Medications can be life-changing, even life-saving in some cases, but if quickly chosen - or if no longer needed - they can cause more problems than they solve. And sometimes a focus on meds distracts from important therapy work. I'm a therapist first and a pharmacologist second. Medications can be extremely helpful early in treatment, to reduce the anguish of severe depression or acute anxiety, and especially in early recovery from substance use disorders. Over time as healing occurs and emotion regulation skills develop, the need for medication often decreases. Keeping medications going longer than is needed can be like keeping a cast on after the broken bone has healed - it can get in the way of further growth and healing. Knowing whether and when to make changes involves a trusting, open, collaborative approach.
Parents, you can't prevent your kid from doing dumb stuff and neither can I. There is a saying that "we make the mistakes we need to make". This is how learning occurs. Don't deprive your kids of critically important life lessons by bailing them out of the pickles they get themselves into (social, school, financial, legal) as the stakes get higher as they get older. Common examples: calling your child out of school when they sleep in; paying a parking ticket for them; or putting money in their bank account to cover an overdraft. Next thing you know your kid is begging you to pay off a drug debt and you're thinking "how the heck did we get here??"
Our task as parents is to move from manager to consultant, to be less a fixer and more a wise and respected mentor. That said, if your child's behavior is screaming "Help me, I'm making mistakes faster than I can learn from them!" or if you suspect an underlying mood or substance use disorder, then it may be time to consult a professional.
Parents, if your child is doing drugs it is not necessarily "self-medication". And if they are engaging in criminal behavior - stealing, dealing, assault - don't "medicalize" it (see above). Sometimes a depressed kid discovers that using drugs makes them feel better temporarily and then progresses to problematic use. More often, an otherwise healthy kid discovers that weed or alcohol alleviates boredom or provides an avenue for social connection. Regular use then derails important developmental tasks - discovery of self; ability to self-soothe and tolerate boredom; development of social competence; discovery of ambitions, clarity and motivation to take effective actions. Sometimes education and limit-setting are enough to steer a child back toward health. In other cases more intensive intervention may be required.
Cannabis is not medication*, despite what well funded marketers want you to think. Heavy, regular cannabis use in adolescence impairs emotional development, worsens depression and anxiety, probably lowers intelligence, definitely quadruples the risk of psychosis, and increases rates of violence. Ask me about “medical alcohol”…
(*unless you have glaucoma, a rare form of epilepsy, combat-related PTSD, nausea from chemotherapy or AIDS wasting syndrome)
Medication-assisted treatment for opioid use disorder greatly improves outcomes. Suboxone maintenance is not trading one addiction for another, in fact it can be life-saving. Patients who struggle to stay clean are playing Russian roulette since fentanyl is showing up in all kinds of street drugs.
