It can be hard to get a teenager to talk about anything, period. So when it comes to talking to teens about drugs and addiction? Yikes. River, a teacher, wants to know how to talk to her students about addiction, without stigmatizing people who have addictions. And Suzanne, who works in a treatment center and has two teenage sons of her own, is curious why no one talks about difficult emotions and coping mechanisms as addiction prevention. So this week, Nzinga tells us how she talked to her own kids, and she and Claire do another roleplay.
Please note, In Recovery contains mature themes and may not be appropriate for all listeners.
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Other resources mentioned in the show:
● Video from Dr. Hope Seidel: https://www.youtube.com/watch?v=XwG5UqbePj8
[00:01] Dr. Nzinga Harrison: OK, Zahir. So what’s the earliest you remember me talking to you about addiction? About how old were you?
[00:10] Zahir: I was like nine or 10. And I came and asked you a question about something medicine related. And we ended up going into a tangent about all things medicine, which included addiction.
[00:25] Dr. Nzinga Harrison: So, OK, now that you are 14 years old, what thoughts do you have about addiction?
[00:37] Zahir: It’s much more serious than a lot of people tend to think. And it’s harder to get out of and break out of the cycle than a lot of people think. They kind of make light of it when they’re just scratching the tip of the iceberg.
[00:55] Dr. Nzinga Harrison: OK. That was pretty deep. So if you were talking to adults and you were gonna give them a piece of advice about how to talk to a teenager about addiction, what piece of advice would you give them?
[01:12] Zahir: I can’t exactly give like a general statement for how to talk to all of them, but never actually give up on talking to them, because if you keep trying, eventually you’re going to break through and something’s going to happen.
[01:27] Dr. Nzinga Harrison: I love it. That is actually really, really great advice, because one thing that we all need is, when we’re at our most desperate, somebody who can be there to reach out their hand and grab a hold of us.
[01:55] Dr. Nzinga Harrison: So you just heard me talking to my son Zahir, who’s 14, about addiction. And you can sort of tell it was a little awkward. I wasn’t even talking to him about his own drug use and it was still kind of awkward. So this is what we’re talking about today: how to have conversations with teens about addiction, because not only can it be awkward, it can be painful. It can be scary. It can be very intense. But we have to do it. So let’s talk about how we get past all of that awkward, painful, scary and intense and have this conversation. So for those who might be new, thank you for tuning in. You’re listening to In Recovery with Dr. Nzinga Harrison. That’s me. I’m your host. I mentioned I’m a doctor, psychiatrist, addiction expert, mom, wife, human. And we talk about all things addiction on this show. This show is a question and answer show. So we really try to approach all different types of addictions. So drugs, yes, but also sex, exercise, work, things that we wouldn’t necessarily usually think of as addiction, but things that can absolutely bring us negative consequences. And we answer your questions about it and we talk about how we can approach those with compassion and evidence base and what works to help people stop having negative consequences of things that might be acting like addiction in their lives. And so with that somewhat long introduction this week, maybe we can jump right into the show.
[03:31] Claire Jones: Nzinga, I want to hear a little bit about when you start talking to your kids about addiction and what your approach was?
[04:03] Dr. Nzinga Harrison: So that’s so funny — I think kids just can’t remember before nine years old. So I remember Zahir was in pre-K, so he was four years old, and it was career day at school. And I was like, oh, this school has no idea what they have gotten into asking me to talk to these kids for Career Day. And so the way Career Day was structured, it’s elementary school, so it’s pre-K through five. And you basically spent 30 minutes in each grade in a different class. So 30 minutes, I started in pre-K, and then I went to K, and then I went to 1 to all the way up to fifth grade. I was there all day and I wore my white coat. And for the pre-K kids, I said, I’m a doctor and I specialize in the brain. And the brain illness that I specialize in taking care of is addiction to alcohol and drugs. Anybody here know what alcohol and drugs are? That was the pre-K talk. And I mean, surprisingly, these pre-K kids were worldly. They knew exactly what alcohol and drugs were. And I hate to tell you parents, but they spilled all of the business in the streets. Because they’re four years old. So they’re like, “do you mean when my daddy hides his beer cans in the trash so mommy won’t see?” And I was ohhh, I wasn’t trying to put daddy’s business all out in the street like that, but yes, this is what I mean.
[05:46] Dr. Nzinga Harrison: And so with the pre-K kids, it was so, you know, when mommy or daddy or your brother or sister has a cold and they’re really sick, and you want to do everything that you can do to make sure you can help them feel better? This is the same thing. People get sick and they have this addiction and we want to do everything we can to help them get better. And then as it got to the older kids, it was there is a genetic risk. So just like we inherit high blood pressure and diabetes and asthma, we inherit our risk for addiction. And so for my kids, I have a serious family history of addiction, both sides. My maternal side and my paternal side. And so I was telling the kids like, listen, you know, at some point in adolescence, trying drugs is a normal part of development. And so you’re going to be with your friends and you’re going to be like, “I want to smoke weed. Everybody else is smoking weed.” I’m like, just know, your DNA has risk for schizophrenia and drug addiction. So your friend might be able to smoke marijuana and be just fine. You might smoke marijuana and develop psychosis. Your friends might be able to do a line of cocaine, and it’s just a line. Based on our family history, if you do a line of cocaine, we have some very serious implications coming. And so it’s a wider than just say no, because teenagers don’t like us telling them what to do. They’re independently thinking beings that have the ability to draw a connection between their thoughts and their feelings and the space in between, which is decisions and then their behaviors. And so we have to give them the information and the credit for that. And so what I told my kids is you can always tell me everything, even if you know it’s gonna make my eyeballs fall out and my earballs fall off. You can always come and you can always tell me that, because my goal is just to keep you safe and to help you develop into an adult that can line up your thoughts and your emotions. Accept them from what they are. Use information to try to make the best decision in the moment.
[08:17] Claire Jones: We had a question from a listener who is a teacher and wants to know the best way to talk about addiction and drugs and alcohol without stigmatizing people who have an addiction. And so I’m sort of just curious, like, how do we have these conversations when it’s somebody else’s kids? You know, especially in the context of teaching, you probably have to adjust per kid. You probably have to adjust between different schools. So it’s like, how do you have a conversation about evidence-based compassion and this view, like you kept saying, like this is an illness, to kids who are getting a totally different education about addiction. The listener’s specific question is, “how do I talk about drugs for a teenager or young adult? I know that a lot of teens experiment with weed and alcohol, so how do I approach this conversation with the kids I work with so they understand how to keep themselves safe without stigmatizing people with addiction?”
[09:19] Dr. Nzinga Harrison: Claire, you put your finger right on it, which is that it really has to be individualized. That said, I think the first assumption we can make is that every teenager you’re talking to has had some experience in their life with somebody that has had an addiction of some sort. Because what we’ve been deluding ourselves, or pretending in this country when we have this conversation is that addiction is the exception in this country, when in reality, addiction is the rule. Like, there almost is no person who has not had their own experience with addiction. And so I think if we first make that assumption that this teenager has probably had some own personal life experience, some kind of way, then this is true of when you’re talking to a teenager about anything, is really approaching the conversation in the listener role. Not in the ‘I’m telling you what you need to know. I’m about to teach you something’ role. And this is the kind of conversation that you need to open up with. “What has your experience been? What are your current thoughts about it? What feelings, thoughts, emotions do you have around addiction? And how has your life experience kind of formed that thinking?” And then you take the information that you get from those teens and start layering in the education.
[10:46] Claire Jones: You’re also not their parents. And that is a really different role where you can be like this is a safe space to talk about the stuff honestly, because that is how we can be the safest about it. Teenagers are sort of — that’s like when a lot of people start to explore drugs and alcohol. So if they have a person where they can feel safe and honest about it, and they can go to them questions, that is a really good setup for them. I’m curious — you have two teenage sons. What’s your sense of what this conversation is right now with teens. What’s their substance use education? Or like what’s the equivalent of, you know, like the birds and the bees talk, sex education in school? What’s like the drugs and alcohol equivalent that teens are getting today?
[11:35] Dr. Nzinga Harrison: Yeah. So I think it really varies. I have to say, Zahir finished freshman year of high school a couple of months ago, and I was shocked and pleased when he was doing health education and he brought home a worksheet that was like, these are the different kinds of drugs. This is how you use these drugs. Like, it was just different educational facts about drugs, how drugs can affect the body, how drugs can affect the relationship, risk of drugs. And I was like, you guys are doing this in health? And he said in Georgia, you actually have to pass this drug education curriculum in order to be eligible to get your license. And so I was like, that’s great. What I also really appreciated about the information that he was bringing home is that it was not value-laden information. It was not like you should never use drugs. It wasn’t people who use drugs are — it was literally just like these are the different classes of drugs. This is how they affect you if you take it. This is what’s going to happen if this starts happening. This is how, you know, it might be a problem. Like, it was very just neutral drug education, which I appreciated, because what it did, when I saw that homework sheet, was open the opportunity for us to talk about drugs from our value perspective as a family. The only thing I want teachers to do is to be able to provide objective education, like, yes, this person teaches people that trying pain pills for fun go on to get addicted to heroin. This is what that pathway looks like. So if you see yourself or someone else walking on that pathway, this is how you intervene. Like, just very objective information for the first part, and then the second part is making sure every kid has an adult — and it doesn’t have to be you. But if it can be you, that’s great. But just like one adult where they can have a nonjudgmental, non-finger-wagging non-this is what you must and must not do conversation about drugs. The same for sex.
[14:13] Claire Jones: OK. So we now know relatively how to have a conversation with kids about drugs and addiction, which can be pretty hard. But the nice thing is, at least that conversation is happening, right? Like from sex education to drug education to addiction education, they’re like awkward and like not super fun to have. But it does seem like that is something that’s happening. But it seems like not a lot of people actually have an explicit conversation about the things that actually lead to drug use. Like a family is way more likely to be like, here’s what you need to know about drugs. But it seems a lot less likely that they’re going to be like, let’s talk about emotions and labeling emotions and trauma and how to cope with those things. We got a voicemail from a Last Day listener about how she works in a treatment center, she’s in recovery herself. And a lot of adults that she works with in this treatment center who are learning new coping skills for the first time, and learning how to deal with trauma and difficult emotions, all the time are asking her, like, why did we not learn this earlier? So let’s listen to a little bit of that. And then I want to know what those coping skills are for both kids and adults later on and how we have that conversation.
[15:31] Caller: “Over and over again, I hear, why didn’t I learn all of this in middle school and high school? And basically what they’re referring to is the coping skills when it comes to stress and basically managing discomfort. You know, when I talk to my kids, I say to them, do you know how many people I need that they say I can’t even imagine socializing without alcohol or weed or something like that.” And so what I explain to my kids is that everybody has social anxiety. Everybody feels awkward in social situations to some degree. During that time, you’re basically learning that every time I go out to a party, every time I’m socializing, every time I’m nervous, every time I’m stressed, every time I feel socially awkward or I don’t have enough courage to speak to somebody or whatever it is, you start to basically ingest some substance, then that is what your brain is learning.
[16:33] Dr. Nzinga Harrison: Yeah. Wow. Thanks, Suzanne, for your voicemail. That is just spot-on. So let’s say 60 percent of your addiction risk is coded for in your DNA. Then it is our responsibility to make sure your other 40 percent, your nurture 40 percent, is not compounding your biological risk. The literature shows kids that have meditation and yoga in elementary school have reduced risk for mental health and substance use disorders later in life. Kids that learn what emotions are, what thinking is, how to create that space between emotions and thinking, which are automatic, and decisions, which are intentional and lead to behaviors. Kids that have that kind of coping skills training and support do better later in life. And so it’s a tall order because I don’t know about you, Claire, you’re probably a decade younger than me, but certainly in my decade, like emotions was not part of our curriculum. Coping skills, not part of our curriculum. Bullying was damn near part of our curriculum growing up, right? And at least in my kind of growing up, and I think part of this might be black families, part of this might go beyond that. But my experiences growing up in a black family is like kids are seen, not heard. So you’re a kid over here having all these thoughts and feelings and questions and no avenue to raise those in a way that’s validated and appreciated.
[18:25] Dr. Nzinga Harrison: Kids are born different. Zahir was born and he is like impulsive, do it right now, think about it later. So from the time he was two years old, we had a mantra for him. That was “think first. Think first.” We started yoga and meditation for both kids, two years old. We started talking about emotions. This is how our emotions affect our thinking. This is how that affects what we do. We want to be conscious of what we do. We started that work very, very early. Nassir, on the other hand, was born risk-averse. I promise you that child could have walked three months before that child walked. I see you. You can walk. And you can, like, see his little brain be like I don’t know! Walking seems dangerous! And so the parenting for his 40 percent is different. The parenting for his 40 percent is like, you can take a risk. This is how you recognize the risks that are safe to take. If you take a risk and it turns out not to be safe, this is how you get out of it. And part of that can always be calling me and dad and just being like, so I messed up. And I’m in a situation, yeah. And I need some help getting out of it. We are always going to try to get you out of a situation. Zahir, you don’t have to take every risk. Nassir, you should take some risks. Both of you: meditation, mindfulness, and they’ll let me leave out therapy. Everybody in this family has had a therapist. I try to get everybody to have a therapist. We love it. OK. To the point that I feel really proud. Both of my kids have come to me independently at points in their lives and said, can I go back and see my therapist? We have to look at priorities, right? So everybody will say, oh, there’s so much happening in schools already, there is no space for it. There’s no time. But you honestly just have to prioritize mindfulness and coping over the Pythagorean theorem.
[20:57] Claire Jones: Do you want know what I have spent so many hours in my adult life? Therapy. Do you want to know what I haven’t used one since I learned it? The Pythagorean Theorem.
[21:07] Dr. Nzinga Harrison: And don’t get me wrong, because I am a math lover all day and all night. But you literally just have to prioritize it. You just do. Because it’s the foundation, like you were saying, it’s the foundation of all learning. So you would actually need less time to teach the Pythagorean Theorem if kids were able to emotionally regulate.
[21:33] Claire Jones: Yeah. And like for schools that struggle with funding, like, you can have higher test scores if you put your kids in a position where they can learn.
[21:58] Dr. Nzinga Harrison: So, Claire, you know, we talk a lot, kind of theoretically, but one of the things I definitely want to do on this podcast is give like real language and real skills for how to go out and have these conversations in real life. So are you up for a role-play? So I’m going to play the expert, like I do in real life. I’m going to play the mom, actually, is what I’ll do. I’ll play the mom. And can you play the teenager? A senior in high school who has a history of anxiety. And she’s starting to feel kind of angry and hopeless because she feels like her drug and alcohol use is going beyond kind of normal high school partying. And as a mom, I’m also starting to be pretty worried about her. And so let’s start in the middle of a conversation that we’re having about her alcohol and drug use. So I’ll start it all here. So, Claire, I think you know that I’ve been worried about your alcohol and drug use. So I wanted to talk to you about how you’ve been feeling about it.
[23:13] Claire Jones: Yeah. I mean, I feel like I know it also can be sometimes problematic, but also I just do not know what to do. I don’t know what my options are.
[23:25] Dr. Nzinga Harrison: Yeah, I think it might be for us to just take a step back and see even outside of alcohol and drugs, because I don’t want that to be the only thing we’re talking about when we’re talking about how you feel and what I’m trying to like — you know, be your number one supporter mom. Because you’re obviously so much more than just whatever drugs or alcohol you’re using or what that pattern is. So just tell me, like, just you. How are you doing? I feel like I see you going through something. I don’t know exactly what it is. Just tell me about you. What’s what’s going on?
[24:06] Claire Jones: I just feel pretty overwhelmed. Like, it seems like everyone around me is applying to college. They’re all getting these, like, amazing internships that they had over the summer. Everybody did all this great work for the summer. And they’re either like applying to colleges and getting in right away. And just like accomplishing so much in their senior year of high school. And I’m just not. I just, you know, it’s like I didn’t do anything over the summer. I didn’t do any internships. I just don’t feel like I like him doing anything that’s cool or notable.
[24:42] Dr. Nzinga Harrison: Yeah, no, super stressful. I remember having some of those same kind of feelings. How do you feel — are you able to talk to your friends about it? Like, what kind of things are they saying about how you’re feeling? Are you getting any support from anywhere?
[24:55] Claire Jones: No. I mean, I feel like if I tried to talk to them, it would only just make me feel like more lame, because it’s like not only am I not doing the same kind of things that they’re doing, but I’m also like, now here I am being the one that’s like complaining to them about it. So I don’t really talk to them about it and can’t talk to anybody.
[25:16] Dr. Nzinga Harrison: You feel kind of on an island? I feel like that’s kind of what I’ve been noticing is that you seem kind of — I don’t know what a good word is — isolating and sad.
[25:29] Claire Jones: When I’m with my friends and we’re partying, it feels like we’re on the same level again. That feels like relief to me.
[25:40] Dr. Nzinga Harrison: So you think if you could find a way to feel on the same level and that relief without partying, would you do it, or you want partying at the level it is right now?
[25:52] Claire Jones: Well, I think it’s hard because if I found some other way to, like, be on their level, if I had to give up partying, then it’s like then I’m losing one of the main things that actually does connect me to those people. You know, it’s like now I’m the sober one, now I’m like now I can’t handle drugs and alcohol. I don’t know if that’s really what I want. I feel like I would lose my friends.
[26:20] Dr. Nzinga Harrison: And the pain of feeling like you’re losing your friends right now is like the whole situation we’re dealing with. Like that’s the whole thing that we started with. Kind of a vicious circle. I get it. Are you open to the idea of maybe trying to get at the root cause, like what’s driving this feeling of not feeling so sure about yourself or not being on the same level? Because my main goal here is like I see you not feeling good. And I’m just like, what do we have to figure out to try to get you back feeling better about yourself?
[26:57] Claire Jones: What would that look like? Like what would that be?
[27:02] Dr. Nzinga Harrison: I think the first thing is probably finding a therapist that’s closer to your age. Like kind of young. That you could just talk to, no holds barred, no judgment. You don’t have to live up to anything, you can just, like, here’s what’s going on with me. There are specifically young adult peer recovery-type of people who have been exactly in this place that you’re in that could talk to you about how they navigated their friend networks and the feelings that they had and how they kind of made it through.
[27:38] Claire Jones: Do you really think I’m at that level? Like, I don’t feel like I’m partying that hard, you know, or like that much more than my friends.
[27:47] Dr. Nzinga Harrison: I don’t think you’re partying that hard, but am I worried about you? Yes, because I know that it’s a slippery slope. And also, even if there was no drugs or alcohol at all, like, I don’t want you feeling bad about yourself. I don’t want you feeling bad about what you’re doing, feeling bad about your accomplishments. You know me. I’m like, you see a very early sign, like, get on it right now. And so I just want us to get on that right now.
[28:17] Claire Jones: I guess I just want there to be some kind of, like, medium place where this is something I can still do. Because it’s like every time I do go out, like there is a certain — you know, it’s like it’s fun up until a point. And then it’s like I feel like I lose control. And then I like, wake up in the morning with all of these texts and people are mad at me. And I have acted out at my friends. I just want to get to that point where it’s like I can go to these parties and I can still sort of maintain some sense of normalcy without sort of just falling off at the end of the night.
[29:02] Dr. Nzinga Harrison: I mean, you know, like your mom, I definitely have the impulse to be like, just don’t use at all. But as your mom, I also know that might not be like your goal, right? You’re telling me right now that you want to be able to use in a controlled way. Maybe it’s possible, but what we know is that with the skills you have right now, it hasn’t been possible. And so all I’m saying is like if we want to try this out — and I’m with you, I’ll be on this ride with you — we have to find somebody that can try to help you figure out, like, is this a skill-set you can have? I’ve read all kinds of things on the Internet, like, if it’s drinking, then you have your first two drinks and then after that you have virgin drinks that look like you’re drinking, so you’re not standing out, but so that you’re not getting piss-drunk, and then people are calling you the next day, like, what’s your problem? So I think there are probably a bunch of tricks that maybe we don’t know about, but that a professional, or a person who has been through this themselves, or a professional who has been through this themselves, like somebody knows this. And so all I’m asking is like, can we try to find somebody? Because I don’t know it. You don’t know it. Somebody knows it. Like, can we try to find somebody that can help you try to learn it so that you can at least try it out? Because what you’re telling me right now is what you’re doing right now ain’t meeting the goal.
[30:38] Claire Jones: Yeah, that sounds good. I think I’d like to try. I would like to find a way to do this in control.
[30:46] Dr. Nzinga Harrison: So let’s find somebody who can maybe give some ideas for how that happens.
[30:53] Claire Jones: OK. Yeah, thanks. That sounds good.
[31:12] Dr. Nzinga Harrison: So if I had to pull out the kind of learning points that I want from that role-playing, it’s like number one, come in in a listening stance. Number two, like I always say, divorce the behavior from the person. So we started very early on with, like, OK, let’s put the drugs and alcohol over there. Let’s just talk about how you’re doing. And number three, like you want the goal of that conversation to be that the drug use is not in the middle of you. They’re backing away. No, I don’t want to do this. No, I’m not going to do this. No, I’m not gonna do this. No, I’m not going to do this. It’s like I totally understand that. How do we get it to be me and you, and drug use is over there. OK. That’s not an option. We can take that off the table for now. How do we get it to be me and you against the drug use?
[32:08] Dr. Nzinga Harrison: Before we close, a little bit related to talking to teens and having a question from a teacher is the fact that we are in back to school time period during COVID. And I see so much stress and distress, and people are reaching out to me asking, what do I think as a physician, as a psychiatrist, as a mom about whether kids should go back to school. And so I actually wanted to share the words of wisdom from — you may have seen this viral video pediatrician, her name is Dr. Hope Seidel. But she’s a pediatrician in Cary, North Carolina. And she did this really beautiful just two minute video. And Claire, if we can drop this in the resources for the listeners. It started out with “the decision that you make for your family is the right decision, period. Every family’s circumstances are so very different. And the way you think about this decision, about whether to send your kids back, or whether to keep your kids at home, or whether to do a hybrid model, or whether to do home schooling, or whether to hire a tutor depends entirely on what’s going on with your family.” And I think part of the grace that we have to give ourselves as parents is that we are making the right decision for our kids based on the information that we have right now. So to quote Dr. Hope Seidel, “the decision you make about school for your kids is the right decision for you and your family.” And I want you to feel comfortable in that. And I want you to take peace and solace in that. And there are also no permanent decisions. You’re constantly taking in new information. You can change that decision. So that’s the best for you and your family and your kids. So, please, if you are agonizing and struggling, just take two minutes to watch Dr. Seidel’s video. I think it will make you feel better.
[34:30] Dr. Nzinga Harrison: In Recovery is a Lemonada Media original. The show is produced by Claire Jones and edited by Ivan Kuraev. Music is by Dan Molad. Jessica Cordova Kramer and Stephanie Wittels Wachs are our executive producers. Rate and review us and say nice things. And follow us @LemonadaMedia across all social platforms, or find me on Twitter @naharrisonmd. If you’ve learned from us, share the show with your others. Let’s help de-stigmatize addiction together.