–13-year-olds not already drinking weekly and who met other criteria for the study, the combined parenting and education intervention curbed the initiation of weekly drinking and heavy weekly drinking over the next 22 months (and reduced the frequency of drinking). In contrast, on their own, neither the parenting elements nor the lessons made any significant difference when the whole sample of children not yet drinking weekly at the start were included in the analyses.

Main findings

The featured report tested whether these effects were still apparent a year later, 34 months after the start of the study and when the pupils averaged just over 15 years of age, a time when two thirds of Dutch youngsters are already drinking weekly and will soon (age 16) be able to legally buy alcohol. Of the 2937 in the initial sample of non-weekly drinkers, 2533 (86%) completed the follow-up assessment. The probable responses of the remainder were estimated on the basis of prior assessments and other data. As before, the parenting elements or alcohol education alone had made no statistically significant differences to drinking, but the impacts of both together in retarding uptake of weekly and heavy weekly drinking were greater than a year before chart. Compared to 59% and 27% in education-as-usual control schools, after the combined intervention 49% and 15% of pupils were drinking weekly or drinking heavily each week. After adjusting for other factors, the results meant that in combined intervention schools, the odds of these patterns of drinking versus less extreme drinking had been reduced to 0.69 relative to education as usual, highly statistically significant findings. Put another way, for every four pupils allocated to parenting plus alcohol education, one was prevented from drinking weekly and also one from drinking heavily each week at age 15.

The authors’ conclusions

In a liberal drinking culture where adolescent and underage drinking is common, targeting both parents and young adolescent pupils (but not either on their own) exercises a sustained and substantial restraining influence on the development of regular and regular heavy drinking as the youngsters approach the legal alcohol purchase age. The findings underline the need to target adolescents as well as their parents and of targeting adolescents at an early age, before they start to drink regularly and when family factors are a major influence on youth drinking. Doing so has the potential to create appreciable public health gains.

Source: Koning I.M., van den Eijnden R.J., Verdurmen J.E. et al.
American Journal of Preventive Medicine: 2011, 40(5), p. 541–547.

Many mothers and fathers think that allowing their children to have a supervised drink is a good way of exposing them to alcohol safely and taking away its illicit thrill. But new research suggests it sends mixed signals that result in them being more likely to abuse alcohol as they enter their core teenage years.
A joint American-Australian study of more than 1,900 12 and 13-year-olds found that those whose parents took such a “harm minimisation” approach were more likely to have experienced “alcohol-related consequences” – such as not being able to stop drinking, getting into fights, or having blackouts – two years later than those whose parents had a “zero-tolerance” strategy.
A year into the study, almost twice as many Australian teenagers (67 per cent) had drunk alcohol in the presence of an adult than their American counterparts (35 per cent), reflecting general attitudes in Australia and the US when it comes to supervised underage drinking.
The following year, just over a third (36 per cent) of the Australians had experienced alcohol-related consequences compared to only a fifth (21 per cent) of the Americans.
While cultural differences alone could feasibly account for the disparity, the results also found that teens who had been allowed to drink while supervised were more likely to have had such experiences regardless of which country they were from.
The results of the study, conducted by the Centre for Adolescent Health in Melbourne, Australia, and the Social Development Research Group in Seattle, USA, are published today in the Journal of Studies on Alcohol and Drugs.
British attitudes to teenage drinking are more similar to those in Australia than America, a matter reflected in law. While in the UK and Australia one can buy an alcoholic drink in a pub or off-licence from the age of 18, in the US the minimum age is 21. However, two years ago Sir Liam Donaldson, then England’s chief medical officer, said children under 15 should never be given alcohol, even though it is legal for parents to give a child over five alcohol in the home.
A separate Dutch study of 500 12-to-15-year-olds, also published in the JSAD today, found that it was the amount of alcohol available at home, and not how much parents drank, that determined teenage drinking habits – suggesting parents should keep their drinks cabinets locked.
Dr Barbara McMorris, of Minnesota University, who led the first study, said: “Both studies show that parents matter. “Despite the fact that peers and friends become important influences as adolescents get older, parents still have a big impact.” She added: “Kids need parents to be parents and not drinking buddies. Adults need to be clear about what messages they are sending. Kids need black and white messages early on. “Such messages will help reinforce limits as teens get older and opportunities to drink increase.”

Source: www.telegraph.co.uk/health 28th April 2011

A new study suggests that the brain damage suffered by children whose mothers used metamphetamine during pregnancy may be even worse than the effects that alcohol has on a fetus.

Researchers at the University of California, Los Angeles, found that some of the brain regions of meth-exposed children were even smaller than in alcohol-exposed children. One such region is the caudate nucleus, which plays a role in learning, memory, motor control, and motivation.

“Our findings stress the importance of drug abuse treatment for pregnant women,” said research team leader Elizabeth Sowell.

According to Sowell and her colleagues, being able to identify which brain structures are affected in meth-exposed children may help predict the specific types of leaning and behavioral problems that will afflict these children.

 Source:  The Journal of Neuroscience. March 17 2011

A new assessment tool may allow doctors to evaluate the impact of methamphetamine on babies exposed in the womb. The tool may help identify which babies will go on to develop problems due to exposure to the drug, according to a new study.

Medical News Today reports that doctors at the Warren Alpert Medical School of Brown University andWomen & InfantsHospital inProvidence,RI, looked at the effects of prenatal exposure to methamphetamine in 185 newborns and compared them with 195 newborns who were not exposed to meth, but were exposed to alcohol, tobacco or marijuana before birth.

They reported at the Pediatric Academic Societies meeting inDenver that an assessment tool called the NICU Network Neurobehavioral Scale (NNNS) was used to evaluate the babies during the first four days of life and again when they were one month old.  The tool evaluates the babies’ muscle tone, reflexes, behavior, motor development and stress.

The researchers said that the tests could help identify which babies are doing well and which are the ones who could benefit from intervention and prevention services.

Source: www.drugfree.org/join-together  3^rd May 2011

An Evaluation of the Kids, Adults Together Programme (KAT)

INTRODUCTION
A key influence on the timing of young people’s first alcohol use is the family (Spoth et al. 2002) and a number of substance misuse prevention programmes (mainly in the USA) have tried to influence families. Most are based in schools, which potentially provide an efficient way to reach large numbers of young people and their families (Bryan et al. 2006). However, in practice, school-based initiatives have not always managed to engage significant numbers of parents (Lloyd et al. 2000; Rothwell et al. 2009; Stead et al. 2007; Ward and Snow 2008).
This report describes the findings from an exploratory evaluation of a new school-based alcohol misuse prevention programme – Kids, Adults Together (KAT), which engaged with parents as well as children. The programme comprised a classroom component for children, a family fun evening, and a DVD. The research study evaluated the development and early implementation of KAT, and aimed to establish the theoretical basis for the programme. It explored implementation processes and acceptability, and identified plausible precursors of the intended long-term outcome which could be used as indicators of likely effectiveness.
METHODS
Mixed qualitative data-collection methods were used during two phases of evaluation. The first phase of the evaluation investigated how KAT had originated and developed; its relationship to existing evidence and theory; and its aims. Methods used were an analysis of thirty-two documents selected by the programme organizers and meant to provide an ‘audit trail’ of programme development up until the start of the evaluation; a literature search; and interviews with six members of the working group who had been involved in setting up the programme, the programme organiser and his assistant, the KAT DVD producer and the organiser of the Australian PAKT programme (on which KAT is based).
The second phase comprised observation of the classroom preparation and KAT family events in two pilot schools; focus groups with forty-one children; interviews with both head teachers and with teachers who delivered the classroom preparation; follow-up interviews with the programme organisers and six Working Group members; interviews with twelve parents who attended the KAT family events; and a questionnaire for parents of all 110 children who had been involved in the classroom preparation. There were two rounds of focus groups and parent interviews: the first as soon as possible after the KAT event at each school and the second months later.
Programme aims
The main aim of KAT was identified as reducing the number of children and young people who engaged in alcohol misuse. Exploration of the programme’s implementation suggested that family communication should be reaffirmed as its primary objective. This was consistent with the social development model (Catalano and Hawkins 1996) which links family communication with children’s alcohol-related behaviour later in life.
Acceptability
KAT achieved high levels of acceptability among pupils, parents and school staff. Parents enjoyed the fun evening, and thought it was delivered in an, engaging and non lecturing way. Participants thought it was good that the KAT programme had been run in the school setting, and felt that such work should be delivered to children at a young age. Staff in both pilot schools believed that the way in which the evening was promoted as an opportunity for parents to find out what their children had been working on helped avoid a perception that the fun evening was designed to lecture parents.
INITIAL IMPACT
Communication
The KAT programme’s most significant and persistent impact on communication was the effect on family conversations about parental drinking. Many children who thought their parents drank too much alcohol reported trying to change their (parents’) behaviour.
The classroom preparation was effective in promoting communication about alcohol issues amongst members of the class but outside the classroom, its effect was minimal, and until the work had culminated in the fun evening, few children said much at home about it. Most children were very keen to go to the fun evening, to show off their work, to see what it was like and to enjoy the refreshments and entertainment. Many put pressure on their parents to attend.
The fun evening acted as a catalyst for setting off conversations about what children had done in the classroom and activities during the evening. The DVD was effective in extending the influence of the programme beyond the school-based components.
Knowledge
Both children and parents reported having gained new knowledge about alcohol as a result of their involvement with the KAT programme.
Attitudes
There was little evidence that involvement in KAT (as a whole or its constituent components) had led to changes in parents’ or children’s attitudes to alcohol consumption. Overall the children held critical attitudes towards alcohol and the effects which its consumption might lead to. Most parents who were concerned about the dangers of alcohol and the use of alcohol by their children held pre-existing concerns or attitudes.
Awareness
KAT raised children’s and parents’ awareness of issues relating to alcohol and some parents had thought about their own drinking practices, particularly how drinking alcohol in front of their children could influence them.
Intention
Evidence from participants suggested that KAT had only a small effect on intentions regarding future behaviour. These intentions were often stimulated by specific aspects of the programme such as the DVD or leaflets in the goody bag.
Behaviour
There was evidence from some parents and children at both schools that drinking behaviour of parents and other family members had changed as a result of KAT. The effect was not confined to those who had attended the fun evening, suggesting that KAT was able to influence communication within wider networks of family and friends.
IMPLICATIONS
The report highlights five main findings from the evaluation of KAT:
1. KAT has demonstrated promise as an alcohol misuse prevention intervention through its short term impact on knowledge acquisition and pro-social communication with family networks
2. The interaction between the programme’s core components (classroom activities, family fun evening and the programme DVD/goody bag) appear to have been integral to the impact on knowledge acquisition and communication processes that occurred within participating families
3. The timing of KAT (its delivery to children In primary school Years 5 and 6) is appropriate both because it precedes the onset of drinking (or regular drinking), and because it engages families whilst they are still a key attachment and influence in young people’s lives
4. KAT achieved high levels of engagement and acceptability among parents, and this included some families with problems/support needs in relation to alcohol
5. Engagement levels among parents were higher among mothers than fathers. The research was not able to explore the in-depth experiences of those parents/carers who did not or could not attend the KAT fun evening
The following five recommendations are made for the future development and evaluation of KAT:
1. Further research is needed to refine and develop the theoretical model of how KAT works, whether short term changes in knowledge, communication and behaviour are sustained over the longer term, and how these processes might reduce alcohol misuse
2. KAT needs to be delivered and evaluated in different school contexts to further test its underpinning model, and explore the acceptability and local adaptation of the programme within these settings
Future research needs to explore in more detail the reach of the programme (including the engagement of fathers), examine what barriers to attendance might exist and put in place strategies to minimise them
3. Future stages of implementation should clarify if KAT specifically aims to reach families with problems/support needs in relation to alcohol, or whether it is intended as a primary prevention intervention for general school populations
4. It is important to address the support needs of children whose attempts to discuss issues raised by KAT (particularly around parental drinking) are rejected or not received positively by their parents

Source: http://www.aerc.org.uk/insightPages/libraryIns0070.html Alcohol Insight number 70

Research Summary

The more parents expect their teens to engage in risky behaviors such as drinking and using drugs, the more likely their teens are to follow through with those behaviors, Reuters reported Oct. 16.
Researchers found that adolescents with mothers who expected them to be more rebellious and take greater risks reported higher levels of risky behavior than other adolescents during follow-up surveys.
On the other hand, parents may lower the rate of risky behavior among their adolescent children by expecting that they can resist negative peer pressure and instead engage in positive behavior, according to the study.
“Parents who believe they are simply being realistic might actually contribute to a self-fulfilling prophecy,” said study author and Wake Forest University psychology professor Christy Buchanan. “By thinking risk-taking or rebelliousness is normal for teenagers and conveying that to their children, parents might add to other messages from society that make teenagers feel abnormal if they are not willing to take risks or break laws.”
The study’s recommendations for parents included modeling good behavior for their teens, exposing them to examples of positive things that other teens are doing, and making sure their teens know there are consequences to risky behavior.
The study was based on surveys of more than 200 6th- and 7th-graders and their mothers.
Source: Journal of Research on Adolescence. June 2009

A new American study suggests that parental monitoring can help bring down the cases of marijuana use by adolescents.
Psychologists Andrew Lac and William Crano of the Claremont Graduate University examined various studies to find the connection between parental monitoring (when parents know where their children are, what company are they in and what they are doing) and adolescent marijuana use.
Lac and Crano selected 17 studies containing data on over 35,000 participants. They assessed parental monitoring on the basis of admissions made by adolescent themselves and not their parents’ reports of keeping an eye on their children. The researchers found a strong link between parental monitoring and the decreased use of marijuana by adolescents.
The authors write: “Our review suggests that parents are far from irrelevant, even when it comes to an illegal and often secretive behavior on the part of their children.” They also believe that their analysis might come in handy for marijuana-prevention programs that are aimed at parents.
The findings of the review have been published in the latest issue of Perspectives on Psychological Science, a journal of the Association for Psychological Science. (ANI)

Source: Health Wise November 17th, 2009

A new Australian study suggests that parental encouragement leads to alcoholism in teenagers. The latest MBF Healthwatch survey found that 63percent of Aussies in the higher income bracket approve of alcohol consumption by 15 to 17 year olds at home under the eyes of parents.
“Our survey suggests many Australians believe it’s acceptable to buy alcohol for teenagers and allow them to drink under parental supervision at home,” Bupa Australia Chief Medical Officer, Dr Christine Bennett, said.
Dr Bennett continued: “Some parents may think this is harmless; some may see this approach as a way to teach their teenage children about socially responsible drinking. But we want parents to understand that early exposure may actually be doing them damage. “Evidence suggests that the earlier the age that alcohol is introduced, the greater the risk of long-term alcohol related health problems.
“Binge drinking in young people is on the rise. Too much alcohol impairs young people’s judgement, which can lead to violence, injury and build a pattern of use that leads to lifetime dependence. “It’s shocking to think that one teenager a week dies of alcohol abuse. We teach children about the harmful effects of smoking, unsafe sex and taking illicit drugs, but we also need to teach them about the damage that alcohol can do.”
The survey also found that people’s acceptance of supervised underage drinking was closely related to their income levels. Nearly 63percent people earning over 100,000 dollars approved supervised drinking; 53percent people with incomes between 70,001 to 100,000 dollars were comfortable with the idea followed by 48percent people getting paychecks ranging from 40,001 to 70,000 dollars.
Dr Bennett added: “Given that social drinking is a common part of the Australian culture, our challenge is to help our young people learn how to enjoy alcohol in a socially responsible way and protect them from harm now and in the long-term.
“That will mean educating young people about the risks of underage drinking and, as parents and a community, being good role models.”

Source: Health News Dec. 3rd 2009

Children, whose parents allow them to have alcohol at home in a bid to teach responsible drinking, drink even more outside of home, a new study claims.
A study of 428 Dutch families has found that teens who drank under their parents’ watch or on their own were at a greater risk of developing alcohol-related problems. The researchers insists that the study puts into question the advice of some experts who recommend that parents drink with their teenage children with the aim of limiting their drinking outside of the home.
Dr. Haske van der Vorst, the lead researcher on the study, said: “The idea is generally based on common sense. For example, the thinking is that if parents show good behavior-here, modest drinking-then the child will copy it. Another assumption is that parents can control their child’s drinking by drinking with the child.” Every family, which was quizzed, had two children between the ages of 13 and 15. Parents and teens completed questionnaires on drinking habits at the outset and again one and two years later.
The researchers found that, in general, the more teens drank at home, the more they tended to drink elsewhere; the reverse was also true, with out-of-home drinking leading to more drinking at home.
In addition, teens who drank more often, whether in or out of the home, tended to score higher on a measure of problem drinking two years later.
Haske van der Vorst, of Radboud University Nijmegen in the Netherlands concluded: “I would advise parents to prohibit their child from drinking, in any setting or on any occasion. “If parents want to reduce the risk that their child will become a heavy drinker or problem drinker in adolescence, they should try to postpone the age at which their child starts drinking.” (ANI)

Source: Health News. Jan 28th 2010

From the founding of National Families in Action during the height of the War on Drugs to Joseph A. Califano’s book, How to Raise a Drug-Free Kid, parents and communities have been touted as the keys to preventing alcohol and other drug problems among youth, and research now shows that environmental and genetic risk factors can be trumped by parental engagement during the critical adolescent years, according to Nora D. Volkow, M.D., director of the National Institute on Drug Abuse (NIDA).
“Parents are incredibly important in raising drug-free kids, but in many instances they are not there or are not involved” — absences that can have measurable effects on brain development as well as other aspects of growing up — said Volkow. For example, studies of orphans have demonstrated that the brains of children who lack connections to parents actually mature more slowly, raising the risk of drug use and other impulsive behaviors. Half of all vulnerability to addiction can be traced to an individual’s genetic background, but that hardly means that a child’s fate is sealed if they have a family history of addiction. Rather, Volkow said that addiction is, in many ways, a developmental disorder that is intimately linked to the maturation of the brain from childhood through adolescence and into early adulthood.
Delivering the keynote address at the Nov. 17 CASACONFERENCESM How to Raise a Drug-Free Kid: The Straight Dope, organized by the National Center on Addiction and Substance Abuse (CASA*) at Columbia University, Volkow compared this brain development to a sculptor taking a block of stone and transforming it into a work of art.
“In childhood the brain is particularly ‘plastic,’” said Volkow. “It is open to stimuli much more than as an adult, and these stimuli affect brain formation both physically and chemically. A child’s cerebral cortex — the brain’s center for memory, attention, perceptual awareness, thought, language, and consciousness — starts out larger than that of an adult, but shrinks as the brain differentiates during the first two decades of life. “The brain of an adult is much more connected than that of a child,” noted Volkow.
The frontal cortex — critical for using cognitive control to regulate desires — is the last part of the brain to fully differentiate, said Volkow, which helps explain why adolescents are especially prone to risk-taking and experimentation. As the brain advances on its “developmental trajectory” it can be strongly influenced by environmental factors, she said. Social stresses are crucially important,” Volkow said, pointing to the Adverse Childhood Experience (ACE) Study research showing that risk of drug abuse rises tenfold among individuals who experience five or more “adverse childhood experiences,” such as recurrent physical or emotional abuse.
“Studies of children raised in orphanages showed that their brain connectivity was much less developed than those with normal parenting,” added Volkow; the effect was most pronounced among the children who had been living in orphanages the longest. The research “directly connected the lack of parenting to delays in the development of the brain,” she said. Children who are genetically predisposed to addiction rarely suffer from drug problems if they have parents who are actively involved in their lives, according to researchers. Those who have both genetic vulnerability and absent or uninvolved parents have a “very significant increase in drug addiction,” however, according to Volkow.
Studies of prevention programs like “Preparing for the Drug-Free Years” (PDF) and “Communities That Care” demonstrate that parents, families and communities can create an environment that is protective against youth drug abuse. Moreover, said Volkow, researchers have found that interventions can actually improve dopamine levels in the brain. Even though kids may be born to very adverse environments, the plasticity of the brain now gives us a path forward in terms of identifying interventions to help reverse the changes caused by these stimuli and increase the likelihood that kids will be able to stay drug-free,” said Volkow.
The NDPA would agree with the comments below – you can be an excellent parent and still have a child who chooses to use drugs…. However, the article ids also correct in stating that parents who know as much about illegal drugs as their children and who parent ‘actively’ (i.e. know where their children are, who are their friends, how are they achieving in school etc.) are less likely to have the problem of drug use in their family.
COMMENTS ON THIS ARTICLE:
Posted by Amy Rosenman, MD on 07 Dec 09 02:07 PM EST
This review is too simplistic.There are still many children brought up in ideal circumstances who develop drug problems. This review still seems to “blame” the family for something beyond their control in many circumstances. However, knowing that family involvement and support is crucial gives many hope that recovery is possible. I too have worked with families of addiction for many years in my medical practice. 12 step programs are very valuable and help keep the family relationships constructive.
Posted by Emily on 07 Dec 09 06:28 PM EST
I agree that parental involvement helps prevent drug abuse, but I know of families that were doing everything right, and their child still became addicted to drugs. In at least one case, the child had no risk factors for substance abuse other than an alcoholic grandparent. I think it is important for parents to know that a family history of alcoholism or drug abuse should not be ignored. In such cases, parents need to be better educated regarding what to do to prevent substance abuse and how to recognize it when it happens.
Posted by Jay Arr on 10 Dec 09 10:35 AM EST
We are the product of our reactions to all the forces of our genes, enviroment, inter-personal relationships,cultural impact, and our reactions to them. Sometimes we are the victims by being stuck in a prison of emotional immaturity. Alcohol and drugs beckon us to escape this life of lies and the lies eventually become our reality. The reality is SAD-S for stigma, A for apathy, and D for denial..I was saved by Alcoholics Anonymous-25 years ago.
Source: CASA Conference. Columbia University Nov. 17th 2009

Children in families experiencing alcohol or drug abuse need attention, guidance and support. They may be growing up in homes in which the problems are either denied or covered up. These children need to have their experiences validated. They also need safe, reliable adults in whom to confide and who will support them, reassure them, and provide them with appropriate help for their age. They need to have fun and just be kids.
Families with alcohol and drug problems usually have high levels of stress and confusion. High stress family environments are a risk factor for early and dangerous substance use, as well as mental and physical health problems. It is important to talk honestly with children about what is happening in the family and to help them express their concerns and feelings. Children need to trust the adults in their lives and to believe that they will support them. Children living with alcohol or drug abuse in the family can benefit from participating in educational support groups in their school student assistance programs.
Those age 11 and older can join Alateen groups, which meet in community settings and provide healthy connections with others coping with similar issues. Being associated with the activities of a faith community can also help. Dependence on alcohol and drugs is our most serious national public health problem. It is prevalent among rich and poor, in all regions of the country, and all ethnic and social groups. Millions of Americans misuse or are dependent on alcohol or drugs. Most of them have families who suffer the consequences, often serious, of living with this illness. If there is alcohol or drug dependence in your family, remember you are not alone. Most individuals who abuse alcohol or drugs have jobs and are productive members of society creating a false hope in the family that “it’s not that bad.”
The problem is that addiction tends to worsen over time, hurting both the addicted person and all the family members. It is especially damaging to young children and adolescents. People with this illness really may believe that they drink normally or that “everyone” takes drugs. These false beliefs are called denial; this denial is a part of the illness. Alcoholism and other drug addiction have genetic and environmental causes. Both have serious consequences for children who live in homes where parents are involved. More than 28 million Americans are children of alcoholics; nearly 11 million are under the age of 18. This figure is magnified by the countless number of others who are affected by parents who are impaired by other psychoactive drugs.
Alcoholism and other drug addiction tend to run in families. Children of addicted parents are more at risk for alcoholism and other drug abuse than are other children. Children of addicted parents are the highest risk group of children to become alcohol and drug abusers due to both genetic and family environment factors. Biological children of alcohol dependent parents who have been adopted continue to have an increased risk (2-9 fold) of developing alcoholism. Recent studies suggest a strong genetic component, particularly for early onset of alcoholism in males. Sons of alcoholic fathers are at fourfold risk compared with the male offspring of non-alcoholic fathers. Use of substances by parents and their adolescent children is strongly correlated; generally, if parents take drugs, sooner or later their children will also. Adolescents who use drugs are more likely to have one or more parents who also use drugs. The influence of parental attitudes on a child’s drug taking behaviors may be as important as actual drug abuse by the parents. An adolescent who perceives that a parent is permissive about the use of drugs is more likely to use drugs.

Source: Public Service Announcement from SAMHSA in the public domain 27th Jan 2010

Parents who try to teach responsible drinking by letting their teenagers have alcohol at home may be well intentioned, but they may also be wrong, according to a new study in the latest issue of the Journal of Studies on Alcohol and Drugs.

In a study of 428 Dutch families, researchers found that the more teenagers were allowed to drink at home, the more they drank outside of home as well. What’s more, teens who drank under their parents’ watch or on their own had an elevated risk of developing alcohol-related problems. Drinking problems included trouble with school work, missed school days and getting into fights with other people, among other issues.

The findings, say the researchers, put into question the advice of some experts who recommend that parents drink with their teenage children to teach them how to drink responsibly — with the aim of limiting their drinking outside of the home.

That advice is common in the Netherlands, where the study was conducted, but it is based more on experts’ reasoning than on scientific evidence, according to Dr. Haske van der Vorst, the lead researcher on the study.

“The idea is generally based on common sense,” says van der Vorst, of Radboud University Nijmegen in the Netherlands. “For example, the thinking is that if parents show good behavior — here, modest drinking — then the child will copy it. Another assumption is that parents can control their child’s drinking by drinking with the child.”

But the current findings suggest that is not the case.

Based on this and earlier studies, van der Vorst says, “I would advise parents to prohibit their child from drinking, in any setting or on any occasion.”

The study included 428 families with two children between the ages of 13 and 15. Parents and teens completed questionnaires on drinking habits at the outset and again one and two years later.

The researchers found that, in general, the more teens drank at home, the more they tended to drink elsewhere; the reverse was also true, with out-of-home drinking leading to more drinking at home. In addition, teens who drank more often, whether in or out of the home, tended to score higher on a measure of problem drinking two years later.

The findings, according to van der Vorst, suggest that teen drinking begets more drinking — and, in some cases, alcohol problems — regardless of where and with whom they drink.

“If parents want to reduce the risk that their child will become a heavy drinker or problem drinker in adolescence,” she says, “they should try to postpone the age at which their child starts drinking.”

Available at: http://www.jsad.com/jsad/link/71/105

Source: H. van der Vorst Journal of Studies on Alcohol and Drugs 71 (1), 105-114. Jan 2010

• Compared to 12- and 13-year olds who have frequent family dinners, those who have infrequent family dinners are six times likelier to use marijuana, four times likelier to use tobacco, and three times likelier to use alcohol.
• Compared to teens who attend religious services at least weekly, those who never attend services are more than twice as likely to try cigarettes, and twice as likely to try marijuana and alcohol.
• Compared to teens who have frequent family dinners, those who have infrequent family dinners are one and a half times likelier to report getting grades of C or lower in school. 

Source: www.casacolumbia.org   Sept.2009

A recent study published in the Journal of Epidemiology and Community Health has revealed that women who continue to smoke during pregnancy are more likely to have children with behavioral problems. Disturbances caused can show signs as early as when the child is three years old.
For the sake of the study, over 14,000 mothers and child pairs were observed. The pairs were picked from the millennium cohort study. All the children observed had been born between 2000 and 2001. Professor Kate Pickett from the Hull York medical school, University of York, carried out the research.
Mothers, who were categorized as light or heavy smokers with regards to the number of cigarettes they smoked each day during pregnancy, were given a questionnaire which required them to score their children’s behavior. While 12.5% women said they smoked lightly and 12.4% said they had stopped smoking altogether when pregnant, 10% admitted to smoking heavily all throughout the term.
Based on the data collected, the study confirmed that children whose mothers smoked heavily were two times more prone to behavioral problems, a thing which kept going down as the number of cigarettes smoked during pregnancy went down. According to the study, smoking when pregnant, damages the developing structure and functioning of the fetus’s brain. Boy fetuses are more prone to damage.
Source:www.topnews.net.nz 3/11/2009

As frequency of family dinners increases, reported drinking, smoking and drug use decreases.Compared to teens who have frequent family dinners (five to seven family dinners per week), those who have infrequent family dinners (fewer than three per week) are twice as likely to have used tobacco or marijuana, and more than one and a half times likelier to have used alcohol.

The relationship between the frequency of family dinners and substance use is especially strong among the youngest teens in the survey.

Compared to 12- and 13-year olds who have five to seven family dinners per week, those who have fewer than three family dinners per week are six times likelier to have used marijuana, four times likelier to have used tobacco, and three times likelier to have used alcohol.

Source: www.casacolumbia.org Sept.2009

Half of all U.S. children live in a house where a parent or other adult uses tobacco, drinks heavily or uses illegal drugs, according to a report released on Tuesday.
These adults are three times more likely to abuse their children and four times more likely to neglect them than parents who do not abuse alcohol or drugs or use tobacco, said the report from Columbia University’s National Center on Addiction and Substance Abuse.
“Children of alcohol and drug abusers are at increased risk of accidents, injuries and academic failure. Such children are more likely to suffer conduct disorders, depression or anxiety, conditions that increase the risk children will smoke, drink and use drugs,” the center said in a statement.
The report is an analysis of the center’s own research as well as dozens of reports from groups ranging from Alcoholics Anonymous, U.S. government surveys on families and health behavior and the Children’s Defense Fund, a nonprofit social welfare organization.   It found that 35.6 million U.S. children, about half of all children in the country, live in a home where a parent or other adult uses tobacco, drinks heavily or uses illicit drugs.
More than 37 percent of U.S. children live with an adult who uses tobacco, nearly 24 percent live with a binge or heavy drinker and 12.7 percent live in a household where a parent or other adult uses illicit drugs, the report found.
Several studies show that children exposed to household cigarette smoke have a higher risk of sudden infant death syndrome, asthma and ear infections. They are more likely to have their tonsils or adenoids surgically removed and recent studies show they have a bigger risk of cancer and heart disease.
“If substance abusing parents are not concerned about what drugs, alcohol and tobacco are doing to themselves, they should be concerned about the ill effects they have on their children,” center Chairman Joseph Califano said.
“Children of substance abusing parents are much likelier to become substance abusers themselves,” he added.
“A child who gets through age 21 without smoking, using illegal drugs or abusing alcohol is virtually certain never to do so.”

Source:   WASHINGTON (Reuters) Mar 29, 2005

In a new study, researchers have determined that prenatal exposure to cigarette smoking, when combined with a specific genetic variant, places children at increased risk for aggressive behavior and other behavioral problems.
The study, led by scientists at the Institute for Juvenile Research at the University of Illinois at Chicago, identified a long-lasting influence on a child’s behavior precipitated by the monoamine oxidase A (MAOA) gene variant in conjunction with prenatal exposure to tobacco. MAOA is an enzyme which regulates key neurotransmitters in the brain. 
The genetic variant responsible for increased risk of behavioral problems differs between boys and girls, researchers said. In boys exposed to tobacco smoke prenatally, the low-activity MAOA (MAOA-L) gene variant was associated with increased disruptive social interactions, aggressive behavior, and serious rule-violating.
Among girls, the high-activity MAOA (MAOA-H) gene variant was associated with increased disruptive behavior. In addition, girls with both the MAOA-H variant and prenatal exposure to cigarette smoke had an increased “hostile attribution bias” — a tendency to perceive anger in a range of facial expressions — that was not seen among boys.
There was a higher risk of disruptive behavior for both boys and girls the more their mother smoked during pregnancy, according to the study.
“The tendency to over-perceive anger suggests the possibility that the combination of prenatal tobacco exposure and the MAOA risk variant affects the brain’s processing of emotional cues,” said Lauren Wakschlag, the study’s principal investigator. “Clearly, close attention to sex differences in these patterns will be critical for future studies,” she said.

Source:Join Together. March 16th 2009

A literature review
Results
The most extensive and consistent evidence relates to young people’s interaction with their
families. The key predictors of drug use are parental discipline, family cohesion and parental
monitoring. Some aspects of family structure such as large family size and low parental age
are linked to adolescent drug use. There is also consistent evidence linking peer drug use
and drug availability to adolescent drug use. There is extensive evidence on parental
substance use, although some studies report no association while others indicate that the
association is attenuated by strong family cohesion. Age is strongly associated with
prevalence of drug use among young people reflecting a range of factors including drug
availability, peer relationships and reduced parental monitoring. There is limited evidence
suggesting that genetic factors account for a significant proportion of the variance in liability to
use cannabis, however this interpretation has been criticised by other writers. There is a
similar level of evidence linking self-esteem and hedonism to drug use. The available
evidence indicates that higher levels of drug use are strongly associated with young people’s
reasons for using drugs after controlling for risk factors.
Categories where evidence linking specific factors is mixed include: mental health, Attention
Deficit Hyperactivity Disorder (ADHD), stimulant therapy, religious involvement, sport, health
educator interventions, school performance, early onset of substance use and socioeconomic
status. For some of these categories there is evidence of indirect effects; for
example, socio-economic status may influence parental monitoring which in turn influences
drug use. The review did not consider any studies relating to previously identified risk and
protective factors such as ethnicity or impulsivity.
For young drug users in treatment, psychosocial risk predicts drug abuse at treatment entry
but not follow up. In contrast, protective factors are of increased importance during recovery
The overall ratio of risk to protection may be more important than any individual factor. These
results, although supported by a relatively small body of research, support the concept of
resilience to drug use. According to this view resilience to drug use is enhanced by increasing
social skills, social attachments and material resources despite constant exposure to known
risk factors.
Whereas risk and resilience are, to a large extent, independent of individuals’ motives, there
is evidence that the latter are just as important as the former in determining drug use. Young
drug users consistently report getting intoxicated and relief from negative mood states as
reasons for their drug use. Qualitative research shows that the context in which young people
experience drugs is crucial for understanding how risk and protective factors operate in
relation to experimental and sustained drug use.
Risk factors have differential predictive values throughout adolescence. Some factors may
occur at birth (or before) while others occur at varying times throughout adolescence. Some
factors may persist for long periods of time while others are transitory. The distinction
between early and late onset risk factors is important as preventive measures need to focus
on particular age groups.
Conclusion
This review was pragmatic because it was time constrained and not all the studies identified
could be reviewed in detail. From the studies reviewed, the evidence relating to factors
associated with increased (or decreased) risk of drug use is described. Further analysis would
require a detailed assessment of individual studies, with clear specification of exposures (risk
and protective factors), outcomes (type and level of drug use) and study design (i.e. did
exposure precede the outcome).
Much of the current knowledge about risk and protective factors is not yet available in a form
that would permit the calculation of the effect of reducing exposure to risk (or enhancing
protective factors), even if was possible to modify the exposure. The evidence indicates that
risk and protective factors are context dependent and operate on people taking drugs for
disparate reasons. With these caveats, improving the general social environment of children
and supporting parents will probably be the most effective strategies for primary prevention of
drug use. Studies indicating that risk and resilience can be successfully altered include
interventions for parental monitoring and enhancement of social attachments and skills.
These interventions show promise but have rarely been implemented or evaluated in the UK.

Source:   Home Office OnLine report 05/07 Martin Frisher et al

Research Summary
A Penn State researcher says that parents who let teens drink alcohol may be setting their kids up for binge drinking in college, but the study by Caitlin Abar of the school’s Prevention Research and Methodology Center makes no distinction between parents who simply let kids drink some wine during meals and those whose permissiveness extends to drinking outside the home.
Science Daily reported June 11 that Abar surveyed 300 college freshmen and correlated their alcohol use to the drinking rules set down by their parents. Abar found that students whose parents never allowed them to drink were less likely to report heavy drinking in college.
On the other hand, “the greater number of drinks that a parent had set as a limit for the teens, the more often they drank and got drunk in college,” said Abar.
Abar said the research argues in favor of “zero tolerance” for teen drinking and against the theory that parental restrictions on drinking casts alcohol as attractive “forbidden fruit” and leads to greater temptation to drink in college. Whether or not parents themselves drank had little impact on college binge drinking, Abar added.
Thirty-one states allow parents to legally serve alcohol to children under age 21.
The research was presented at the recent and.
Source: annual meeting of the Society for Prevention Research ,to be published in the journal Addictive Behaviors June 24, 2009

Children of drug users are at high risk for developing substance use disorders themselves later in life. From 1991 to 1993, researchers funded by NIDA recruited families, with a parent in methadone treatment for heroin addiction and at least one young child, into a randomized trial of the Focus on Families (FOF) intervention, which includes relapse prevention services and parent training skills. Results from the original analysis of the trial showed that FOF both reduced parents’ drug use and improved children’s delinquent behavior compared with participants in the control group, who only received standard services provided by methadone clinics. To assess whether FOF continued to have an effect on children as they grew up, the researchers performed a 12-year followup study—85 percent of the children originally enrolled in the trial participated. Of those, 59 percent had met the criteria for a substance use disorder at some point in their life. Overall, the rates of substance use and dependence were similar between childhood participants in the FOF and control groups. However, when the results are broken down by gender, males who received the FOF intervention had a significantly lower risk of developing a substance use disorder—specifically, alcohol and marijuana disorders—than those in the control group. This may be because the FOF intervention focuses on teaching parents to handle externalizing problem behaviors (such as getting into fights), which are more common in boys than girls, explain the authors. Of concern was the fact that at the time of the followup study, 32 percent of the parents in the FOF group had died, compared to 13 percent of parents in the control group. High mortality is typical in long-term studies of patients on methadone, though the researchers could not find evidence that higher exposure to the FOF intervention was related to mortality in this study. In fact, the highest mortality rate was found among families who were assigned to FOF but never participated in the skills training or case management. FOF participants who attended 75 percent or more of the assigned sessions had about the same mortality rate as participants in the control group.

Source: Haggerty KP,et al. Long-term effects of the Focus on Families project on substance use disorders among children of parents in methadone treatment. Addiction. 2008 Oct 8

There is growing policy and practice interest in the effect of parental substance misuse – both drugs and alcohol – on children. Despite this, young people are often neglected in both policy discussion and service provision. This qualitative study was undertaken in Scotland and explored the lives of 38 young people between the ages of 15 and 27 years whose parents have or had a drug and/or alcohol problem. It found:

• Parental drug and alcohol misuse created considerable problems for most of the young people. Many felt that their parents were unable to provide consistent practical or emotional care. While the effects of drug and alcohol abuse were similar, the former brought with it more anxiety and social stigma and the latter was more associated with violence and parental absence.

• Many of the young people felt their childhood was shortened through having to assume early responsibility for their own and others’ wellbeing.

• Although the young people in this study lived in a range of circumstances, they showed resilience and adaptation in finding ways to deal with their difficulties.

• A sense that others, especially parents, cared about them even when they did not care for them helped them keep going.

• Informal relationships – with extended family members, neighbours, friends and friends’ families – were very important. But such support was seldom either reliable or unconditional.

• Where experienced, a strong personal relationship with a service worker was highly valued.

• The young people shared similar goals and dreams – of jobs, houses and families – but not all were on the way to achieving this. Education and work were key factors in putting them in a position to achieve their goals.

In the UK there are estimated to be between 250,000 and 350,000 dependent children living with parental drug misuse, and 920,000 living with parental alcohol misuse. Parental substance misuse can cause considerable harm. Children are at risk from emotional and physical neglect as they grow up. They also risk developing emotional and social problems later in life. Both outcomes are of growing concern to policy and practice. Older children, especially those aged 16 and over, are often neglected in policy discussion and in service provision. More needs to be known about their lives so that effective policy and service support can be developed.

The study involved interviews with 38 young people between the ages of 15 and 27 years old (most were between 16 and 21) who had been affected by parental substance misuse. The late teens and early twenties is a period of transition to adulthood, and interviews explored past experiences and present situations, before asking interviewees to consider the future.

While most of the young people came from socio-economically disadvantaged backgrounds, six had middle-class backgrounds. Some of the young people appeared to be managing well for themselves, and within this group several were in higher education. Others had relatively chaotic or precarious lives. Twelve had serious drug problems; most of this group were receiving treatment.

• ways to support continued ties with a parent or parent-figure where this is desired by the young person while at the same time supporting the young person in independent living above the age of 16.

• Young people should be involved in debates about the kinds of support they need and value. It is important to recognise their own ability to manage adverse life circumstances.

• Children who care for adults and siblings, and foster carers within the immediate family, should be supported. Young carers’ groups were especially appreciated by those involved with them. Non-stigmatising acknowledgement of the situation of the young carers together with informal and unobtrusive support can prove extremely helpful.

• Youth work could do more to help young people set themselves up as independent people. An expansion of such services might help support young people affected by parental substance misuse as they grow up.

The study was based at the Centre for Research in Families and Relationships at the University of Edinburgh. Data was collected using in-depth qualitative interviews conducted by Sarah Wilson. Interviewees were recruited from a wide range of drug, youth work and homelessness services, and through leafleting and ‘snowballing’.

How to get further information

The full report, Parental drug and alcohol misuse: Resilience and transition among young people by Angus Bancroft, Sarah Wilson, Sarah Cunningham- Burley, Kathryn Backett-Milburn and Hugh Masters, is published by the Joseph Rowntree Foundation as part of the Drug and Alcohol series (ISBN 1 85935 248 0, price £13.95)..

According to a new report, more teens first try marijuana in June and July than any other months of the year. To help parents prevent their teen from using marijuana this summer, the Office of National Drug Control Policy’s (ONDCP) National Youth Anti-Drug Media Campaign, the YMCA of the USA, and the American Camping Association kicked off this year’s “School’s Out” initiative.

The Media Campaign is offering new action-oriented advice and resources to help parents keep teens drug-free once school is out; a summer drug-free checklist, a summer calendar with suggested activities, and an interactive self-rating tool (Does Your Summer Plan Stand the Heat?). These resources are available on the Campaign’s Web site for parents at www.TheAntiDrug.com/SchoolsOut.

An Alabama doctor who lost a brother to methamphetamine addiction has formed a support group called “After he died, I started looking into it as a physician, as a scientist”, said Dr. Mary Holley, an obstetrician in Albertville. “What is this drug that destroyed his life in just two years?”

Holley formed the group last year and there now are chapters in Tennessee, Georgia, Oklahoma, Missouri, and Ohio.

The group works with churches to form addiction-support groups. In addition, the MAMa website offers information that explains the dangers of meth.

“People don’t realize what this drug is doing,” Holley said. “One look at the brain scan in my pamphlets will change that attitude.”

Holley, a Christian, said a religious approach to treating drug addiction is more effective than law enforcement. “Law enforcement is helpless. They can’t possibly bust every lab. They can’t keep them in jail long enough for them to heal,” Holley said. “Education is helpless. They lack the resources and the moral authority to change the situation.”

Holley said that when speaking with young people, she found that, “20 percent of meth users are basically healthy kids who made a bad decision. About 75 percent are broken, hurting people, abused and battered as kids.

Children with asthma who have at least one parent who smokes are twice as likely to have asthma symptoms all year long compared with children of non-smokers, according to researchers from the University of Michigan (U-M) Health System.The involved in-depth telephone interviews with 896 parents of asthmatic children ages 2 to 12 years old in 10 states. “We set out to look at children who have seasonal asthma symptoms, but found that a substantial percentage have symptoms year-round,” said Kathryn Slish, a researcher in the U-M Department of Pediatrics. “We looked more closely and found a strong relationship between parents’ smoking status and the likelihood that their child would have problems all year long.”

“The only other factor that was associated with year-round symptoms was Medicaid insurance coverage,” added Cabana.

With well-publicized information that secondhand smoke can trigger asthma in children, Slish said, “it’s astounding that so many parents smoke around their asthmatic kids, and don’t stop even though their children are having trouble breathing all year.”

The researchers recommended that pediatricians, family physicians, and nurses address the subject of smoking with the parents of any child diagnosed with asthma and to provide resources to encourage them to quit.

The study’s findings were presented May 4 at the Pediatric Academic Societies annual meeting.

Youth who say their parents would ‘strongly disapprove if they tried marijuana once or twice” used any illicit drug at a rate of 7.1 per cent, compared with 31.2 per cent for youth who thought their parents “did not strongly disapprove.”

A study issued by the Substance Abuse and Mental Health Services Administration’s (SAMHSAs) Center for Substance Abuse Treatment (CSAT) this month found that drug-and alcohol-dependent women who are pregnant or have children significantly reduce their alcohol or drug use as well as criminal behaviour following residential substance abuse treatment. Treatment also produced improved birth outcomes for pregnant women. The study, 1993-2000 Residential Treatment Programs for Pregnant and Parenting Women, evaluated residential substance abuse treatment programs designed for pregnant women or women with infants or older children. The report examined 50 programs that provided on-site residential care for both parents and their children.

Among women in treatment, use of crack declined from 51 percent before treatment to 27 percent six months after treatment. Similar declines were noted in use of marijuana (from 48 percent before treatment to 15 percent after treatment); powder cocaine (34 percent to 9 percent); methamphetamine (21 percent to 6 percent); heroin (17 percent to 6 percent); and alcohol (65 percent to 25 percent). Over 60 percent of women reported being completely drug-and alcohol- free throughout the first six months following discharge from residential care. An additional 13 percent relapsed at some time after discharge but were completely alcohol-and drug-free in the past 30 days. Women who stayed in treatment longer than three months were more likely to remain alcohol-and drug-free than were those who left within the first three months of treatment (68 percent vs. 48 percent).

Criminal Outcomes

As compared to the 12 months prior to treatment, the percentage of clients arrested for alcohol or drug offenses (selling drugs, public intoxication, driving drunk, etc.) declined from 28 percent to 7 percent during the six months following discharge. A decline from 32 percent to 11 percent was seen in the percentage of clients arrested for non-substance offenses, such as shoplifting, burglary, prostitution or assault. Women who remained in treatment longer than three months were less likely to be arrested than were those who left treatment prior to three months – 9 percent vs. 20 percent.

Relationships And Parenting

The percentage of clients living with an alcohol-or drug-involved spouse or partner declined from 45 percent prior to treatment to 12 percent after, according to the report. The percentage of clients reporting that they and their family use drugs together declined from 26 percent to 4 percent.
Clients who had physical custody of one or more children increased from 54 percent before entering treatment to 75 percent after treatment. Clients who had children living in foster care declined from 28 percent before treatment to 19 percent after treatment.

A new survey finds that unsupervised teens are four times more likely to be D students than teens supervised every day. The survey, After School for America’s Teens, released by YMCA of the USA, finds that 59 percent of teens are unsupervised after school at least one day in a typical week. And those teens are more likely to drink alcohol, smoke cigarettes and engage in sexual activity, nearly three times as likely to skip classes at school. They are also three times more likely to use marijuana or other drugs.
The survey of 500 teens 14-17 years of age reveals a strong interest in community and neighbourhood-based after school programs. Although many teenagers participate in after school programs, more than half of all teens (52 percent) wish there were more community or neighbourhood-based activities available. Some 62 percent of teens left alone during the week say they would likely participate in after school programs, while two in three teens (67 percent) expressed interest in programs that would improve their grades, develop leadership skills and involve them in the community.
Unsupervised teens are in the ‘Danger Zone’ the hours of 3 to 6 p.m. after school  when being unsupervised can lead to problems with alcohol, drugs, sexual activity and even crime. This danger cuts across race income and family structure, according to the University of Minnesota’s National Longitudinal Study of Adolescent Health, the largest-ever survey of American adolescents. Teens who are failing school and “hanging out” with friends are more likely to engage in at-risk behaviours.
The After School survey revealed that teens who do not engage in after school activities are five times more likely to be D students than those who do, while nearly eight in 10 teens (79 percent) who participate in after school programs are A or B students. Only half (52 percent) of teens who do not participate earn such high marks.

In a study involving twins, researchers found that addiction to alcohol is often influenced by genetics as well as family environment. For the study, researchers from Palo Alto Veterans – Affairs Health Care System in Menlo Park, Ariz., interviewed 1,213 identical and non-identical male twins  with an average age of 50, 1,270 of the twins’ children, ages 12 to 26, and 862 mothers of those children.

The researchers found that children of twins who had a history of alcohol addiction were more likely to show signs of alcohol misuse or dependence than children of non alcoholic fathers. But while children of alcohol-abusing identical twins whose co-twin was alcohol-dependent were more likely to be alcohol-dependent than children of non alcoholic twins, children of an identical twin with no history of alcohol abuse whose co-twin was alcohol-dependent were no more likely to abuse alcohol than the children of non alcoholic twins. These findings support the hypothesis that family environment effects do make a difference in accounting for offspring outcomes, in particular, that a low-risk environment (i.e., the absence of parental alcoholism) can moderate the impact of high genetic risk regarding offspring for the development of alcohol-use disorders,” the study’s authors said.

Author: Renee Besseling

In 1982, the grocery store on the corner of my street in Amsterdam was replaced by a “coffee shop’ For me, a mother of two young children, this was reason enough to delve into the matter of drugs. Children, who earlier might get an apple from the store owner, were now suddenly greeted by a hemp leaf in the window. For them, in the beginning, this only meant that we had to go some- place else to get fruits and vegetables, but it also quietly introduced the drug-selling coffee shop into their world.

Yesterday’s child is grown up today, and will be tomorrows parent They are the ones who will not only have to support their elders, but look after the younger generation. They ensure society’s development and progression. Their development is important not only for their future, but for that of all of us. Drug use slows down this development – sometimes to a complete stop.

Why a book on drugs from a Dutch perspective?

The reputation of the Netherlands is based to a great extent on the image of liberal Dutch drug policies as portrayed in the American press and entertainment industry as well as in more scholarly books and articles that seek to undermine the war on drugs. Dutch drug policy essentially advertises a use of certain illicit drugs which have been deemed safe’ or “recreational”, inviting users from abroad to try the wide selection of drugs available in Amsterdam while exporting a tolerance detrimental to children and society everywhere.

Discussion in the United States is heating up. While the government actively wages the “war on drugs” in the United States and abroad, voter-supported initiatives on city and state levels seek to decriminalize the use of some drugs, especially marijuana, and install programs in inner cities distributing methadone and syringes. Some countries allow shooting galleries – even giving out heroin to dependent persons. Through the use of these and other “harm reduction” measures, health organizations are failing to combat the causes of drug dependence, leaving the dependent person to their own devices. Now, for the first time – from a parent’s perspective – the destructive liberal drug policies of the Dutch are exposed for the failure they are.

For whom is this book intended?

This book is meant for parents, educators and alarmed citizens to aid then in the debate on drugs. It aims at a better understanding of the mechanisms of dependence and the prevention of drug abuse, but it is also meant to strengthen the position of parents and educators who often find themselves ill-equipped in discussions with so-called experts. Hopefully, this book will be useful as a second opinion for those who are responsible for creating national and local drug policies to counter the simplistic and irresponsible propaganda supporting drug tolerance and ‘harm reduction,”

The author Renee Besseling. is a mother of two children. For the last 20 years she has been involved in the struggle for a restrictive drug control policy in the Netherlands and Sweden. She is co-founder of Europe Against Drugs (EURAD), and currently the International Secretary of the organization. She is a local chapter chairperson of Swedish Immigrants Against Drugs (SIMON) and an international delegate to Drug Watch International (USA).
To order visit www. prponline. net and look under ‘Prevention Books. (ISBN:O-944246-05-2, $19.95) For more information, please contact George T. Watkins at 1-800-453-7733 or george@prponline.net

Half of all U.S. children live in a house where a parent or other adult uses tobacco, drinks heavily or uses illegal drugs, according to a report released on Tuesday.

These adults are three times more likely to abuse their children and four times more likely to neglect them than parents who do not abuse alcohol or drugs or use tobacco, said the report from Columbia University’s National Center on Addiction and Substance Abuse.

“Children of alcohol and drug abusers are at increased risk of accidents, injuries and academic failure. Such children are more likely to suffer conduct disorders, depression or anxiety, conditions that increase the risk children will smoke, drink and use drugs,” the center said in a statement.

The report is an analysis of the center’s own research as well as dozens of reports from groups ranging from Alcoholics Anonymous, U.S. government surveys on families and health behavior and the Children’s Defense Fund, a nonprofit social welfare organization. It found that 35.6 million U.S. children, about half of all children in the country, live in a home where a parent or other adult uses tobacco, drinks heavily or uses illicit drugs.

More than 37 percent of U.S. children live with an adult who uses tobacco, nearly 24 percent live with a binge or heavy drinker and 12.7 percent live in a household where a parent or other adult uses illicit drugs, the report found.

Several studies show that children exposed to household cigarette smoke have a higher risk of sudden infant death syndrome, asthma and ear infections. They are more likely to have their tonsils or adenoids surgically removed and recent studies show they have a bigger risk of cancer and heart disease.

“If substance abusing parents are not concerned about what drugs, alcohol and tobacco are doing to themselves, they should be concerned about the ill effects they have on their children,” center Chairman Joseph Califano said.

“Children of substance abusing parents are much likelier to become substance abusers themselves,” he added.

“A child who gets through age 21 without smoking, using illegal drugs or abusing alcohol is virtually certain never to do so.”
Source: WASHINGTON (Reuters) Mar 29, 2005

Five class-action lawsuits have been filed nationally that accuse the alcohol industry of marketing to underage drinkers.

Lynne and Reed Goodwin are the lead plaintiffs in a case filed in Los Angeles County Superior Court against Miller and Anheuser-Busch; their daughter, Casey, 20, was killed by an 18-year-old drunk driver, and the couple believes that the beer industry encourages kids to drink.

Similar class-action cases have been filed during the past 14 months in Ohio, Colorado, North Carolina, and Washington. The lawsuits accuse the industry of using raunchy and provocative ads to target adolescents in youth-oriented magazines and on TV shows with large youth audiences. Also targeted is marketing of flavored malt beverages (a.k.a. “malternatives” or “alcopops”) like Smirnoff Ice and Mike’s Hard Lemonade, which critics see as appealing to teens who dislike the taste of beer or alcohol.

The lawsuits seek damage awards and restrictions on advertising. Most of the nation’s biggest brewers and distillers are named in one suit or another. The industry says it does not advertise to anyone under age 21 or encourage underage drinking. Companies point to the fact that they have funded “responsible drinking” messages, training for clerks to spot fake IDs, and education for parents about preventing youth drinking.

The companies also challenge the lawsuits for seeking damages for kids or parents who illegally purchased or consumed alcohol. “These cases seek to reward underage drinkers, or their parents, for breaking the law,” said Edward M. Crane, a lawyer for Anheuser-Busch. “That would send an undesirable message to teens — namely that underage drinking is OK and might even be profitable.”

A 2002 federal report estimated that 12-to-20-year-olds consume 11.4 % of all alcohol sold; other studies put the figure closer to 20 % — a $22.5 billion market.

The industry, aware of the impact of the 1998 nationwide tobacco settlement, also has moved to prevent similar lawsuits from being filed by states. Former Mississippi Atty. Gen. Mike Moore, who spearheaded the tobacco settlement, has been hired by Anheuser-Busch, and other former state attorneys general have been retained as lobbyists by other alcohol companies.

Kids of smokers, drinkers especially prone to these behaviors, study findsChildren with a parent who smokes, drinks heavily or uses marijuana are more likely to adopt these behaviors when they’re teens or adults, U.S. research suggests.

Children of smokers are especially at risk, say a team from the University of Washington.

“If your parents were smokers, it is a double whammy because you are more likely to use drugs in general and even more likely to smoke cigarettes,” study co-author Karl Hill, a research associate professor at the university’s Social Development Research Group, said in a prepared statement.

“There is something about tobacco that if parents smoke, their kids are more likely to smoke. It may be that parents who smoke might leave cigarettes around where their children can see and get to them. Parents may not leave marijuana and alcohol around in the same way,” Hill said.

The researchers tracked 808 people who were students when they were first recruited from Seattle elementary schools in 1985. Data was also collected from their parents and their children.

In addition to a family/substance abuse link, the researchers found familial links for child behavior problems such as conduct disorder (fighting, stealing); attention-deficit disorder (lack of focus, inability to sit still or maintain attention); and oppositional-defiant disorder (problems with authority).

“Children of smokers, heavy drinkers, or marijuana users are more likely to have behavior problems when they are young, and consequently more likely to have drug problems themselves as they get old. These children then grow up to be adult substance users, whose kids have behavior problems and the cycle is repeated,” study author and research scientist Jennifer Bailey said in a prepared statement.

The study was published in the current issue of the Journal of Abnormal Child Psychology.

More information

The American Academy of Pediatrics offers information about preventing substance abuse in children.

SCOTS parents want teenagers to be given random drug tests in schools, according to new research.

More than three quarters (78%) of Scottish parents said they would support the move in a bid to stamp out the growing use of drugs in the playground.

The research found that almost all parents (95%) said they were worried about the problem.

Two-thirds (65%) said they backed random testing – because they are afraid schools are not doing enough to tackle the drugs problem.

They want education leaders to introduce random urine tests for recreational drugs such as cannabis, ecstasy and cocaine.

Researchers questioned more than 600 parents and guardians of secondary school teenagers across the UK.

Nearly half of those questioned thought testing was the most effective way to reduce drug abuse among teenagers.

But fewer than one in five thought information campaigns worked.

One in nine wanted an increased police presence near schools that have a problem with drugs.

The poll comes after a study by Glasgow Universities Centre for Drugs Misuse last year found that Scots children as young as ten have taken cocaine and heroin.

And it revealed that hundreds of primary school pupils regularly smoke cannabis and experiment with other Class A drugs.

The most recent study was carried out for drug-test supplier Euromed by market research company, 1FF Research.

Euromed sells tailored test kits – which provide results in under ten minutes – to clients such as NHS trusts and the UK Prison Service.

A spokeswoman for Euromed said: Drug testing in schools is a very sensitive issue and they must be careful if they are considering introducing them.

“But random testing has proven a successful way to tackle drug misuse.

“This research shows how drugs in secondary schools are a worry to parents and how parents are not confident that schools are successfully tacking the issue.”

She added: “In Scotland there was by far the highest concern among all UK parents about drugs being available in secondary schools.

“And more parents in Scotland backed their own children being randomly drug tested.”

The FAN Club involved the parents of youth participating in the Boys and Girls Clubs of America’s SMART Moves program and the SMART Leaders booster program. Participants included parents of 11 to 13-year-old boys and girls of various ethnic groups. The club was designed to strengthen families and promote family bonding, which has been shown to increase children’s resistance to drug use. Parents in the FAN Club received stress management support and participated in educational and enrichment activities, parental leadership activities, and regularly scheduled group social activities.

After their parents participated in the FAN Club, children showed a greater ability to refuse alcohol, marijuana, and cigarettes. They also learned of the health consequences and prevalence of substance use.

The Dare To Be You program included preschoolers, ages 2 to 5, and their families, teachers, and related community members in four ethnically diverse areas in Colorado. Parents participated in a 24-hour educational curriculum where trained facilitators taught them responsibility, personal efficacy, self-esteem, communication and social skills, problem solving and decision-making skills, and child development and home-management strategies. Facilitators also provided them with booster sessions and monthly family group meetings and participated in periodic community events for ongoing support. The children were enrolled in a 20-hour educational program focusing on communications, responsibility, self-esteem, and problem solving.
Dare To Be You showed a dramatic improvement in the parents’ sense of competence, satisfaction with – and positive attitude about – being a parent, and use of nurturing family management strategies. There were substantial decreases in the parents’ use of harsh punishment, and significant increases in the children’s developmental levels compared with non-participant peers.

Preliminary report shows that medical emergency episodes related to marijuana/hashish use have increased 200 percent since 1990. In 1995, 47,100 people among both sexes, all age groups, and across cultures reported to hospital emergency departments for medical care related to their use of marijuana and/or hashish.

A long-term study looking at the PRIDE prevention programme (for youth and parents) over five years found that there had been a continuous decrease in the use of all substances by almost all age groups. One example was that cannabis use by 16 – 17 years old had decreased from 45% to 30% among youths who participated in the programme. [Adams, R., “The PRIDE Survey,” Western Kentucky University, 1989].

In an assessment of 42 schools that participated in parent education and organisation, the findings showed that prevalence rates for cigarettes, alcohol and marijuana were significantly lower at the one year follow-up study. The net increase in drug use prevalence in schools receiving prevention programming was half that of other schools. [Pentz, Dwyer, et al., 1989].

When families are included in school programmes, risk factors can be reduced and early signs of problems can be reversed. One study has shown that three months of targeted family problem-solving training reduced drug use and a correlate factor (school failure) by the end of a 16 month follow-up, while control group families which did not get the training remained the same. [Biy, 1986]. (Quoted in Life Education International Fact Sheet. 1999).

A study of six schools examining the effects of drug prevention lessons for children to complete at home with parents showed that the children reported significantly less perceived peer use of alcohol, tobacco and marijuana, as well as significantly less peer pressure susceptibility to experiment with cigarettes. Mothers reported significantly more recent and frequent communication with their children about refusing drugs and, along with fathers, significantly greater discussions on how to resist peer pressure to use alcohol, tobacco and marijuana. Fathers also reported significantly greater motivation to help their children avoid drug use. [Werch, C.E; et al. Effects of a Take-home Drug Prevention Program on Drug-Related Communication and Beliefs of Parents and Children;” Journal of School Health: 61 (8): 346-350; ~1991].
In general, from existing studies on prevention programmes for parents, it has been found that those assessing children have shown reductions in their use of tobacco and alcohol. [Bry, National Institute on Drug Abuse; 1983].

Parent training can help reduce children’s behaviours that are precursors of drug use and increase positive behaviours such as school achievement, social skills and family involvement. [StouthamerLoeber, 1986].

Introduction
Recent surveys show that we are making progress in our national battle against some drugs.  Casual use is declining, attitudes are changing, and we know more about what works to prevent drug use by our young people.  As parents, we can build on that progress in our own families by having strong, loving relationships with our children, by teaching standards of right and wrong, by setting and enforcing rules for behavior, by knowing the facts about alcohol and other drugs, and by really listening to our children.

Teaching Values
Every family has expectations of behavior that are determined by principles and standards.  These add up to “values.”  Children who decide not to use alcohol or other drugs often make this decision because they have strong convictions against the use of these substances – convictions that are based on a value system.  Social, family, and religious values give young people reasons to say no and help them stick to their decisions.
Here are some ways to help make your family’s values clear:
 

Communicate values openly.  Talk about why values such as honesty, self-reliance, and responsibility are important, and how values help children make good decisions.  Teach your child how each decision builds on previous decisions as one’s character is formed, and how a good decision makes the next decision easier.  Look for conflicts between your words and your actions.  Remember that children are quick to sense when parents send signals by their actions that it’s all right to duck unpleasant duties or to be dishonest.  Telling your child to say that you are not at home because a phone call comes at an inconvenient time is, in effect, teaching your child that it is all right to be dishonest.

Make sure that your child understands your family values.  Parents assume, sometimes mistakenly, that children have “absorbed” values even though they may be rarely or never discussed.  You can test your child’s understanding by discussing some common situations at the dinner table; for example, “What would you do if a person ahead of you in line at the theater dropped a dollar bill?”

Setting and Enforcing Rules Against the Use of Alcohol and Other Drugs
Parents are responsible for setting rules for children to follow.  When it comes to alcohol and other drug use, strong rules need to be established to protect the well being of a child.  Setting rules is only half the job, however; we must be prepared to enforce the penalties when the rules are broken.

Be specific.  Explain the reasons for the rules.  Tell your child what the rules are and what behavior is expected.  Discuss the consequences of breaking the rules: what the punishment will be, how it will be carried out, how much time will be involved, and what the punishment is supposed to achieve.
Be consistent.  Make it clear to your child that a no-alcohol/no-drug use rule remains the same at all times – in your home, in a friend’s home, anywhere the child is.
Be reasonable.  Don’t add new consequences that have not been discussed before the rule was broken.  Avoid unrealistic threats such as, “Your father will kill you when he gets home.”  Instead, react calmly and carry out the punishment that the child expects to receive for breaking the rule.

Getting the Facts
As a minimum, parents should:

• know the different types of drugs and alcohol most commonly used and the dangers associated with each;
• be able to identify paraphernalia associated with each drug;
• be familiar with the street names of drugs;
• know what drugs look like;
• know the signs of alcohol and other drug use and be alert for changes in your child’s behavior or appearance.
• know how to get help promptly if you suspect your child may be using alcohol and other drugs.

Parents who are clear about now wanting their children to use illicit drugs may find it harder to be tough about alcohol.  After all, alcohol is legal for adults, many parents drink, and alcohol is a part of some religious observations.  As a result, we may view alcohol as a less dangerous substance than other drugs.  The facts say otherwise:

• Many teenagers have a drinking problem.
• Alcohol-related accidents are the leading cause of death among young people 15 to 24 years of age.

Children and Alcohol
About half of all youthful deaths in drowning, fires, suicide, and murder are alcohol-related.  Young people who use alcohol at an early age are more likely to use alcohol heavily and to have alcohol-related problems; they are also more likely to abuse other drugs and to get into trouble with the law.  Young people whose body weight is lower than adults reach a higher blood alcohol concentration level than adults and show greater effects for longer periods of time.
We know that smokers are 10 times as likely as non-smokers to develop lung cancer and 3 times as likely to die at early ages from heart attack.  In fact, in 1985, smoking was the leading cause of early death among adults.  Nicotine, the active ingredient in tobacco, is as addictive as heroin, and fewer than 20 percent of smokers are able to quit the first time they try.  Despite these facts, many children use these products.

Facts on Tobacco

• Young people who use cigarettes are also at great risk for all other drug use.
• Cigarettes contain more than 4,000 harmful substances, many of which cause cancer.

Talking With and Listening to Your Child
Don’t wait until you think your child has a problem.  Many young people in treatment programs say that they had used alcohol and other drugs for at least two years before their parents knew about it.  Begin early to talk about alcohol and other drugs, and keep the lines of communication open.
Don’t be afraid to admit that you don’t have all the answers.  Let your child know that you are concerned, and that you can work together to find answers.
Be a good listener.  Listen closely to what your child says.  Don’t allow anger at what you hear to end the discussion.  If necessary, take a 5-minute break to calm down before continuing.  Take note of what your child is Not saying, too.  If the child does not tell you about problems, take the initiative and ask questions about what is going on at school or in other activities.  Young people need to know that they can rely on their parents for accurate information about subjects that are important to them.  If your child wants to discuss something at a time when you can’t give it full attention, explain why you can’t talk, set a time to talk later, and then carry through on it!
Give lots of praise.  Emphasize the things your youngster is doing right instead of always focusing on things that are wrong.  When parents are quicker to praise than to criticize, children learn to feel good about themselves, and they develop the self-confidence to trust their own judgment.
Give clear messages.  When talking about the use of alcohol and other drugs, be sure you give your child a clear no-use message, so that the child will know exactly what is expected.  For example, “In our family we don’t allow the use of illegal drugs, and children are not allowed to drink.”
Model good behavior.  Children learn by example as well as teaching.  Make sure that your own actions reflect the standards of honesty, integrity, and fair play that you expect of your child.
Communication.
Effective communication between parents and children is not always easy to achieve.  Children and adults have different communication styles and different ways of responding in a conversation.  In addition, timing and atmosphere may determine how successful communication will be.  Parents should make time to talk with their children in a quiet, unhurried manner.  The following tips are designed to make communication more successful.
Listening
Pay attention, Don’t interrupt, Don’t prepare what you will say while your child is speaking, Reserve judgement until your child has finished and has asked you for a response.
Looking
Be aware of your child’s facial expression and body language.  Is your child nervous or uncomfortable – frowning, drumming fingers, tapping a foot, looking at the clock?  Or does your child seem relaxed, smiling, looking you in the eyes?  Reading these signs will help parents know how the child is feeling.
Tips
 During the conversation, acknowledge what your child is saying -move your body forward if you are sitting, touch a shoulder if you are walking, or nod your head and make eye contact.
Responding
“I am very concerned about…” or “I understand that it is sometimes difficult…” are better ways to respond to your child than beginning sentences with “You should,” or “If I were you,” or “When I was your age we didn’t…” Speaking for oneself sounds thoughtful and is less likely to be considered a lecture or an automatic response.
If your child tells you something you don’t want to hear, don’t ignore the statement.
Don’t offer advice in response to every statement your child makes. It is better to listen carefully to what is being said and try to understand the real feelings behind the words.
Make sure you understand what your child means. Repeat things to your child for confirmation.

40.8% of paediatricians in the USA failed to diagnose illegal drug abuse when presented with a classic description of an adolescent patient with symptoms of drug abuse.  The symptoms included red eyes and runny nose, frequent sore throat, headache and chronic fatigue, loss of appetite and loss of interest in school and worsening relationships with parents.
The study illustrates why parents, caregivers and other adult influencers need to be aware that every child is at risk for trying or using drugs, and that adults words and actions make a difference in keeping young people drug free.

Report Shows Parents Unaware of Children’s Ecstasy Use

While nearly 3 million teenagers in America have already tried the club drug Ecstasy, only one percent of parents believe their son or daughter is among them – and half of all parents are unclear about the effects of the so-called ‘love drug,’ according to a national survey by the Partnership for Drug-Free America (PDFA).
The 2001-2002 Partnership Attitude Tracking Study (PATS) surveyed 1,219 parents across the country from December 2001 to January 2002. (Margin of error + / -2.8 percent. Data are nationally projectable.) This is the 14th installment of parents data fielded for the PATS study since
1987. Top line findings include the following:

• Spreading the word: 92 percent of all parents have heard about Ecstasy. Parents of children in grades 7 to 12 are more likely to have heard about Ecstasy (93 percent) than parents of younger children in grades 4 to 6 (89 percent).
• Instilling the meaning: One of every two parents in America (49 percent) is unclear about Ecstasy’s effects on users. Some 60 percent of all parents are unsure of what is in the drug.
• Not acknowledging the risk to their children: With 12 percent of teenagers in the country (2.8 million teens) reporting use of Ecstasy, the study released today shows that only one percent of parents believe their teen might have tried the drug. (Teen use of Ecstasy has jumped 71 percent since 1999- and is now equal to or greater than adolescent consumption of cocaine, crack, heroin, LSD and metbampheta mine.)
• Parent & teen perceptions far apart: Parents underestimate the availability of Ecstasy to teenagers, and overestimate the degree of risk teens associate with the drug. Almost three out of four parents (72 percent) believe their teen sees great risk in using Ecstasy once or twice. (Just 42 percent of teens agree.) Some 41 percent of parents think Ecstasy would be very or fairly difficult for their teen to get. (Just 26 percent of teens agree.)
• More reminders, more talks: Exposure to anti-drug ads correlate with frequent parent-child communication about drugs. Among parents who reported seeing or hearing an anti-drug message every day or more, 55 percent talk frequently. Among parents exposed to fewer messages, 44 percent talk frequently.
• Ecstasy-specific talks: Among the drugs parents talk ‘a lot’ about with teenagers, parents were more likely to discuss inhalants (36 percent)
• cocaine/crack (48 percent); marijuana (60 percent) and alcohol (70 percent) than Ecstasy (29 percent).

‘Kids who learn a lot about the risks of drugs at home are less likely to try drugs’ Pasierb said. “Yet millions of parents sincerely don’t believe that their kids are the ones experimenting with drugs like Ecstasy. It’s these assumptions that enable drug use to go undetected. rf you’re a parent hearing this, the question we beg you to consider is ‘Could this be me?”
Ecstasy–chemically known as 3,4 methylenedioxymethamphetamine, or MDMA – is a synthetic, psychoactive drug with amphetamine-like and hallucinogenic properties. Taken orally in pill form, Ecstasy can be extremely dangerous, especially in high doses. Ecstasy accelerates the release of serotonin in the brain, producing an intense high, often characterized by extreme feelings of love and acceptance – ‘the very emotions teens crave the most,” Pasierb said. Ecstasy can cause dramatic increases in body temperature and can lead to muscle breakdown, as well as kidney and cardiovascular system failure, as reported in some fatalities. A growing body of research has found Ecstasy to be neurotoxic. According to the National Institute on Drug Abuse, MDMA can damage the neurons that use the chemical serotonin to communicate with other neurons.
As reported by the Partnership’s research and other studies, Ecstasy use has increased significantly across the country. Partnership research indicates that older teens (16-17) are more likely to experiment with Ecstasy than are younger teens (13-15); most users are boys, but by a slim margin. Unlike methamphetamine and other drugs that are more regional in nature, Ecstasy is a drug that has been found in major cities and small towns throughout America, with noteworthy emergence in locations as diverse as Baltimore, Maryland and Billings, Montana. (See “Pulse Check” findings.) Emergency room mentions related to Ecstasy increased nearly 13-fold from 421 in 1995 to 5,542 in 2000.

Vancouver, British Columbia, a city unaccustomed to widespread crime, is facing a rise in gang-related violence stemming from drug dealing and local turf wars between young people of Indian descent, “They are Indo-Canadians killing Indo-Canadians,” said Kash Heed, commanding officer of the Third Police District in Vancouver. “Seventy-six murders mainly within one ethnic group. The cycle of violence, we’ve not cracked it yet.”

Immigrant community leaders blame inaction on the part of Vancouver police for the rise in gang violence. “Out here, it’s a slap on the hand,” said Amar Randhawa, co-founder of the Unified Network of Indo-Canadians for Togetherness and Education Through Discussion (UNITED). “Law enforcement can’t crack the lower hierarchy, let alone get to the top.”

But police officials said the cycle of murder and revenge has hampered their efforts. “One day suspect, and the next day victim,” said Heed. “One day you are the shooter. The next day you’re lying in your coffin.”

According to police, gangs deal in the potent variety of marijuana called B.C. bud, which is grown in the province. “It is often exchanged for cocaine, cash, or firearms. It is a deal between two criminal gangs, one on the south side of the border and one on the north side, guns for marijuana,” said constable Alex Borden of the Royal Canadian Mounted Police. “If there is violence in our streets and firearms are involved, we are concerned the firearms come from across the border.”

According to Joe Giuliano, assistant chief at the local U.S. Border Patrol office in Blaine, Wash., 23 Canadian smugglers have been arrested on the U.S. side of the border so far this year. “Virtually all marijuana smuggling in the past fiscal year is either directly or indirectly tied back to the Indo-Canadian community,” he said.

According to officials, gang members are generally from upscale families. “Unlike in other countries, people involved in the gang activity here are not the poor or disadvantaged,” said Wallace Oppal, a justice of the Court of Appeal of British Columbia. “For the most part, kids involved here are people who come from middle-class and upper-class homes. They get involved for the glamour.”

Heed added that parents should get more involved in discouraging their children from joining gangs. “We’ve gone to notify people their son was killed and they have been in such denial they slammed the door in the police officer’s face,” Heed said. “They don’t want to believe their child is involved. They will ask the question to their dying day after their son is murdered why they didn’t do something.”

The present study investigated whether maternal cigarette smoking and marijuana use during pregnancy were associated with an increased risk of initiation and daily/regular use of such substances among one hundred fifty-two 16- to 21-year-old adolescent offspring. The participants were from a low risk, predominately middle-class sample participating in an ongoing, longitudinal study. Findings indicated that offspring whose mothers reported smoking cigarettes during their pregnancy were more than twice as likely to have initiated cigarette smoking during adolescence than offspring of mothers who reported no smoking while pregnant. Offspring of mothers who reported using marijuana during pregnancy were at increased risk for both subsequent initiation of cigarette smoking (OR=2.58) and marijuana use (OR=2.76), as well as daily cigarette smoking (OR=2.36), as compared to offspring of whose mothers did not report using marijuana while pregnant. There was also evidence indicating that dose-response relationships existed between prenatal exposure to marijuana and offspring’s use of cigarettes and marijuana. These associations were found to be more pronounced for males than females, and remained after consideration of potential confounds. Such results suggest that maternal cigarette smoking and marijuana use during pregnancy are risk factors for later smoking and marijuana use among adolescent offspring, and add to the weight of evidence that can be used in support of programs aimed at drug use prevention and cessation among women during pregnancy.
Porath AJ, Fried PA. Department of Psychology, Carleton University, Ottawa, Ontario, Canada K1S 5B6. aporath@ccs.carleton.ca

Source: PMID: 15734278 [PubMed – indexed for MEDLINE

Children exposed to secondhand smoke at home are more likely to carry the streptococcus pneumonia bacteria in their nose and throat, according to Israeli researchers.

A study involving more than 200 children and their mothers found that 76 percent of children exposed to secondhand smoke carried the bacteria in their noses and throats, compared to 60 percent of those not exposed to smoking. The bacteria can cause minor illnesses like ear infections or more dangerous conditions like sinusitis, pneumonia, and meningitis.

Among the mothers, 32 percent of smokers carried the bacteria, compared to 15 percent of nonsmokers exposed to tobacco smoke and 12 percent of nonsmokers not exposed to secondhand smoke.

“Since carriage in the nose is the first step in causing disease, the increased rate of carriage suggests more frequent occurrence of the disease. Indeed, active and passive smoking are associated with increased rate of respiratory infectious diseases,” said lead study author David Greenberg, M.D. “This should definitely encourage the parents not to smoke in the presence of their child, especially if this child has predisposing factors such as asthma.”
Source: Journal Clinical Infectious Diseases. April 1, 2006

Research Summary

Researchers have found that infants as young as three months old accumulate nicotine and carcinogens in their bodies when they are exposed to tobacco smoke, the Guardian reported May 12.

Authors of the study — the first to test smoke exposure on children so young — said that parents who smoking around infants could raise children’s’ risk of addiction, cancer, and other health problems later in life. “The take-home message is that parents should not smoke around their children, because they will suffer from the exposure,” said Stephen Hecht of the University of Minnesota cancer center.

The study of 144 children (ages three months to one year) who lived with family members who smoked found that 98 percent had nicotine in their urine, and 93 percent had cotinine, a marker for nicotine metabolism. Further, 47 percent of the infants had detectable levels of NNAL, a carcinogenic metabolite of cigarette smoke.

“Persistent exposure to environmental tobacco smoke in childhood could be related to cancer later in life,” said Hecht

The study appears in the journal Cancer Epidemiology Biomarkers and Prevention.
Source: The Guardian May 15 2006

Mon Mar 24, 5:33 PM

NEW YORK (Reuters Health) – A new study in rats suggests that prenatal exposure to marijuana may affect offsprings’ behavior and memory, Italian researchers announced Monday.

The findings reaffirm advice for pregnant women and lactating women to avoid marijuana use, according to one of the study’s authors.

“We cannot say that findings in rats can be directly translated to humans,” said Dr. Vincenzo Guomo of the University “La Sapienza’ Roma in Rome via e-mail. “But we know that animal studies can generate predictive information on various aspects of human brain function and could represent an essential step in the development of interventions to manage human diseases.”

“In this regard, our findings suggest that both pregnant and lactating women should avoid the use of marijuana,” Cuomo said.

The findings are pub]ished in the advance online edition of the journal Proceeding of the National Academy of Sciences (news – web sites).

Although marijuana is one of the most widely used illegal drugs, studies of its effects on pregnant women and their offspring have had conflicting results, said Cuomo.

This may be explained by possible impurities in the drug and by the use of tobacco along with marijuana, according to Cuomo. Rigorous studies on the effects of marijuana in pregnancy are reratively rare, Cuomo said.

However, some researchers have for many years been following relatively large numbers of children whose mothers smoked marijuana during pregnancy, according to the Italian researcher. In general, their findings suggest that exposure to marijuana during pregnancy is related to later adverse effects on mental and motor development, Cuomo said.

In the current study, Cuomo’s team injected pregnant rats with a synthetic compound that is similar to a chemical found in marijuana. The daily dose in rats corresponded to the low-to-moderate dose people get when they smoke marijuana.

Among the rats born to exposed mothers, the researchers identified memory and behavioral problems. The offspring of exposed mothers were hyperactive, though this difference in behavior was not long lasting. However, rats whose mothers bad been exposed to the marijuana-like compound did have memory problems, according to the report.

The results of the study, Cuomo said, are in line with clinical data showing that the use of marijuana by women during pregnancy has negative consequences on the mental function and behavior of their children.

SOURCE: Proceedings of the National Academy of Sciences 2003/lO1073/pnas.05378491 30.

Administered by Kentucky’s Council on Prevention and Education, CLC worked with five church communities to identify and recruit 11- to 15-year-olds. Over 131 ethnically diverse youths and their families living in rural, suburban, and inner-city areas in Kentucky participated in the program. CLC provided youths with 15 hours of training and parents/caregivers received 55 hours of training on substance abuse issues, communication skills, refusal skills, and family issues. CLC also provided referral services to families that required intervention or other social services. Evaluators found that both parents and children had increased involvement with the church community and an increase in resiliency as they learned about alcohol and drug issues. Youths increasingly declined drug and alcohol use and some inexperienced with drug use delayed initial experimentation with drugs. Participants also increasingly consulted community services for resolving family and personal problems and reported greater communication and bonding between parents and children.

A search was made to assess what research has been done in the areas of parent surveys and parent programmes for drug prevention with children – most research on drug prevention education has been done in the late 1970s, early and mid 1980s. In regard to parent surveys, a study entitled ‘Parents’ Attitudes Towards Drugs’ (International Research, Central Office of Information) was done in England and Wales (1985). This survey was the only one found and was administered some time ago. However, it assessed parents’ attitudes, beliefs and knowledge about drugs; whether parents or schools should be doing drug prevention work; how parents would cope if they found their children were using drugs; parental responsibility; whether parents had seen any drug abuse leaflets, ads, or other publicity; and the presence of a drug problem in their areas.

Pertinent findings from this survey included:

45% felt that there was a big drug problem in their area,
58% of parents believed they did not know enough about drugs,
87% said they would take total responsibility if they found out their child was using drugs (10% would take partial responsibility, 1% would not take any and 2% did not know).
A survey of youth attitudes in the same year included the question “If you had problems with drugs and wanted help, who would you turn to?” Of respondents, 56% mentioned one parent or both, specifically:
Mother: 23%
Father: 5%
Parents: 28%
Specific research on parental influence and the need for parental involvement in prevention programming showed the importance of parents. Many of these studies come from America. One study assessed family risk factors for alcohol and other drug use (Kumpfer, 1987). These risk factors included:
Parental dependency and family history of dependency
Parental psychological and social dysfunction
High levels of family conflict
Family social isolation
Special needs/special problem children
Non-nurturant and ineffective parenting
The family has been found to be very much involved in “the initiation, maintenance, cessation and prevention of drug use’ (Coleman, 1980). In assessing adolescent correlates, Young and West (1985) concluded that ‘the family has the greatest influence on alcohol and other drug use.” Family influences were cited as correlated with alcohol use in 52% of the articles reviewed, in 46% of the time in marijuana use, 80% of the time in illicit drug use and in 59% of the studies of general drug use. A 1984 study by Harford found that “both abstinence and drinking in parents are frequently paralleled by abstinence or drinking in their adolescent children.”
It has been found that “children are influenced most by the adults in their lives when they are young, prior to the onset of peer influence. Parents of young children should be aware of what they model for their children” (Benard, et al. 1987). Parents can influence children through even their use of prescription and over the counter medicines (Perkins and McMurtrie-Perkins, 1986). Research indicates that children are at greatest risk of beginning to use alcohol and marijuana before the age of 15, and thus, need to learn resistance skills “preferably before age 9 and no later than age 12. Fortunately, many children at these ages are opposed to drug use and are receptive to parents’ efforts to teach them skills that reinforce their current attitudes.” (Hawkins, et al. 1988).

In a 1987 study by Catalano of 10 to 15 year olds, 36% of 10 year olds, 54% of 13 year olds and 79% of 15 year olds had already refused an offer of alcohol or another drug. These students mentioned their parents most often as the single most important reason for refusing alcohol or other drugs. Hawkins (1988) also found that establishing a clear family position on alcohol and other drugs provides children with the motivation to refuse these offers.

Research on specific parent programmes for preventing drug use in children was difficult to find and one journal stated there is a need for more studies in this area. Family-focused programmes that improve parenting and family management skills are seen as promising prevention strategies for alcohol and other drug use. One reason for this is that parents “can be trained to be effective change agents and their effect will be enduring and powerful” Kumpfer (1988) and Alvy (1985) believed that parent training is “a necessary component of any comprehensive prevention plan that can affect a wide range of social and health problems.” Most successful programmes train parents by addressing effective parenting through groupwork, videos/films, games, manuals, and exercises. Practice in the home is encouraged to reinforce skills.

Bry (1985), after reviewing research on the topic, concluded that “family involvement is very important, if not essential, for positive outcomes in prevention programmes. She found that when families are included in school programmes, risk factors can be reduced and early signs of problems can be reversed. A l986 study showed that three months of targeted family problem solving training reduced drug use and a correlate (school-failure) by the end of a 16 month follow-up, while control group behaviours in this study remained the same.

From existing studies, it has been shown that when parents do attend a drug prevention education programme, they are responsive. It has been found that parents will change their approach to parenting, but behaviour has not been examined. Very few studies have examined changes in children as a result of parent training, but those that tested the children have shown reductions in their use of tobacco and alcohol (National Institute on Drug Abuse: Bry. 1983).

In some studies, even the parents reduced their use of tobacco and drugs (National Institute on Drug Abuse: Flay and Sobel, 1983). Also, it has been found that school-based efforts will be more successful if combined with a parent component (National Institute on Drug Abuse: Leukefeld, 1988).

Many different research designs have shown the effectiveness of parent training in reducing problem behaviours in children (1988). Parent training can help reduce children’s behaviours that are precursors of drug use and increase positive behaviours such as school achievement, social skills and family involvement (Stouthamer-Loeber, 1986).

Three other studies were found that examined parent programmes. However, in all cases, the parent programme was a component of more comprehensive programming and was not individually assessed. For example, a 1987 study examined a school programme which included parent groups to learn about the drug problem and monitor their children’s behaviour, community meeting with key community members; coalitions and work in schools (teacher education, prevention curricula and policy). This comprehensive programme was found to decrease drug related incidents in the school and improve academic achievement.

Another prevention project including parent education and organisation, school-based education for children, mass media programming, community organisation and health policy was assessed in 1989 (Pentz, Dwyer, et al). There were 42 schools that participated and were assessed. Findings showed that prevalence rate for cigarettes, alcohol and marijuana were significantly lower at the one-year follow-up study. The net increase in drug use prevalence in schools receiving prevention programming was half that of other schools.

Finally, “Family Effectiveness Training” was assessed in 1989 (Szapocznik, Santisteban, et al) and looked at families who had the risk factors for developing a drug abusing adolescent. Results showed that families undergoing this training had greater improvement than did control groups on measures of family functioning, problem behaviour by adolescents and child self concept. Results were maintained at a six-month follow-up study.

Source: Susan Kaplin, Research Officer. Life Education Centres. April 1992 updated 1997.

A Queensland University study of 5000 pregnant women has found a correlation between smoking and poverty. The three year study measured smoking against income levels, with the lowest earners defined as those who attract an income of $4,144 a year and the highest above $21,639 a year. Two thirds of the lowest income group smoked before pregnancy compared with 46 per cent of middle income earners and 39 per cent of higher income earners. Young and impoverished single mothers are more likely to be heavy smokers with half of the lowest income earners puffing during pregnancy. And 14 per cent of them are such serious smokers that during pregnancy they light up more than 20 cigarettes a day.

Source: British Medical Journal 7135:316

A UK report draws attention to the dangers of passive smoking for young children. Mothers who smoke double the risk of sudden infant death syndrome (cot death) (odds ratio 2.08) and if both parents smoke the odds ratio rises to 3.79 Parental smoking increases the risk of asthma attacks and respiratory symptoms in schoolchildren, although at a lower risk than for infants. Maternal smoking had a greater effect than paternal smoking. The pooled odds ratio where children were exposed to two parents smoking were 1.52 for asthma exacerbation, 1.40 for wheeze and 1.61 for cough. (i.e. 61 percent risk increase over that of a baby with neither parent smoking).

Source: The Observer, 1/3/98

It is important to distinguish between experimental and problem drug use. While more than a third of 16 year old students in the UK say they have tried at least one illegal drug, only a very small percentage go on to develop problem drug use which is of most concern.

Key risk factors for problematic drug use are:

a chaotic home life
lack of mutual attachment between child and parent
parental drug use
poor academic achievement by young people and their parents
low socio-economic status
Key behavioural risk factors are:
poor social skills
being unusually shy or aggressive
association with deviant peers
anti-social behaviour

Researchers and practitioners assign a crucial role to the family in the development or prevention of drug-related behaviours. The family is seen to exercise influence in a variety of ways:

Close family relationships. The closeness of the parent-child bond is found to protect against problem drug use by encouraging mutual parent-child trust, effective communication, positive self-perception and choice of friends who resist involvement in general anti-social behaviours, including drug use. Poor communication, poorly defined or stated expectations of behaviour and inconsistent or harsh discipline can all predict substance misuse. Parents have a very powerful influence as role models for their children, who tend to follow what their parents do rather than what they say. Parents, however, very often don’t realise the power of their influence, a situation which has potentially profound implications. This seems to be a key area in which parents need education.

Family management. Parents who lack effective management skills are less well equipped to deal with family crises, to reward or punish appropriately, to develop positive social behaviours in their children or to protect them from negative influences. Also parenting skills tend to be passed on down the generations. There are positive signs from research that with the right training, parents can provide an environment in which children can develop a whole range of abilities including self-confidence, self mastery and positive behaviours, all of which can offset negative peer influences.

Parental supervision. Parents knowing where their children are and what they are doing can delay or prevent the onset of drug use. Surrogate parent figures in after-school programmes or recreation activities can also be effective. The influence of this supervision can be direct in keeping children away from drugs, or indirect by reducing contact with drug-using peers. Parental monitoring can be improved through parent training programmes, but clearly parents need booster courses particularly during the child’s transition into adolescence.

Parent vs. peer influences. Parents and peers may be mutually influential and emphasising the power of peer pressure may lead parents to underestimate their own effect. Although parental influence does wane at particular stages of a child’s development, research indicates that they do affect the child’s behaviour in the long term. A debate continues on the relative influence on adolescent drug use of peer influence as opposed to peer selection. In summary, there are a lot of influences in a child’s life and family and parents are one bit of a jigsaw. However there is no doubt that families do have a very important role and that this offers valuable opportunities for drugs prevention. The latter part of the paper looks at the evaluations the team has carried out with five DPI parent projects and identifies key issues in their success. The research shows that almost every element of projects involving parents – building local credibility, recruiting parents, assessing needs, meeting some of these needs, and evaluating the impact on children – requires a considerable amount of time. Much of the success seen in the projects evaluated can be attributed to the efforts of project workers in establishing a trusting relationship with parents, with local schools and community agencies. The team’s research so far has identified the following strategies for success:

Build effective partnerships at the outset. Financial partnerships, profes-sional support, contact with parent groups are all crucial.
Be imaginative in recruiting parents through school. Build credibility, for example by getting an enthusiastic teacher to help, and use creative ways to involve parents, such as getting children to put on a performance built around drugs prevention activity.
Take plenty of time to establish the profile and credibility of your project when recruiting in the community.
Parents are more likely to get involved in projects with more general labels which avoid the potential stigma of drugs, such as “Living with Teenagers” or “Keeping your child happy, healthy and safe”

Conclusion: Children are exposed to a range of substance use behaviours from their parents, other adults, peers and the mass media. Perceptions of what is considered normal behaviour in the home may encourage or discourage young people from drug misuse.

Source: The authors – Richard Velleman, Willm Mistral and Lora Sanderling are all members of the University of Bath. Bath Mental Health Care NHS Trust Joint R&D unit. – Published in ‘Evaluating Effectiveness: Drugs Prevention Research Conference’

The team which was responsible for evaluating the DPI’s projects working with parents has an unequivocal message in this paper:

parents and family environment have a strong influence on the drug-taking behaviour of their children.
parents can be educated and supported to produce a positive influence, delaying or preventing drug misuse by their children.

Strengthening Families is a selective multicomponent, family-focused program that provides prevention programming for 6-10-year-old children of substance abusers. The program began as an effort to help substance-abusing parents improve their parenting skills and reduce their children’s risk factors. The program has been culturally modified and found effective (through independent evaluation) with African-American, Asian/Pacific Islander, and Hispanic families. The Strengthening Families program contains three elements: a parent training program, a children‘s skills training program, and a family skills training program. In each of the 14 weekly sessions, parents and children are trained separately in the first hour. During the second hour, parents and children come together in the family skills training portion. Afterward, the families share dinner and a film or other entertainment. Parent training improves parenting skills and reduces substance abuse by parents. Children‘s skills training decreases children’s negative behaviors and increases their socially acceptable behaviors through work with a program therapist. Family skills training improves the family environment by involving both generations in learning and practising their new behaviors. This intervention approach has been evaluated in a variety of settings and with several racial and ethnic groups. The primary outcomes of the program include reductions in family conflict, improvement in family communication and organization, and reductions in youth conduct disorders, aggressiveness, and substance abuse.

Source: Kumpfer et al. 1996

Parents play a key role in their children’s education and social development and therefore can be influential in educating their children about drugs. Despite this, there has been little research done to date that explores parents’ perceptions. This paper reports research from questionnaires, which sampled 947 parents of 14-to 16-year-olds; telephone inter views of 60 of these responses; and 6 focus groups of primary and secondary school parents. The issues explored included parent’s concerns, needs, and knowledge of drug issues in respect to their children as well as parents’ perspective on drug education. The results show that parents are concerned about drugs in relation to their children, and they report that drugs are easily available to young people and a part of the present youth culture. The study revealed that parents are largely misinformed about the drug situation and request accurate and up-to-date information. They are unaware of their children’s school drug policies and programs and feel the need for easier access to relevant services. Parents rate drug education as important and report that such education should begin during late primary school age. Parents predominantly want their children to be taught the ‘Just Say No’ message. Finally, issues of communication about drugs, between parents and their children, were raised. A number of implications of the results for drug education are presented.

Source: Mallick, J.; Evans, R; Stein, G., Drugs: Education, Prevention and Policy, 5(2):169- 176, 1998. Availability: International Periodical Publishers, Carfax Company, P0. Box 25, Abingdon, Oxfordshire 0X14 EUE, United Kingdom.

Analysis of the etiology for adolescent substance use emphasizes the major role of social influences. Peer pressure, norm perceptions, advertising, and other social factors constitute major determinants of adolescent substance use and non-use. Membership in groups can influence dramatically how much or little pressure one gets to use drugs. A teen’s lifestyle decisions also have the effect of channeling youth into different peer groups. Membership in peer groups is a dynamic process. The same friends a child “hangs out with” in third grade often are not the same people as a child’s friends in high school. A child’s response to repeated offers from peers to smoke can be a pivotal event. The decision to smoke or not smoke influences which peer group a child joins. The child who smokes at age 12 more likely will be channeled into a group of friends where members use marijuana at age 16.

A number of other social/behavioural models explain the social dynamics of tobacco’s gateway drug function. The Theory of Reasoned Action emphasizes the crucial role “subjection norms” play in adolescent behaviour. Teens are influenced tremendously by what they perceive everyone else to be doing. Both drug-using and non-drug-using teens over-estimate the prevalence of substance use among teens, but adolescents who belong to a peer group where smoking is the norm may hold even greater norm misperceptions regarding substance use. From the perspective of a teen who belongs to a group where smoking is the norm, it may appear that “everybody is doing it” when it comes to illegal drugs. This “internal peer pressure” born of norm misperceptions facilitates use of illicit drugs.

The importance of “enabling factors” as defined by the PRECEDE/PROCEED health promotion model also becomes apparent in peer groups. The child who uses tobacco and belongs to a peer group where smoking is the norm simply experiences greater availability of and accessibility to drugs. Adolescents in peer groups that smoke are likely to receive more offers to use illegal drugs and experience many socially reinforced opportunities to do so. Most importantly, this availability occurs at a much younger age when the child is more susceptible to peer influence. Social Learning Theory also contributes to understanding the social dynamics of nicotine’s gateway drug function. Adolescents in a tobacco-using peer group will be coached on the “how tos” of illicit drug use. The unhealthy behaviours of peers who are veteran drug users will be modeled and learned by novices of illicit drug use. An adolescent’s willingness to use cigarettes often is socially reinforced and approved by members of the peer group. This peer approval provides a powerful influence and reinforcer. Young people socially reinforced for using tobacco likely will use illicit drugs to maintain the same social reinforcement they received by using a gateway drug. Substance use can become a defining element of membership in a group and a factor that enhances comradery. Cigarettes also can become an expression of independence from authority. When parents or school officials criticize cigarette use, the topic may become a bone of contention that generates other expressions of a rebellious “I’ll do as I want” attitude. This feeling may predispose a teen-ager to use illicit drugs as a further statement of personal freedom from authority. Again, adolescents’ willingness to smoke channels them into a group where friends socially reinforce defiant attitudes and behaviours.

Perhaps the simplest explanation for tobacco’s gateway drug function involves what teenagers learn when they smoke cigarettes. According to one source, “. . .the gateway drug phenomenon is simply an example of practice conditioning, that leads to the development of learned behaviour. Children who experiment with and later use gateway drugs are, in effect, practising the wrong social skills and learning the wrong behaviours. They then apply these conditional behaviours to other more sinister functions…” Adolescent cigarette smokers acquire and practice a number of skills that make it easier to use illicit drugs. First, they learn to administer drugs by mastering the complex behaviour of smoking. Marijuana, crack, and to a lesser extent, opiates are introduced into the body through smoking. The veteran adolescent smoker overcomes the body’s initial negative reaction of acute irritation, coughing, and nausea that result when one first inhales smoke. Extensive use by adolescents of low-tar, filtered brands facilitates acquisition of smoking behaviour. The bodies of adolescent smokers adapt or become desensitized so smoking marijuana does not create the initial adverse reaction in a veteran cigarette smoker that a nonsmoker experiences when beginning marijuana use. The veteran smoker also becomes comfortable and familiar with the process of lighting up, handling, holding, inhaling, and exhaling, which are ritualistic learned behaviours that accompany illicit drug use. Veteran adolescent tobacco users also acquire the ability to ‘unit dose” so not too much or too little of the psychoactive drug is administered. Smokers quickly learn to deliver the desired therapeutic dose by adjusting the number of puffs taken, degree of inhalation, and duration of holding smoke in the lungs. Mastery of these nicotine dose regulator skills facilitate the ability to use and get high on other drugs.

Teenagers who smoke cigarettes often do so in violation of parental wishes, school rules, and state laws. This practice fosters development of skills to conceal cigarette use. The behaviour of masking signs of use such as breath odor, denying use and lying to parents or officials also are practiced. These same skills can be useful for a rookie illegal drug user.
Nicotine users learn that moods and feelings can be modulated or altered by using drugs. Cigarette smokers discover that these chemical lifts are immediate and do indeed make one feel better. Conversely, adolescent smokers who learn to cope with boredom and stress by taking chemical shortcuts may be less likely to develop acceptable, healthy coping skills to deal with life’s challenges. Their deficiency of healthy coping skills and their direct experience with nicotine’s stress reduction function predisposes them to behaviour patterns of using other substances for mood altering purposes.

Monkeys exposed to cocaine during pregnancy give birth to Infants whose brains contain fewer than half the neurons needed in the cerebral cortex.

Source: Author M.S.Lidow and Zan-Min Song, Published in Journal of Comparative Neurology Vol 435, Issue 3, 2001

Researchers determined that women who use cocaine during pregnancy risk affecting the brain structure of their children. In studying the brains of rhesus monkeys, researchers at the University of Maryland found that prenatal cocaine use could result in the loss of more than half of the brain cells in the infant’s cerebral cortex. The highest level of the brain, the cerebral cortex is responsible for such functions as sensation, voluntary muscle movement, thought, reasoning, and memory.

“This is the first study that clearly shows the possibility that cocaine may affect the brain structure. It shows that it could happen,” said Dr. Michael Lidow, one of the study’s authors. “This is a warning sign. For the study, four monkeys were born to mothers who were given 20mg/kg of cocaine per day during the second trimester of pregnancy. Four other monkeys received no cocaine. Researchers found that that the cerebral cortex in the monkeys whose mothers received cocaine contained 60 percent fewer neurons and was about 20 percent smaller than that of the monkeys who received no cocaine.

Lidow said additional research is needed to determine how the study’s findings may apply to humans.

Source: Author Dr. M. Lidow. Published in the Journal of Comparative Neurology. June 2001

The number of children being born with foetal alcohol syndrome (FAS) is rising, with an estimated 5 000 FAS babies born each year. According to the Centres for Disease Control and Prevention (CDC), cases of foetal alcohol syndrome are up six-fold since the mid-1980s. Furthermore, about 50 000 babies each year have disabilities stemming from maternal use of alcohol during pregnancy. Children born with FAS suffer stunted growth and facial deformities, attention and behaviour problems, and, in some cases, mental retardation. Foetal alcohol syndrome is the leading known cause of mental retardation.

Experts point out that children never outgrow FAS. As a result, each afflicted child will cost $1.4 million over his or her lifetime in institutional and medical costs. Louise-Floyd, acting chief for the CDCs Foetal Alcohol Branch said waning education about FAS and increased publicity about the health advantages of certain types of alcohol has resulted in women viewing alcohol as more benign than other drugs. “They think, ‘If I’m not using heroin or cocaine like the people down the street, if I just using beer, that’s OK,” Mitchell says.

Source: Louise Floyd, Center for Disease Control Sept 2001

This study examined early behavioural outcomes among young children of alcoholics (COA) as a function of differences in subtype of paternal alcoholism. Participants were 212 children (106 girls and 106 boys, ages 3 through and both of their biological parents. Families were characterised as antisocial alcoholics, non-antisocial alcoholics, and non-alcoholic control. There were significant familial subtype group differences on parent reporting measures of children’s total behaviour problems, externalizing behaviour, internalizing behaviour, and on measures of children’s intellectual functions and academic achievement. In all instances, COAs had poorer functioning controls. In the behaviour problem domain, but not for the domain of intellectual functioning, children from antisocial alcoholic families had problems than children from nonantisocial alcoholic families. In addition subtype effects, boys had higher levels of behaviour problems than girls in three areas, and older children had more internalizing problems than younger children. Maternal functioning pertaining to lifetime alcohol problem involvement and antisocial behaviour also contributed to child subtype differences in internalizing behaviour. Results indicate that, even at very ages, male and female COAs are heterogeneous populations that are distinguishable by way of familial subtype membership, as well as distinguishable from their non-COA peers. Thus, findings underscore the need to consider the heterogeneity of alcoholism when looking at its effects on development.

Source: Puttler LI, et al Department of Psychiatry,Alcohol Research Centre, University of Michigan Ann Arbor, USA
Published in Alcohol Clin. Exp. Research Dec. 22 (9):1962-72. 1988

Parents are unaware of the health risks of passive smoking on their children, a new report by ASH has shown, Only a quarter of parents are aware asthma can be a risk. And just 3% of parents identified cot death as a consequence of passive smoking. The survey says the two in five children in the UK who live with at least one smoker are at risk. However, parents in other countries are taking note of the health risks of passive smoking to children. In Australia, for example the proportion of smokers who restricted smoking in their homes rose from 2% in 1989 to 32% in 1997.

ASH’s research manager Amanda Sandford said: “Parents must recognise that passive smoking causes ill-health in children. Parents who smoke must accept there is a risk attached not only to their health, but to their children’s too.” She called for more government campaigns to raise parents’ awareness of the risks to their children of developing illnesses including asthma, bronchitis and glue ear. She said: “Clearly, the best way to eliminate children’s exposure to passive smoking is for parents to stop smoking and to make their homes smoke-free.”

But she said if parents could not or would not stop smoking, they should try to limit their child’s exposure to tobacco smoke. ASH quotes World Health Organization figures which indicates babies are at five times greater risk of cot death if their mothers smoke. Children also have a 20 to 40% increased risk of asthma if they are exposed to tobacco smoke, and a 70% increased risk of respiratory problems if their mother smokes. ASH says 17,000 children are hospitalised every year because of passive smoking. The survey was carried out by SmokeFree London. The questioned 2,000 people, 22% of whom were parents.

Source: BBC Online. May 2001