As a new school year begins, many parents are legitimately concerned about their children's drug and alcohol use. According to the Emerging Drug Trends Report from the Hazelden Betty Ford Foundation, released this month, research demonstrates that substance use and addiction affect children in families of all socioeconomic backgrounds.
Prevailing attitudes might have some communities holding onto the notion that addiction is a byproduct of social injustices, but that’s simply not true, experts warn. In other words, no parent—not even the most affluent mom or dad—should be naïve enough to say, “Not my kid.”
Joseph Lee, MD, medical director, Hazelden Betty Ford Foundation Youth Continuum, says the findings in the drug trends report don’t surprise him. However, the stigma persists.
“As we have learned from our own history, we can see that addiction is equal opportunity, and it doesn’t need any qualifiers,” Lee tells Addiction Professional.
While stakeholders might want to tie addiction to trauma, mental health disorders, socioeconomic factors or political hot-button issues, addiction stands on its own ground, he says. Lee wants to see communities, and especially addiction treatment professionals themselves, reconsider their attitudes.
“It’s a cruel stigma to say addiction is just a downstream byproduct of something else,” Lee says.
Stigma happens in subtle ways, and looking for some “other” factor to point to as the driver of addiction only contributes to the problem, Lee says. He believes eliminating socioeconomic factors or mental health variables doesn’t result in immunity from substance use disorders. If that were the case, then the star students in the affluent communities wouldn’t be part of the rising rates of overdose witnessed in recent years.
He says the conditions or situations related to addiction certainly play a significant role, but focusing only on qualifiers will silence the open dialogue about addiction as a disease of its own.
Research does track certain correlations between socioeconomic conditions and kids’ substance use. The 2018 Monitoring the Future survey cited by Hazelden notes that 24% of high school seniors whose parents earned a college degree reported getting drunk in the last month, compared to 16% of those whose parents had not graduated from high school.
“There is social norming in the higher socioeconomic strata about drinking and other drugs, and I think that causes excessive use in certain populations,” Lee says. For example, the rise of craft beer breweries in attractive neighborhoods projects the message that routine alcohol consumption is the social norm.
Suniya Luthar, PhD, professor of psychology at Arizona State University, whose research was cited by Hazelden in its report, says defining a group as middle class or affluent has fallen by the wayside. Now, more communities are tying their social status to the local high-achieving schools instead.
“Now 20 years of research shows that across different types of schools, public or private, across the country, kids from high-achieving schools reflect problems of depression, anxiety, and drug and alcohol use at rates that are significantly higher than the national normative rates,” Luthar says.
She cautions that beyond just the parents, many teachers, coaches and college recruiters might be a source of stress for young people who are consistently expected to perform well.
Some of her research demonstrated that youths in such communities are at an elevated risk for excessive drinking as well as a much higher risk for misuse of prescription stimulants. In fact, estimates for stimulant misuse ranged from 15% to 20%—almost twice as high as national norms.
Parents can provide influence
Numerous studies confirm that parents can influence their children's behaviors when it comes to drug and alcohol use. The Hazelden report suggests three findings, which can help to inform parents participating in family programs:
Strict limits set by parents can reduce the likelihood that kids will engage in risky substance use.
High levels of parental involvement are associated with lower levels of substance use among kids.
Communication between kids and parents about alcohol use and its consequences can result in lower levels of drinking among kids.
In a recovery-oriented system of care, clinicians typically examine family dynamics when treating an adolescent or young adult for addiction.
“I know it’s hard to see a parent who is disengaged or even irresponsible,” Luthar says. “But if the idea is to help the child, the most productive way to do it over the long term is to bring the family together and get the parents functional, rather than saying that they should stop being negligent or disengaged.”
She says clinicians should spend time with the parents to discover what they might need to consider to better engage and be present with the child.
“We live in a time when parents would rather have their girls have an eating disorder than an addiction,” Lee adds. “We try to explain why people become addicted through socioeconomic or mental health variables. The point, however, is that addiction doesn’t need a calling card.”
Addiction professionals annually convene at the National Conference on Addiction Disorders to share what’s working: Clinicians hear from thought leaders on delivering treatment, while executives of behavioral healthcare organizations learn how to run more effective, more efficient, and ethically minded businesses.