Thursday, 30 May 2013

Should I be worried if my teen is going to music festivals?



Music festivals like the Big Day Out, Splendour in The Grass and Good Vibrations have all become major events, with most capital cities and even some of the smaller cities across the country hosting such events. Over the years I have been involved with the organisation and running of some major dance parties and have also been contracted by a number of promoters to assist them with advice around alcohol and other drug safety. Years ago these events were only open to those aged 18 years or over but in recent times there has been a major shift and we are now seeing younger and younger teens attending music festivals.

One of the questions I get asked by many parents is what happens at these events and should I allow my child to attend?

Firstly I would say from a person who has attended dance festivals (in days gone by), as well as worked at many (from an organizer, medical, law enforcement liaison and crowd control perspective) I believe that these are not appropriate for anyone under 16 years of age (although of course this does really depend on so many things - any parent would know that the maturity of a teenager between the age of 15 and 18 can vary considerably). If I was really honest I think they really should have stayed at only being open to those 18 years and above but I’m terrified that this is just me getting older and becoming more conservative in my views! That said, I know this is a view that is shared by many promoters, as well as those who work at these events. These large-scale music festivals can be quite an overwhelming experience for some young people and they certainly are being exposed to a very specific culture that they may not have the maturity to cope with effectively.

Historically there is a strong link between ecstasy and the dance culture. The drug’s popularity increased through the 80s and 90s as the international dance scene grew. Some people who attend music festivals, dance events and nightclubs certainly use ecstasy and other drugs to 'enhance' their experience - altering their perception and giving them energy to dance for long periods of time. This does not mean that all people who are part of this culture use illegal drugs. However, it is important for parents to know that it is highly likely that their child will come into contact with drugs such as ecstasy if they regularly attend such events. Talking about drugs and letting your child know how you feel about drug use will play an important part in helping your child make good decisions in the future.

Young people take part in a range of different activities during their adolescence and beyond. Some of these activities involve risk-taking. Risks range from driving fast cars, abseiling down cliffs and drinking alcohol. Unfortunately, some young people will experiment with illegal drugs no matter what we try to do. Trying to prevent your child from taking part in things they like to do is likely to cause a great deal of problems in your relationship.That said, I believe it is totally acceptable for a parent to tell their adolescent that they believe that some activities are not suitable for young people - some activities are 'adult activities'!

If parents do choose to allow their child to attend music festivals they should make sure they voice their concerns and set rules and boundaries around behaviour. If you are concerned about drug use, let them know and tell them why you are worried. Keep the lines of communication open and let them know at every opportunity that they can come to you and talk about anything at anytime. Even though you may not know much about these drugs, take the opportunity to learn about them with your child. Be as honest as you can when you talk about drugs and don’t try to exaggerate the facts to scare them - warning them that if they try 'this or that' they could die is most probably not going to ring true to most young people. Certainly there are risks and there have been deaths linked to the use of ecstasy and related drugs, but they are not the norm and parents have to be careful in focusing on only the more extreme potential harms.

If you are very concerned that your child may get into a difficult or problematic situation make an emergency plan. For example, if they are out and have no way of getting home let them know that they can catch a taxi and you will pay. If they call you in the middle of the night that you won’t lose it, but will help. This does not mean that you are saying it is okay to take drugs or behave in ways of which you may not approve. But, it does mean that you will be there if thing go wrong in their lives. It also gives you the opportunity to openly communicate about what has gone wrong after the event as you are immediately “in-the-know” because you have been there for them.

It is also important to teach your child what to do in an emergency. Basic first aid skills, as well as simple information such as how to call 000, may help save a life.  Reinforce to your child that in a drug related emergency that the ambulance officers do not have to call the police, unless the person is refusing to seek treatment or there is the risk of injury to them.

Young people involved in the music festival scene also need to know the legal consequences of taking drugs such as ecstasy. New policing strategies such as drug detection dogs and roadside drug testing have resulted in more people from the dance culture being prosecuted for drug offences. Let your child know how being caught for using drugs will affect the rest of their lives.

Finally, make it very clear where you stand about the use of illegal drugs. As much as you may believe your views do not matter to your child, research shows that parental influence is still a major factor in the decisions many young people make.

So to summarise, there certainly is a link between music festivals, dance culture and drug use, however not all young people who go to dance events use drugs. Parents who are concerned should talk about drugs such as ecstasy with their child and let them know how they feel about drug use. It can also be useful to establish an emergency plan with your child if things do go wrong; this does not mean that you are condoning drug use or other unacceptable behaviour, but it does mean that you can be there for your child if things do go wrong.

Sunday, 12 May 2013

What do I say when my child asks about medical cannabis?

The issue of medical cannabis poses an increasingly difficult problem for those trying to provide cannabis prevention messages to young people. Since a number of American states have made 'medical marijuana' available I have had more and more students question why the drug is illegal in this country if it used as a 'medicine' in other countries. I'm also being asked by parents attending my presentations how best to handle questions around the issue ...

I'm not the biggest fan of American TV comedies but recently I have watched a couple of such shows that have based the week's episode around the availability of medical cannabis - as you can imagine, hilarity ensues! When you think how much our society is saturated with American pop-culture references and how much these influence our day-to-day life, it's not surprising that some young Australians are starting to believe that cannabis is also available in this country for therapeutic purposes.

Even those in the 'pro-cannabis' camp acknowledge that the earlier a person starts using the drug, the greater the risks (what those risks are causes the great debate), so it is important to try to prevent early use of cannabis whenever possible. So what do we know about the therapeutic benefits of cannabis and what do we tell young people to clarify the issue and not confuse our basic prevention messages? 

There's no getting away from the fact that the medical uses of cannabis have been recognized for thousands of years. Physicians in ancient China used it to relieve constipation, loss of appetite and pain during childbirth. However, with the development of pharmaceutical drugs in the 20th century, herbal cures in general fell into disuse. In recent times, however, more and more people have been searching for alternative remedies that may have fewer side effects than the medicines they have been prescribed by their doctors.
 
Although there are often existing therapies available for the medical conditions that cannabis may be used to treat, some people experience severe reactions when they are used or they simply don't work effectively for them. Cannabis appears to offer an alternative for those people. Some of these conditions include:
  • pain relief
  • nausea and vomiting, particularly in those people who are having chemotherapy for cancer
  • wasting, or severe weight loss, in people who may have cancer or AIDS
  • neurological disorders such as multiple sclerosis (MS)

Although some people smoke cannabis for therapeutic reasons, there are many researchers around the world who are currently trying to develop synthetic products that work in a similar way to cannabis. We use the term 'cannabinoids' to refer to pharmaceutical quality drugs that act in the same way in the body as some substances in the cannabis plant, such as THC.

It is very important to remember that cannabis and cannabinoids are useful to relieve symptoms of illnesses, but do not cure the underlying disease.
 
Using cannabis for medical reasons is all about 'weighing up the pros and cons'. There are a range of negative consequences associated with cannabis use, some of them linked to smoking the drug, others that are not. One of the most significant of these, particularly for young people, is that the drug continues to be illegal across Australia. A person who uses cannabis for medical reasons and gets caught is not exempt from prosecution. These risks need to be remembered. However, if a person is dying from cancer, is in great pain and does not have long to live, and all the pharmaceutical drugs in the world have not made any difference, the possibility of some relief can make cannabis appear very attractive.
 
When Sid called me to ask me questions about cannabis and its effects, I was immediately impressed by the older gentleman. He had been married to his wife, Mary, for over 50 years and for the past few years she had been extremely ill as a result of cancer. She had been bed-ridden for the past six months and had been in great pain. The doctors had tried every type of pain killer and none had been effective. The doctors said that she did not have much time to live and the best they could do was to keep her as comfortable as possible. Unfortunately they didn’t seem to be doing a very good job.
 
Sid had heard about cannabis from another partner of someone with cancer who had experienced some major pain relief after smoking cannabis. Sid finally went to one of his grandsons and asked him to purchase the drug so he could see if it would have a similar effect on his wife. He had used the drug in a tea and saw an immediate effect on his wife and desperately wanted to know more.
 
He told me that he could not buy the drug through his family anymore. He was well aware that the drug was illegal and did not want to expose any of his family members to the legal ramifications but he did not know where to turn next. I referred him to some pro-cannabis websites that may give him some information and wished him well.
 
Over six months later Sid called me to tell me that Mary had died. The last few months had been almost pain free for the woman due to some cannabis that Sid had been able to purchase through a website he had found which specifically helped people like him.
 
Sid had a major moral dilemma. He did not approve of illegal drugs and he had read up on the health effects of cannabis and was well aware of the legal risks that he was taking. He had 'weighed up the pros and cons' of using the drug, however, and felt that in his circumstance it was worth the risk to improve Mary’s quality of life.
 
When you discuss this topic with your children there are a whole pile of moral issues that come into play. For most parents, this conversation with your teenagers is not going to be as simple as easy as 'cannabis is a medicine' or 'cannabis is illegal'. This is a complex area and one that can stimulate interesting debate and thought from all parties.

Saturday, 11 May 2013

Communicating messages to young people through real-life stories

Anybody who has ever heard me present knows that a big part of my talks are 'stories' – things that have happened to young people and their parents that I have met over the years. Their names are changed and any information that may identify a particular person or event is altered, but it is usually these anecdotes that have the greatest impact on those attending my presentations.

With as many talks as I give I sometimes worry that there will be someone in the audience who may know the person I am talking about – no matter how well disguised there are some stories that may be identified by some. I faced this same dilemma when I wrote Teenagers, Alcohol and Drugs a few years ago. Should I get the person's permission if I use a story they told me? How would someone feel if they pick up the book and find their story on the pages?

As I said in the introduction to the book, my concern was addressed when I was giving a presentation to a group of educators in Perth.

Since 2006 at the end of each of my talks to school communities, I have told the story of a Perth teenage girl who died under tragic circumstances. I use the story to illustrate how important it is that young people have basic life skills so that they will know what to do in an emergency.

The story is very moving and never fails to result in the audience being shocked at the tragic loss. However, during this talk one woman’s reactions were extreme to say the least. As I was sharing the story she began to become very upset. She was crying and the man who was sitting next to her needed to console her. There was nothing I could do at the time and continued with the story.

Once the presentation had finished the woman made her way to the front of the stage and I moved towards her to apologise if I had upset her in any way. Fighting back the tears she told me that the girl in the story had been her niece. I had no idea what to say. Had I got the story wrong? Had I misrepresented the young girl or brought back bad memories to the aunt?

She was quick to set my mind at rest and thanked me for talking about her niece. She told me that she had been a lovely girl and that the family was still recovering from the loss of teenager.

"If telling her story protects one other young person from dying in a similar way, then tell the story as often as you can," she said.

Since that time I have been contacted by another member of the girl's family who also wanted to thank me for using the story in a positive way. They have attempted to keep the story alive but had found it difficult. In my privileged position I am able to do so.  

Real-life stories are a great way of getting messages across to any audience. That is why news and current affairs programs are always looking for a personal tale to attach to new research findings or the latest statistics. Numbers are powerful but someone talking about their own story tugs at the heart-strings and is sure to get an emotional response.

We can talk to young people all we want about the risks attached to particular adolescent behavior but we know that they 'weigh risk reward differently' - most of them certainly understand the dangers but they just give more weight to the payoff they receive, leading them to do risky things. Young people remember stories and if we can tie them emotionally to a story, it may increase the chances of them remembering the messages being communicated.

At a time when our younger generation are getting a 'bad rap' from the media it is important that we maintain some perspective. We actually have a group of young people who are genuinely interested in collecting information on keeping themselves and their friends as safe as possible. Unfortunately we are so obsessed about providing them with information about negative side effects of drugs (the information we think they should have in an attempt to get them to not use) that we ignore how they process information and make decisions.

There are certainly no guarantees that using real-life stories to communicate messages will prevent them making unhealthy choices (and I'm certainly not advocating ex-drug users presenting to students about their struggles as the evidence does not support this practice) but finding real-life stories that support the messages we want to get across to young people is certainly an approach that I find to be successful ...

Tuesday, 7 May 2013

Steroids and supplements: Are they an issue for school-based young men?

 
The story of two secondary school students caught with steroids at a private boys school in Queensland last week received national attention. Details of what they were selling and/or using have not been made public but what made this story particularly interesting is that it is the first time in my memory that performance and image enhancing drugs (PIEDs) have been seized in a school setting.

The principal responded swiftly and when you go to the school website there is a message from him that acknowledges that the "... incident, while serious, highlights the issues associated with body image for young men." He goes on to write that the "... College will continue its drug education program throughout the pastoral care program with a renewed interest and effort around body enhancing drugs and supplements."

So should we be worried about PIEDs and supplements? What does the evidence say and is use increasing amongst secondary school students?

Unfortunately we don't know much. Trying to find out anything about the use of these type of substances has always been difficult, even the excellent National Drug Strategy Household Survey (NDSHS), which provides us with most information on the alcohol and other drug use of the Australian population sheds little light on how many people have actually ever used steroids (it doesn't ask questions on any other PIEDs or supplements). According to the 2010 NDSHS there were only 0.4% of the Australian population who have ever used steroids for non-medical purposes and just 0.1% who used these drugs in the past year! This just doesn't make any sense and realistically just proves that this is an extremely difficult group to access and is what we call a 'hidden population'. They simply are not captured effectively in this type of population-wide survey.

When you look at the 2011 ASSAD survey that provides information on secondary school students' alcohol and other drug use, the questions are based around "using steroids without a doctor's prescription in an attempt to improve sporting ability, increase muscle size or improve appearance". The numbers are small, but still significant, with 2.4% of 12-17 males and 1.5% females reporting ever using steroids - the highest rate of use was amongst 15 year old males at 3.1%.

For many years we have talked about body image issues for young women but increasingly there is more discussion about the pressures that young men face in this area. If you watch any movie, TV show or advertisement, it is becomingly rare to see any young man who does not have the 'V shape' of broad shoulders, a tiny waist and 'washboard abs'. Like young women who try desperately to achieve the waif-like figures of catwalk models, many young men attempt to reach the often unachievable lean, muscular bodies of high-profile actors and sportsmen.

A study of PIEDs use in NSW conducted a number of years ago reinforced the importance of body image as the major motivation for PIEDs use, particularly the desirable effects on physique. The reported benefits of PIEDs use included: muscle definition, increased size, increased weight, increased strength, improved self-esteem, increased confidence and positive feedback from others. When you look at those 'benefits' it's not surprising that some young men going through that difficult time called adolescence see PIEDs use as a way of 'helping them through a little'.

Supplements like Creatine Monohydrate are incredibly popular at schools across the country, with coaches at some schools actively promoting the product. Let me make it clear at this stage that I'm not suggesting there is anything particularly wrong with this product but once you start promoting any supplement, it's not necessarily a huge leap to start using others, some of which may be more problematic, particularly for adolescents who have not completed their growth spurt. So what is creatine?
 
Creatine is normally obtained from the foods we eat and put simply supplies energy to the muscles. It is also believed that it increases the volume of muscles by pulling water molecules into muscle cells.  The highest sources of naturally-occurring creatine are meat and fish. Creatine Monohydrate, the substance that you buy at the health food store, is the synthetic form of naturally-occurring creatine. I have met many young men in schools across the country who use creatine, some who have been doing so for some time. Few of these knew very much about the product they were using and when I asked them why they chose creatine as a supplement, the usual response was that someone had told them that it 'worked'! That attitude worries me ...

I really have no idea how many school-based young men are using steroids or supplements. I certainly don't think there is an 'epidemic', but it's certainly happening and little quality education is currently provided to those are who may potentially use this wide range of substances. There is certainly great pressure on young men to look a certain way and, for some, PIEDs and supplements offer what appears to be an 'easier way' to achieve that goal. With the recent media coverage of elite sportsmen being supplied with a range of products by their club to give them the competitive edge, there has never been a better time to discuss how we should deal with this issue as far as school-based young people are concerned. 

Thursday, 2 May 2013

Is there such a thing as a 'recreational drug'?

Put simply, there is no such thing as a 'recreational drug'. It is a term not used in the scientific literature and anyone from the alcohol and other drug field who knows what they're talking about would never use it. Politicians and the media love the term, tossing it around frequently and then yell and scream about the term being 'inappropriate' – when in actual fact, they are the only ones who really use it!

Although there are no such things as recreational drugs, there is 'recreational drug use'. Maybe that seems like semantics but there really is a huge difference. It would appear that the media and some politicians use the term to describe a particular drug that is somehow less problematic than others. It is frequently used to describe drugs such as ecstasy and amphetamine ('speed'), but has also been used in discussions about many other substances.

This is a little like the terminology 'soft drugs' and 'hard drugs', words used to categorize particular substances as less or more harmful, although it is not quite clear how these assumptions are always made. Once again, as far as I’m aware, these are not terms that are used by anyone who knows what they're talking about.

So what is recreational drug use? Essentially, although the drugs can change, there have been five patterns of use identified, these are as follows:

  • Experimental use - is usually motivated by curiosity and a desire to experience the effects the person has heard about. Experimental use is generally in social settings and among close friends and is limited in the number of times it occurs. An example could be a young girl having her first drink of alcohol at a party.
  • Recreational use (also known as social-recreational use) - this use tends to occur in social settings among friends who wish to share an experience. Unlike experimental use which is limited to a few episodes, social use tends to be repeated regularly.
  • Circumstantial-situational use - this usually takes place in response to a specific situation. A great example of this is the person who can't have a drink without lighting up a cigarette. The smoking of the cigarette is defined as circumstantial use.
  • Intensified use - this is long-term patterned drug use at least once a day. This type of use takes place to relieve a persistent problem or stressful situation or a desire to maintain a certain self-prescribed level of performance. A cocaine user who uses the drug to keep him alert while at work would be an example of this type of drug use.
  • Compulsive use - drug use that has gotten completely out of control and producing some degree of dependence. They often keep using even though they are experiencing major problems, often to prevent withdrawal. This is the most widely discussed type of drug use with an example being a heroin user who needs to inject regularly. 

Recreational drug use does not try to describe the drug, rather it examines the way a particular drug is used. A person who is demonstrating recreational drug use may eventually start to use it intensively or compulsively – it all depends on the person and the situation they find themselves in. Of course, there are some drugs that by their very nature (i.e. their addictive qualities) are more likely to lead to compulsive use than others, e.g. heroin. Others are far more likely to be used in an experimental way due to their availability and effect, e.g. magic mushrooms and inhalants.

Where the confusion comes in is that a drug like ecstasy or LSD is much more likely to be used in a recreational (or social-recreational) manner than say an intensive or compulsive way (although it can happen in rare cases). It is usually used in a social setting amongst a group of friends who wish to share an experience and use is repeated regularly over time. Another important aspect of this pattern of drug use is that it is rare to see use escalate to abuse, which once again tends to be a characteristic of ecstasy or LSD.

That said, ecstasy or any other drug should not be classified as recreational drug. To describe a drug as 'recreational' is just as ludicrous as calling them 'intensive drugs', 'experimental drugs' (a completely different meaning to that term!) or 'compulsive drugs'.