1. How to Take Action if you Think or Know your Child is using Drugs or Alcohol
Welcome to the “Time To Act!” community education presentation.
Drugs and alcohol exist in our kids’ lives.
For many parents, there will be a moment, or a growing awareness, that your child either might be using, or is using drugs and alcohol.
That moment is your “time to act.” We love our kids. We want the best for them, and taking action when they need our help is the one of the best ways we can show our love.

2. Today’s Presentation
Discuss the drug & alcohol scene in our community – highlight Rx/OTC abuse
Introduce the Partnership for a Drug-Free America’s Time To Act website:
Discuss how parents can take action if you
Think your child is using alcohol or other drugs or
Know your child is using
In today’s presentation, we will talk about the national drug scene, and more importantly, what’s going on here in our community;
We will talk about what we, as parents, can do if we think, or know, our kid is using;
And we will introduce you to a website created by the Partnership with support from Purdue Pharma called “Time to Act.”

3. Parents Moms and dads Grandparents Aunts and uncles
Close family friends
Mentors
Other caregivers
One important point to make up front: When we use the word “parent,” we are talking about anyone and everyone who is a caring presence in a child’s life – grandparents, aunts and uncles, even big brothers and sisters. When we say the word “parent” we are talking about you.
The presence of a caring adult in a child’s life

4. National Drug & Alcohol Scene
Marijuana
Rx Drugs
Inhalants
Ecstasy
Cough Medicine
Cocaine/Crack
Another way to understand the national drug scene is to look at the wide range of drugs that are out there and that we need to talk with our kids about. While alcohol and pot are – far and away – at the top of the list, the number of kids who use other drugs – especially prescription and over-the-counter drugs -- should concern us all.
LSD
Meth
Heroin
Partnership for a Drug-Free America, Partnership Attitude Tracking Study, 2009

5. Real Danger
“Abusing prescription (RX) and over-the-counter (OTC) drugs can be just as dangerous, addictive and even deadly as using ‘street’ drugs”
Prescription / over-the-counter drugs – known as Rx/OTC – are a real danger to teens.
According to the National Institute on Drug Abuse, prescription drugs can be as dangerous, addictive, and deadly as the ‘street’ drugs we’re all familiar with, like cocaine, crack, and heroin. There is a reason why pharmaceutical companies put all those warning labels on drug bottles, and when they’re ignored, users put themselves at great risk.
National Institute on Drug Abuse, 2008

6. Rx/OTC Medicines Being Abused
Rx pain relievers (Vicodin, OxyContin)
Rx stimulants (Adderall, Ritalin)
Rx tranquilizers/sedatives (Xanax, Valium)
OTC cough/cold with ‘DXM’ (Robitussin, Coricidin)
So – what prescription / over-the-counter drugs are being abused?
Rx pain relievers (Vicodin, OxyContin)
Rx stimulants (Adderall, Ritalin)
Rx tranquilizers/sedatives (Xanax, Valium)
OTC cough/cold with the active ingredient dextromethorphan (DXM) - (Robitussin, Coricidin)

7. Troubling Indicators of Medicine Abuse
Unintentional drug poisoning now second leading cause of accidental death in US, after car crashes
Emergency room visits related to Rx/OTC abuse now almost equal to ER visits due to all “street drugs”
Rx drugs are now the most commonly abused drugs among year olds
We’ve talked about the prevalence of Rx/OTC drug abuse – What effect are they having on teens?
Unintentional drug poisoning now second leading cause of accidental death in US, after car crashes
Emergency room visits related to Rx/OTC abuse how almost equal to ER visits due to all “street drugs”
Rx drugs are now the most commonly abused drugs among year olds
Centers for Disease Control and Prevention, The Three Leading Causes of Injury Mortality in the United States, , 2008; Drug Abuse Warning Network; Substance Abuse and Mental Health Services Administration, National Study on Drug Use and Health, 2007

8. Key Factors Driving Teen Medicine Abuse
Misperceptions that abusing medicine is not dangerous (safer than “street drugs”)
Ease of access via medicine cabinets at home or friend’s house, own or other person’s prescriptions
We also saw that when perception of risk is low, and availability is high, use goes up. That’s also happening with Rx/OTC –
Teens misperceive that abusing medicine is not dangerous (they think it’s safer than using “street drugs”)
Ease of access via medicine cabinets at home or friend’s house, or using their own or another person’s prescriptions

9. Teen perceptions of safety
Sanitized
Created in a medical laboratory for healing purposes
Sanctioned
Accepted by society as a “positive”
Safe
Certified by FDA
What beliefs are driving teens’ misperceptions of safety?
They see it as being:
Sanitized -- Created in a medical laboratory for healing purposes
Sanctioned -- Accepted by society as a “positive”; and
Safe -- Because it is certified by FDA

10. Rx New Step in Drug Ladder
heroin, meth, crack
cocaine
shrooms, ecstasy
Prescription / over-the-counter drugs (Rx/OTC)
Kids normally start drug use with cigarettes, alcohol, and marijuana. Before prescription drug abuse became prevalent, it was a huge jump to go from there to using “harder” drugs like cocaine and heroin. Now, the Rx experience facilitates an easier transition in the progression. So how exactly does this happen?
liquor, marijuana
cigarettes, beer/wine
Rx abusers are more likely to add a 3rd rung in the progression 10

11. What about parents’ perceptions?
Street drugs are generally considered more dangerous
Parents are less familiar with “pills” – they often have no frame of reference since these types of drugs of abuse didn’t exist in their youth
There’s a lack of urgency around Rx/OTC
So – What do parents think? As it turns out, their perceptions on safety parallel their kids’.
(Click sequentially)
Street drugs are generally considered more dangerous
Parents are less familiar with “pills” – they often have no frame of reference since these types of drugs of abuse didn’t exist in their youth
As a result, there’s a general lack of urgency about Rx/OTC abuse – and this is troublesome

12. Local Drug & Alcohol Scene
Insert text here
Primary drugs of abuse, stats, news stories, etc.

13. Time To Act Website www.drugfree.org/timetoact
Dynamic, interactive site that allows parents to follow one of two tracks – What to do if:
I think my child is using
I know my child is using
So – we know that drugs are out there; and kids are making decisions whether or not to use.
The Partnership talks with parents – a lot.
The message they’ve received is “don’t just tell me to talk, give me tools to communicate with my kid,” especially when parents are in a crisis.
This led to the creation of the “Time to Act” website at
The Time to Act website is a valuable resource for parents in each of two different situations regarding drug/alcohol use by their children – one is when they suspect their child may be using, but may not be totally sure, and the other is when they know for sure that they are using.

14. But the most important step is to some take action if you think your child is having a problem. We start this section with a video from three parents who talk about the importance of taking action when you see that your child needs help.

16. Today, we are going to show you some of the resources that are available on this site and share some of the most important points you’ll fine there.
This dynamic, interactive site allows parents to follow one of two tracks – What to do if: “I think my child is using” or “I know my child is using.”
We will start by looking at the “think my child is using” track.

17. “I think my child is using”
First Step: Ask
Look for Signs
Learn Risk Factors
Why Teens Use
Need to Know
If you think your child is using, the Partnership recommends five steps:
Ask;
Look for signs;
Learn the risk factors that may make your child especially vulnerable; and
Learn why teens use
We also share some key points we believe parents need to know

18. “1. First Step: Ask” * Plan your conversation
Role play with spouse / friends
Call teacher / coach if others notice issues
Communicate concern & support, not “gotcha”
Know what you are going to ask
It can be easier to start by talking about friends
Learn what they know / think they know
Find the right time to ask
When you can really talk, not “on the run”
If you believe think your child might be using, the first step to take is to ask them.
This may not be an easy conversation, but it is an important one. In the same way that you would prepare for a job interview, or a presentation at work, you need to prepare for it.
Role play with spouse / friends.
Call teachers or coaches to see if they are also noticing the issues that are causing you concern.
But most of all, prepare to communicate concern & support; this should NOT be a “gotcha” situation While it is important to set and maintain rules against substance use, if you think your child is using you need to let them know that you care about them and this is a health issue.
Find the right time to ask and minimize distractions.
Know what you’re going to ask – you may start off by talking about whether they think kids are using at school; whether their friends are using; and finally, whether they have used or are using. *

19. “Communicate with concern”
In this video, Dr. Amelia Arria talks about the importance of communicating with concern.

21. “2. Look for Signs & Symptoms”
Signs of use / abuse
Behavioral issues
Personal appearance
Personal habits
Home, car related issues
Health issues
School or work related issues
Hard to tell difference between signs of use & “normal” teen behavior
Next, look for signs and symptoms that indicate your child may be using.
They may include behavioral issues – especially challenging or difficult behavior; changes in personal appearance, habits, and health issues; are they having problems at school or work?
It can be hard to tell the difference between signs of use & “normal” teen behavior. The keys are look for are multiple changes, or the suddenness of changes. Trust your instincts, and be aware of risk factors, which we will discuss in a moment.

22. At Time to Act, you will find clues that indicate how you can respond to behavioral issues, such as changes in relationships with family members or friends, decreased motivation, or changes in sleep habits.

23. “3. Learn Risk Factors” INDIVIDUAL FAMILY SCHOOL PEER COMMUNITY
In our lives, we analyze and respond to risks every day. For example, if we drive during bad weather, the risk of an accident is greater, so we slow down.
As caring adults, we need to look at the risks our kids face, and determine how to react to them. There are factors that may be present in your child’s life that increase their chances of either becoming involved with drugs/alcohol, or, once involved, increase their chances of getting in serious trouble with them. It should be emphasized that these factors are NOT predictors, but are indications of greater vulnerability.
At Time to Act, we organize these risk factors into individual risks factors; peer factors; family factors; school factors; and community factors.
The important point is that parents can take action to help their kids deal with all of these risk factors.
SCHOOL
PEER
COMMUNITY

24. Here, for example, is a look at the individual factors [CLICK] that contribute to drug use: early first use, low perception of risk, mental health issues, and lack of impulse control.
Just as importantly, Time to Talk provides information about what parents can do – for example, [CLICK]
Parents can model positive interactions with others; and
Help their kids develop problem-solving skills. Give your kid challenges appropriate to their age and abilities. Let them learn that it is ok to struggle – and even fail sometimes. The important part is working – and working hard – to solve the problems that they will face.

25. “4. Why Teens Use”
Many factors and situations affect teen’s choice whether or not to use
Fitting In
Sex
Socializing
Emotional Pain
Transitions
There are many reasons why teens may use. At Time to Act, these factors and situations are organized into:
Fitting In, Sex, Socializing, Emotional Pain, and Transitions.

26. In the time we have today, we can’t discuss all of the reasons why teens use, but we do want to discuss one of the most important reasons: emotional and psychological pain. The stresses kids feel are very real to them – family problems; loneliness; depression; even everyday teen drama can make kids feel that they need drugs or alcohol to erase the pain.
[CLICK] Time to Talk also offers videos from experts ….

27. “Changes in behavior”
In this video, Dr. Michael Thompson discussed changes in teen behavior.

29. “5. Need to Know”
Dispels myths and misperceptions some parents have about teen drug and alcohol abuse, such as:
“Teen drinking is no big deal”
“They’re just experimenting.”
“I would know if my kids are using.”
Time to Act also dispels myths about teen drug and alcohol abuse, such as …
“Teen drinking is no big deal” – At the site, an emergency room doctor dispels this myth by taking about what he sees as a result of teen drinking.
“They’re just experimenting” – Experimentation is not safe. Even first-time use can lead to accidents, injury, and death.
“I would know if my kids are using” -- Research shows that teens put a great deal of energy into concealing drug and alcohol use. From gum (to mask breath) to specially-bought containers that look like household items (to conceal drugs) teenagers are a never-ending source of ingenuity when it comes to hiding drug use.

30. Now that we’ve discussed how to respond you think your child might be using, we can now move to an even tougher discussion – what to do if you KNOW your child is using.

31. “I know my child is using”
Get Focused
Start Talking
Set Limits
Monitor
Get Outside Help
Here are the five steps to take when you know for sure that your kid is using drugs or alcohol (read bullets).

32. “1. Get Focused” Sit down, relax, and take time to breathe, then:
Talk with your spouse/partner
Prepare to be called a hypocrite
Gather any evidence
Expect denial and possible anger
Set an expected outcome
Spell out rules and consequences
Remind your teen of your support
The first step is to get focused:
Sit down, relax, and take time to breathe, then:
Talk with your spouse/partner – You want to present a united front to your child
Prepare to be called a hypocrite – Kids may challenge you about your current or past use. Don’t get diverted – the issue here and now is their use, their health, and their safety. It’s not about your past – it’s about their future.
Gather any evidence – Prior to having the conversation, identify the specific reasons why you think they are using.
Expect denial and possible anger: The most important thing is to keep the conversation going. Resolve to remain calm, no matter what your teen says -- Try not to be baited to respond with anger of your own.
Set an expected outcome -- While it's good to open up the conversation with your teen in any capacity, your conversation will probably go more smoothly if you have a desirable outcome in mind. A reasonable objective, like simply expressing that you don't want her to use, can be a small triumph.
Spell out rules and consequences -- Have an idea of the rules and consequences you'd like to set going in. Listen to your teen's feedback and let him help negotiate rules and consequences. Don't set rules you will have no way of enforcing.
Recognize the significance of addiction in the family -- Drug and alcohol dependence can happen to anyone. But if there is a history of addiction - cocaine, alcohol, nicotine, etc. - in your family, then your child has a much greater risk of developing an addiction. As a parent you need to be aware of this elevated risk and discuss it with your child regularly, as you would with any disease.
Remind your teen of your support -- As angry or frustrated as you feel, try to speak from a place of love, caring and concern - and express these feelings to your teen. Explain to your child that the reason you're talking with her and asking questions is because you love her and care about her and want her to be healthy and successful.

33. “We need to deal with this”
In this video, Dr. Jane Greer, a family therapist, talks about how to have this tough conversation with your child.

35. “2. Start Talking”
Starting a conversation with your child about his or her drug use is the most important step you can take in helping your child.
Prepare yourself
Have a conversation not a confrontation
Don’t just talk, listen
Find the best way to break through your teen’s barriers
Once you have prepared yourself, you want to have a conversation not a confrontation -- Express to your child that you're worried about her (example, "You haven't been yourself lately").
Don’t just talk, listen: Don't answer the phone or allow other interruptions while you're talking to your teen. Give them time and space to express themselves. Rephrase your teen's comments to show him you've heard what he's saying or give nonverbal support and encouragement.
One of the toughest things to do is to break through your teen’s barriers [CLICK]

36. Time to Act provides guidance on how to do this.
[CLICK] Some of the best advice is to remain calm. A screaming match doesn’t help anyone.
Let them know the importance of the truth. Telling the truth is not only important, it is the only way that you can get the bottom of the problems he or she is facing.

37. “3. Set Limits”
Kids want freedom. You don't want to be a nag. But when you've discovered drug or alcohol use, all bets are off.
Lay Down Rules: Rules provide a concrete way to help your kids understand what you expect and learn self– control.
Set Firm Consequences: Setting firm consequences for when your rules are broken is actually a help to your teenager, making it clear what they are to do and not to do.
Kids want freedom, and giving them as much freedom as they can handle is a good idea. But if drugs and alcohol are involved, all bets are off.
Rules provide a concrete way to help your kids understand what you expect and learn self–control. Don't just assume that they "know" you don't want them to drink or do drugs. Teens don't deal well with gray areas, so when they're offered alcohol or drugs, you don't want any confusion in their minds.
For rules to matter, they must be enforced. Be consistent, and make the consequence appropriate to the rule that has been broken.

38. At Time To Act, there is more detail on how to accomplish this, including [CLICK] a model contract that you and your child can use to map out the rules and consequences in your household.

39. “4. Monitor”
Collect Evidence: Parents decide whether or not to look through their child's room and belongings. If you do, remember: it's your house, and your primary responsibility is to the well–being of your child.
Keep Track: Knowing what did or didn’t happen can prevent “he said / she said” conversations.
Start Your Monitoring …
Whether you know your child has used, or think they are using, it is important to know what is going on in their lives.
You must decide whether or not to look through your child’s things, but your key consideration has to be whether your concerns for their health and safety are more important than their desire for privacy.
You want to keep track of what you find and incidents that cause you concern so that you don’t have a “he said / she said” conversation.
Time to Act offers ideas on how to start your monitoring…

40. Here you will find additional information about monitoring, including [CLICK, CLICK] specific ways to monitor:
Spend time with your teen – having family meals and activities are great, but just spending some time talking every day with them is a great way to connect.
Manage their activities. Know where they are, who they are with, and what they are doing.
Talk to other parents – especially the parents of your kid’s friends – so that you can work together to keep an eye on one another’s kids.

41. “5. Get Outside Help”
"Outside help" doesn’t equal “rehab.” There are many actions and approaches you can take that have nothing to do with rehab.
When seeking outside help:
Find out the extent of the problem
Why does my child need help?
Who can help my teen?
Get help for the rest of your family
Finally, be open and willing to get outside help.
While some situations may require your child to enter a treatment facility, don't be put off by the term "get help." Outside help includes school counselors, your family doctor, and even your child's sports team coach. All of them can be great resources and sources of support for you and your teen during this time.
When you seek outside help, you want to know:
What is the extent of the problem? Your child's drug use can be an act of teenage rebellion, a sign of full–fledged addiction, or anything in between. What you need help with first is identifying the actual problem. Professionals can use methods to help you pinpoint the issue you're dealing with.
Why does my child need help? Make no mistake – teen drug and alcohol use is a “big deal.” Whether your child is addicted to drugs, uses them infrequently, or was just "experimenting" one time with friends, a problem exists. It is far more dangerous for an adolescent to use drugs or alcohol than an adult — because his brain and body are still growing, doing drugs or drinking can take a permanent, irreversible toll on a kid. That's why you need to step in now and make sure that your child speaks and listens to all the various people who can help him quit using.
Who can help my teen? In addition to the people mentioned above, you can connect them with caring adults – especially someone your teen already knows and trusts; members of the clergy; or counselors at treatment centers.
How can you help for the rest of your family? Drug addiction affects more people than just the addict. Even if your non–drug–using children seem okay, chances are they're harboring some resentment towards their sibling and you for his destructive behavior or all the attention he's receiving, or may live in fear of the drug user's unknown future. By getting help to make sure that your other children are emotionally stable and fully comprehend their brother or sister's situation, you're aiding in everyone's recovery and healing process. It also helps the non–using sibling to have his feelings of resentment and anger validated. They have a right to be angry, frustrated and hurt about the situation.
You (and your partner) must also be healthy and in a clear state of mind. Many parents lose the ability to think and act rationally when they have a child in danger. Some parents become so obsessed with their child and her problem that they neglect the other important aspects of their own lives: their jobs, physical health, and other kids. It is therefore as vital that you seek help for your own emotional well-being as it is for your drug-using child.

42. The “Get Outside Help and Support” section of the website also contains important information on finding out the extent of the problem.
To solve any problem – especially health issues -- information is critical. Before a doctor puts a cast on your broken arm, you’re probably going to get an x-ray. Before you can get your child the help they need, having them talk with a professional is a good place to start. This discussion between the kid you care about and a doctor or counselor can take place over the phone, or face-to-face at a treatment facility.
If you determine a problem exists, then an evaluation at a treatment center can help you figure out the extent of the problem and the best next steps for your child, and your whole family.
A treatment facility finder is available on this page.

43. “Don’t imagine you can do this all by yourself”
Next, we hear from David Sheff, father of a son struggling with addiction and author of the best-selling book “Beautiful Boy,” and Dr. Richard Rawson, one of the nation’s leading substance abuse researchers.

45. Getting Outside Help in Our Community
Add local information
Local treatment centers, phone numbers, web sites, emergency numbers, support groups and other resources
In our community, here are some places where you can get additional help and support:

46. Next Steps – Prepare your home and family
Safeguard prescription and over-the-counter drugs and alcohol
39% of teens who abuse prescription drugs obtain them from friends, or their family’s medicine cabinet
Dispose of medicines properly
Ask family (especially grandparents)/friends to be alert and also safeguard drugs and alcohol
So – what do you do now?
First – safeguard any prescription and over-the-counter drugs, as well as any alcohol in your home. Four out of ten teens who abuse prescription drugs obtain them from friends, or their family’s medicine cabinet.
If you have unused or expired medications, dispose of them properly. That means removing them from the bottle and mixing them with something unpleasant like coffee grounds or cat litter. Sad to say, but if you just throw them out, some people will go through the garbage to get them.
Ask for help – ask family / friends to be alert and also safeguard drugs and alcohol. Even if you feel comfortable that your child wouldn’t take someone’s drugs or alcohol, you can’t make that same guarantee for all their friends.

47. Next Steps -- Talk
Talk to your teen about alcohol and other drugs: kids who learn about the risks of drugs at home are up to 50% less likely to use.
Talk to other parents / caring adults about what you’ve learned today.
Share this presentation with others.
We thank you for your participation in this presentation, and we ask you to use the information you’ve received today.
Talk to your teen about alcohol and other drugs: kids who learn about the risks of drugs at home are up to 50% less likely to use.
Talk to other parents / caring adults about what you’ve learned today.
And share this presentation and the website with your friends, family, and co-workers.

48. Next Steps – Get more information
Partnership Intervene Blog: intervene.drugfree.org -- A community of experts, parents and caring adults have come together to share our insights, inspiration, guidance and help
Time to Talk: timetotalk.org -- TimeToTalk provides easy-to-use guides and tips to help you have ongoing conversations with your kids to keep them healthy and drug-free
At drugfree.org, learn more, sign up for our newsletters, become a fan at Facebook, or follow us on Twitter
Beyond Time to Act, the Partnership offers many other web resources –
At the Partnership’s Intervene blog, you can become part of a community of experts, parents and caring adults have come together to share our insights, inspiration, guidance and help.
Time to Talk offers guides and tips to help you keep the conversation going; and
At the Partnership’s main site, drugfree.org, you can learn more across the breadth of the substance abuse issue, sign up for newsletters, become a fan on Facebook, or follow us on Twitter.

49. Time To Act and this presentation were made possible
by an unrestricted grant from Purdue Pharma