Another parenting challenge that became salient in the second half of the 20th century, and which continues to require parental vigilance, has to do with the use of tobacco, alcohol, and other drugs, such as marijuana and cocaine. These often health-compromising substances became more available to children and more children began experi-menting and using them during the 1980s, resulting in what was re-ferred to as the War on Drugs. It is a war worth fi ghting.
Consider the following facts about the actual and potential harm-ful consequences of the use of legal drugs such as tobacco and alcohol and their currently illegal or illicit counterparts. This information is drawn from such authoritative sources as the National Clearinghouse for Alcohol and Drug Information, and the National Youth Anti-Drug Media Campaign.43
Tobacco: Cigarettes and Other Nicotine Products
Nicotine is one of the most heavily used addictive drugs in the United States. Cigarette smoking has been the most popular method of consuming nicotine since the beginning of the 20th century.
In 1989, the U.S. Surgeon General issued a report that concluded that cigarettes and other forms of tobacco, such as cigars, pipe tobacco, and chewing tobacco, are addictive and that nicotine is the drug in tobacco that causes addiction. In addition, the report determined that smoking was a major cause of stroke and the third leading cause of death in the United States.
The Environmental Protection Agency (EPA) has concluded that secondhand smoke causes lung cancer in adults and greatly increases the risk of respiratory illnesses in children and sudden infant death.
In terms of the numbers of persons who smoke, in 1998 it was es-timated that 60 million Americans were current cigarette smokers, which is 28% of all Americans aged 12 and older. Of that total, 4.1 mil-lion were children between the ages of 12 and 17, which represents 18% of the youth in that age bracket.44
Thus, multiple millions of American children are being exposed in their families to role models who smoke and also to the impact of sec-ondhand smoke. In addition, more than 4 million children are smokers themselves.45
Alcohol
Health hazards associated with the excessive use of alcohol or with alcohol dependency include dramatic behavioral changes, retardation of motor skills, and impairment of reasoning and rational thinking.
These factors result in a higher incidence of accidents and accidental deaths for those who use alcohol than for nonusers.
In a 2001 national survey conducted by the U.S. Department of Health and Human Services, approximately half of Americans aged 12 or older reported being current drinkers of alcohol (48.3%). This translates to an estimated 109 million drinkers.46
Approximately one-fi fth (20.5%) of persons aged 12 or older par-ticipated in binge drinking at least once in the 30 days prior to the survey. Heavy drinking was reported by 5.7% of the population 12 or older, or 12.9 million people. The highest prevalence of both binge and heavy drinking in 2001 was for young adults aged 18 to 25, with the peak rate occurring at age 21.47
In terms of the data on underage and illegal use of alcohol, the sur-vey indicated that among 12- to 17-year-olds, approximately 17% had used alcohol in the month prior to the survey. Of those users, 10.6%
were binge drinkers and 2.5% were heavy drinkers.48
So, here again, as we saw with tobacco smoking, multiple millions of children are being exposed to adult models who regularly use po-tentially harmful substances, including millions of models who are al-coholics and binge and heavy drinkers. In addition, millions of youth are drinkers themselves, including youth who are binge and heavy users.
Illicit Drug Use
The use of illicit drugs usually causes the same general type of physiological and mental changes as alcohol, although frequently those changes are more severe and more sudden. Death or coma re-sulting from an overdose of drugs is more frequent than overdose from alcohol, but, unlike alcohol, abstinence can lead to the reversal of most physical problems associated with drug use. Here are some examples:
Cocaine. Cocaine is a stimulant that is most commonly inhaled as a powder. It can be dissolved in water and used intravenously.
The cocaine extract (freebase) is smoked. Users can progress from infrequent use to dependence within a few weeks or months. Psychological and behavioral changes resulting from the use include overstimulation, hallucinations, irritability, sexual dysfunction, psychotic behavior, social isolation, and memory problems. An overdose produces convulsions and delirium, and may result in death from cardiac arrest.
Discontinuing the use of cocaine requires considerable assistance, close supervision, and treatment.
Amphetamines (speed, love drug, Ecstasy). Patterns of use and associated effects are similar to those of cocaine. Severe intoxication may produce confusion, rambling and incoherent speech, anxiety, psychotic behavior, ringing in the ears, hallucinations, and irreversible brain damage. Intense fatigue and depression resulting from use can lead to suicide. Large doses may result in convulsions and death from cardiac arrest or respiratory arrest.
Heroin and Other Opiates. These drugs are usually taken intravenously. “Designer” drugs similar to opiates include Fentanyl, Demerol, and “China White.” Addiction and dependence develop rapidly. Impaired judgment, slurred speech, and drowsiness characterize use. Overdose is
manifested by coma, shock, and depressed respiration, with the possibility of death from respiratory arrest. Withdrawal symptoms include sweating, diarrhea, fever, insomnia, irritability, nausea and vomiting, and muscle and joint pain.
Hallucinogens or Psychedelics. These include LSD, mescaline, peyote, and phencyclidine (PCP or “angel dust”). Use impairs and distorts one’s perception of surroundings, causes bizarre mood changes, and results in visual hallucinations that involve geometric forms, colors, and persons or objects. Users who discontinue use may experience “fl ashbacks,” consisting of distortions of virtually any sensation. Withdrawal may require psychiatric treatment for the accompanying persistent psychotic states. Suicide is not uncommon.
Solvent Inhalants (glue, lacquers, plastic cement). Fumes from these substances cause problems similar to alcohol. Incidents of hallucinations and permanent brain damage are frequent.
Marijuana (cannabis). Marijuana is usually ingested by smoking.
Prolonged use can lead to psychological dependence, disconnected ideas, alteration of depth perception and sense of time, impaired judgment, and impaired coordination.
Damage from Intravenous Drug Use. In addition to the adverse effects associated with the use of a specifi c drug, intravenous drug users who use unsterilized needles or who share needles with other drug users can develop AIDS, hepatitis, tetanus (lockjaw), and infections of the heart. Permanent brain damage may also result. The use of alcohol and many other drugs causes birth defects of a very serious nature.
Numbers of Users. In terms of usage of illegal drugs, it was estimated that there were 5.7 million American illicit drug users in 2000, with 76% using marijuana either alone or in combination with other illegal substances.49 Marijuana’s effects on the user depends on its strength and potency, which is related to the amount of THC it contains (THC, or delta-9-tetrahydrocannabinol, is the main active chemical in marijuana). The THC content of marijuana has been increasing since the 1970s, which means that marijuana is a much more potent drug today than it was when so many of today’s parents and grandparents were using it in the second half of the 20th century. In terms of children’s use of marijuana and other illicit drugs, 3.8% of youth aged 12 to 13 reported current use in 2001. Among youth aged 12 to 17, 10.8% were illicit drug users in 2001.50
So, once again, millions of American children are being exposed to potentially very harmful habits in their homes, and sizable numbers have adopted these habits before they are even old enough to vote.
Large numbers of America’s parents are setting poor examples and creating other forms of havoc in the home because of their own use and abuse of these and other substances. And, just as clearly, all children themselves are in need of home guidance away from abusing such potentially unhealthy substances. Hence, guideline 10 in Chapter 4 provides a variety of strategies for helping parents do a better job.