By: Scott Hadland, MD, MPH, MS, FAAP

After years of talking to teens and their parents about drug use, here’s the most important thing I’ve learned: Connection is more than control.

I hear this all the time from parents: “I’m afraid my teenager might be using drugs, but I don’t know how to address it.“These fears are valid. Adolescence is a time of exploration and risk-taking, and today’s drugs—from high-potency cannabis to counterfeit pills laced with fentanyl—are far more dangerous than in previous decades.

But here’s the good news: You have more influence than you think. Here, I want to share what I often tell parents in my clinic: practical advice drawn from research and my experience in real-life conversations to help you keep your teen safe, supported, and informed.

Start with connection, not control

When parents worry about drug use, the first instinct is often to tighten the reins: Take a teen’s phone, search their room, and threaten punishment. But
research and experience shows that what teenagers need most is connection, not control.

Start a conversation

Instead of jumping straight to discipline, start a conversation. It is best to have these conversations early and often, long before you are concerned that your teen has come home after using drugs or alcohol. Conversations are more productive when they take place outside the heat of the moment, when everyone is calm and open.

Ask open-ended questions like “What have you heard about vaping at school?” or “How do your friends feel about drinking?“When teenagers feel judged, they shut down. But when they feel heard, they often open up.

Trust is protective. Scare tactics, on the other hand, can backfire. They can damage communication and make teens less likely to come to you when they’re in trouble.

Research shows that when teenagers feel mistrusted or
ashamedthey are more likely to hide their behavior rather than change it. Building a foundation of openness and honesty gives you more influence in the long run.

Know the drugs teenagers use

Drug use appears
different now than a generation ago. While alcohol is still the most commonly used drug among teenagers, high-potency hashish use – especially in the form of vapors or edible things– is more and more common. Nicotine vaping has also increased in recent years.

One of the biggest concerns today is the risk of
fake pills. Some teens experiment with pills they think are Xanax, Percocet or Adderall — when they may actually contain fentanyl or other substances. Even one pill can be fatal because these contaminants are often very potent and can quickly cause an overdose.

Staying informed about what teens are actually using can help you have more meaningful conversations. When teens sense that you’re up to date on what’s going on in their world—from the slang they use to the risks of vapors and edibles—they’re more likely to take you seriously. It also shows them that you care enough to understand, not just to judge.

When to involve your pediatrician or another professional

Sometimes it’s hard to tell if a teenager is experimenting or really struggling. If you notice changes in mood, sleepappetite, school performance or friendships, talk to your pediatrician.

Pediatricians are trained to screen for drug use and mental health concerns. In addition, teenagers often feel more comfortable talking to a doctor than to a parent. In some cases, your pediatrician may recommend a counselor, therapist, or substance abuse specialist.

For teenagers dealing with true addiction, it’s more
common than that they also face another mental health condition such as anxiety, depression, ADHD or trauma. It is important to treat both mental health and substance abuse problems together – and there is help available.

Focus on delay and safety, not perfection

One of the most important goals in adolescence is to delay drug use for as long as possible. The earlier a teenager starts using, the more
likely they must develop a substance use disorder (addiction) later in life. For example, teenagers who start using cannabis before the age of 18 are twice as likely to develop substance abuse problems than if they start after the age of 18.

That said, the goal shouldn’t be perfection – it’s protection. Even if your teen has experimented, you can still make a difference. Be curious and ask questions like “How might you react if someone at a party offers you a drink?”

Play to a teenager’s strengths. For example, if your teen has an independent streak, use it. You can say, “You’ve never been one to follow the crowd – how do you think it might help you make decisions if friends start using drugs or alcohol?“

Be clear about your values ​​and set expectations.

There are many positive messages about alcohol and drugs on TV and in social media; sometimes you may be the only voice sharing that you think it’s important not to use drugs.

Make a clear recommendation that you do not want your teen to use. For example, you can say “I care so much about your health and safety. I don’t want you to use alcohol or other drugs, especially while your brain is still developing.“Teenagers may roll their eyes – but research shows that they still do
hear you and that matters.

Don’t forget that parents can and should set boundaries and establish clear boundaries for a teenager’s behavior. Read more about it here.

Safety First: Rides and Overdose Prevention

One of the most important family rules to establish is about never driving under the influence – or driving with someone who is.

Tell your teen that they can always call or text you (or another trusted adult) for a ride, no questions asked.

If you’re not available, ride-sharing services like Uber or Lyft can be a good backup option—but only if your teen knows how to use them
certainly. (Talk ahead of time about how to check the driver’s name, license plate and rating before getting in. Also remind them to sit in the back seat and share their ride status with you or another trusted adult).

It is also worth talking about
naloxone (Narcan), a medication that reverses opioid overdoses. Naloxone is safe, easy to use and available at most pharmacies without a prescription. Every household – especially those with teenagers – should have it on hand.

Keep talking – it’s never just one talk

The most powerful prevention tool you have is your ongoing relationship with your teen. Don’t worry about giving a perfect talk. The most important thing is to have many small conversations over time.

Talk during a car ride while doing the dishes, over Sunday family breakfast or at bedtime. Be curious. Be calm. Let them know you’re always there to talk—about anything. Even if your teen has already experimented, it’s never too late to help guide them.

Remember

Your relationship with your teen is the best protection against drug use. Be curious. And reach out for support when you need it. We pediatricians are here to help.

More information