Teenage Substance Misuse: What Parents Do Know

Research from the Research Institute on Addictions (RIA) at the University of Buffalo published in the Journal of Child and Adolescent Substance Abuse found that the majority of parents could accurately evaluate their teenagers' cigarette smoking and substance use. Examples of underestimation were nearly twice as likely to involve frequency of marijuana and quantity of alcohol use. Parents also were less likely to be aware of the extent of use by younger teens or if they themselves had personal problems or were using alcohol more frequently.

This study is believed to be the first to focus on families in which the teen's substance use is causing parental stress, but the teen is not necessarily in substance-abuse treatment. Previous studies have been restricted to families with teens in treatment or with no current substance use issues.

Lead researcher Neil B. McGillicuddy said:

"This study begins to dispel the notion that parents don't know the extent to which their teens are using cigarettes, alcohol and illicit drugs. It seems that, despite a few exceptions, many parents do know the extent of their teenager's substance use. Parents can use this knowledge to help themselves cope with teenage substance use and the resulting stress on the family, as well as to begin conversations with their teen about making changes."

Funded by the National Institute on Drug Abuse, researchers separately interviewed 75 parents and their teenagers about the teens' recent use of cigarettes, alcohol, marijuana and other illicit drugs. Parents were, on average, female (85 per cent), 39 years of age and with 13 years of education. Teens were, on average, male (61 per cent), 16 years of age and not receiving substance abuse treatment (76 per cent).

Reporting over a six-month period, parents accurately reported teen smoking (82 per cent corresponding with the teens' reports); alcohol use (86 per cent) and marijuana use (86 per cent). However, only 72 per cent of parents accurately reported the presence of other illicit drug use by teens.

When there was a discrepancy, parents provided lower estimates of the frequency and amount of substance use. Some were small (for instance how often teens drank alcohol) but others were substantial (parents were nearly twice as likely to underestimate the frequency of marijuana use and the quantity of alcohol use).

Researchers found that parents tended to be less aware of the extent of the teen's substance use if the teen was younger (about 14 or 15) and if they were less aware of what their teens were doing in their leisure time suggesting the need for increased monitoring and to consider substance use at a significantly younger age. Parents dealing with their own problems, and possibly stressed, depressed or using alcohol more frequently, were also less accurate.

Neil McGillicuddy commented:

"What we would hope that people come away with from this study, is that parents can be more aware of their teen's substance use by reducing their own alcohol use, giving more attention to what their teen is doing 24/7, particularly if the teen is younger, and taking steps to reduce their own psychological distress. Participation in parenting programs, especially those geared toward coping with an adolescent's substance use, can give the parent important skills to deal with teen behavior and have been found to reduce the parent's distress."

What Parents Don't Know

A study by a number of co-authors published in the October 2006 issue of Alcoholism: Clinical & Experimental Research examined how helpful parents may be in assessing their children's alcohol and/or drug use and abuse. Previous assessments of child psychopathology have shown that parents can be helpful in reporting symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD). Findings indicate that they do not provide valuable information because they are often unaware of it.

Laura Jean Bierut, associate professor of psychiatry at Washington University School of Medicine explained:

"'Externalizing' disorders such as ADHD and ODD have behaviors associated with them that are obvious and affect others. For example, a child who cannot sit still or focus on his or her work at school and is disruptive in the classroom, or a child who argues with his or her parents or refuses to do the things that they ask. However, the symptoms associated with 'internalizing' disorders such as depression can be much more subtle and not as easily recognized. Things like feelings of worthlessness or loss of interest in favorite activities can be very troubling to a child, but they don't necessarily impact others and might go unnoticed unless the child chooses to talk about them."

Sherri Fisher, project coordinator of the St. Louis site of the Collaborative Study on the Genetics of Alcoholism (COGA) and a co-author added:

"In terms of psychiatric disorders in general, this 'disconnect' points out the importance of talking to both parents and children about the child's behavior and symptoms. In terms of a child's substance use or substance-related problems, however, parents may be unaware of what's going on with their children, or simply repeat information that has already been reported by their child."

To further test this hypothesis, researchers used data gathered as part of COGA, a multi-centre family study initiated in 1989. For this analysis, 591 adolescent-parent pairs who participated in COGA between 1991 and 1998 were interviewed: 12-17-year-olds were administered the child version of the Semi-Structured Assessment for the Genetics of Alcoholism (C-SSAGA), and one corresponding parent, usually the biological mother, was also interviewed about each adolescent using the parent version of C-SSAGA.

Laura Bierut said:

"The three most commonly used substances as reported by adolescents in our study were alcohol at 54 per cent, tobacco at 44 per cent, and marijuana at 23 per cent. We then compared the answers given by the teens and parents to see how often they agreed on this use."

The primary finding was that parents often failed to report that their children had used a substance when the children themselves reported that they had.

Laura Bierut commented:

"Specifically, if a child reported having used alcohol, the parent said their child had used alcohol only 50 per cent of the time. Similarly, when a child reported having used tobacco, the parent reported this only 55 per cent of the time, and when a child reported having used marijuana, the parent report agreed only 47 per cent of the time."

The study found that parents were even more unaware of their child's use of other drugs.

"When a child reported using any of the other drugs we asked about - for example, cocaine, speed, downers - the parent agreed that their child had used any of these drugs in only 28 per cent of the cases" Laura Bierut added.

Even among children who reported experiencing symptoms of alcohol or marijuana abuse or dependence, there were parents who did not know that their child had ever used these substances. The study noted that the age of the child was one of the most influential factors in terms of parental awareness of adolescent substance use.

Laura Bierut said:

"Specifically, there was higher agreement between the reports of parents and older adolescents. Parental agreement was highest with 16- to 17-year-olds, and lowest with 12- to 13-year-olds. This is very troubling because research has shown that starting to use alcohol and drugs at a young age is a risk factor for developing substance abuse or dependence in the future."

Sherri Fisher added:

"In general, we found that parent reports added very little information to our knowledge about adolescent substance use beyond what adolescents themselves were reporting, particularly when compared to other types of psychiatric disorders like ADHD and ODD. Our conclusion is that parents do not provide valuable information about their children's use of alcohol and drugs because they simply don't know about it."

She suggested that researchers may want to reconsider using time and resources to question parents at all when it comes to issues of adolescent substance use, abuse or dependence.

Laura Bierut said that the research clearly indicates that teens are using alcohol and drugs but concluded:

"Parents who were surveyed, however, were largely unaware of this. Although as parents we might like to think that our children are not reflected in these percentages, it is important to realize that our kids do have access to substances and might very well be using them."