Helen: Welcome back to Notes from The Backpack, a PTA podcast. I'm Helen Westmoreland.

Kisha: And I'm Kisha DeSandies Lester, and we're excited to welcome you to a new season of Notes from the Backpack. Today we're covering a topic that's been making headlines around the country. We're going to discuss addiction issues in teens, from vaping to the opioid crisis. We're going to explore what parents need to know to keep their teens and other children safe.

Helen: Yeah, that's right, Kisha, this is a heavy but very important topic. The 2022 National Youth Tobacco Survey revealed that 14% of high school students reported being current e cigarette or vape users. The situation with opioids is even more alarming. Overdoses among 14 to 18 year olds increased by 94%, in 2020 and another 20% in 2021.

Kisha: Yes, Helen, it's a concerning picture for sure. I'm so thankful though that we have Jessica Lahey here to help navigate these issues. Jessica is the author of The Addiction Inoculation, Raising Healthy Kids in a Culture of Dependence and the New York Times bestselling book, The Gift of Failure. For over 20 years, Jessica has taught every grade from 6th to 12th grade in public and private schools, and she spent the last five years teaching in a drug and alcohol rehab for teens. She also co hosts the #AmWriting podcast from her empty nest in Vermont. Welcome, Jess. Thank you so much for joining us.

Jessica Lahey: Oh my gosh, thank you so much for having me.

Kisha: Well, I can't wait to get into this. Can you tell us a little bit more about yourself and what led you to focus your work on teen addiction?

Jessica Lahey: I am in one way a parent's worst nightmare in that, at the end of my teaching in, when I was teaching middle school, was getting to the place where I realized that I really needed help quitting drinking. And luckily my dad did an intervention on me. I got to the place, where I knew I needed help before things started to really go downhill. I wasn't drinking while I was teaching. Thank goodness. There were some lines I was still holding up, but when I stopped drinking myself and I now have 10 years of recovery, I just celebrated 10 years. Congratulations. Thank you. Now I get to be a model for my students in another way.

It's a really huge privilege for me. I looked at my two kids and I said, oh my gosh, I don't know a ton about substance use prevention. I guess I knew some stuff that I'd heard like myths, magical thinking, all that kind of stuff. And I know I come from a long line of people with substance use disorder. And so the question became not just for me, how do I make this stop here now, but how do I help my kids not repeat this.

And then I started teaching at the Rehab for Adolescents and my big question became, from an educational perspective, what can we do? You know, what programs can we use? Do those even work?

So, the Addiction Inoculation is very much a best practices primer from the perspective of someone who is willing to dive into all of the research and say, these myths that we think about or these things we hear online or this advice we get is this good advice, bad advice, neutral advice. So I go into it as objectively as possible, vet all of the advice based on the evidence, and then come up with the best practices.

Helen: We are so appreciative that you do that. And speaking of the research, I cited a couple of stats at the top of the show. But I think one of the things that a lot of parents wonder is like, is it worse than before? Is it the same? What is changing? From your perspective, having looked at all these different stats, how would you describe the landscape of the problem right now? What really strikes you as some of the important concerns?

Jessica Lahey: Well, I want to preface this conversation by saying that a lot of what happens to us parents is we have a 24/7 media apparatus that wants to scare us to death. Yes. Because we know that the articles that go viral are articles that instill fear or anger. Yeah. That's what causes us to share articles. So I always try to help parents, remember that. I go to schools and people will tell me what their biggest fears are and I'll realize. Wait a second. You're not talking to your kids about the dangers of misusing prescription opioids but you are worried about this remote thing that one news station has decided is the new danger. So I always like to start there. We have had over a decade of a long term decline in adolescent and childhood substance use, which is great.

Before we hit COVID, there was a bit of a plateau. And the data that I'm talking about really looks at eighth grade, 10th grade, and 12th grade, And so we've had this wonderful decline that we want to keep moving in the right direction.

So when we see increases, for example, the exception to these decreases are things like an increase from 19 to 30 year olds in using marijuana or periodic increases that we see in vaping, that kind of thing. Now within that landscape, Also, remember that 14% that you mentioned at the top of the podcast, how 14% of high school students report, report that they vape.

We also have a tendency, and by we, I mean all of us, but especially kids, to overestimate the interest that other kids have in using drugs and alcohol. So if you were to ask kids, how many people vape, they are probably going to tell you more than 14%. So one of the magic things about and I talk about it in the addiction inoculation, it's a term called pluralistic ignorance, where we tend to overestimate, especially things like alcohol.

For example, if an eighth grader is offered some beer and they say, no, thanks. And the other kid says, Oh, come on, it's no big deal. And everybody's doing it. It's no big deal.

If you're an eighth grader knows it is a big deal because the adolescent brain is not an adult brain. It is not done developing. Things that are harmful in the adult brain are much more harmful in the adolescent and childhood brain. And number two, no, not everybody's doing it. By the end of eighth grade, only 24.7% of eighth graders report they've had more than a sip of alcohol. That is not everybody. That's important information for your kid to have. That's why The best possible substance use prevention programs are filled with really accurate information.

So that has to be our starting place as adults, and one of the things I get to do when I travel around and go to schools is explain to parents what the real landscape looks like. And how important it is for their kids to have those frequent conversations from a very young age. And when I say young, I'm talking kindergarten and preschool is when the best substance use prevention starts and goes all the way through college.

Kisha: Yeah, that's, that's interesting because Helen and I both have young children. I'm curious if there are things that we can proactively do now to protect our kids and how do you start a conversation and what's the wrong thing to say?

Jessica Lahey: There are a couple of things we know absolutely do not work, scared straight doesn't work. That's why a lot of the prevention programs in schools where they bring someone in and that person who's in recovery talks about their war stories and just how bad things got.

That doesn't work. We also know that ‘just say no’ obviously doesn't work. That does not work because that's about the just do what I say and don't ask any questions. And what does work really well is really good information starting from a very young age. And people say to me all the time, but these conversations are so scary. But here's what I can tell you about these conversations that the more often you have them, the less scary they become. We have these conversations constantly in my house. Yes, my kids are older. But we still have these conversations constantly because that's what keeps them normalized as conversations that don't make us feel all oogie and freaked out and want to, you know, fight or flight.

Kisha: Here we go again. We're going to have that talk.

Jessica Lahey: Right. So when I say Pre K/K, I'm not saying that we start talking to Pre-K kids about methamphetamine. What I'm saying is we talk to them about things like general health and safety stuff. What goes on the outside of our body and what goes on the inside of our body. Why don't we swallow toothpaste when we brush our teeth, if it's good on our teeth, wouldn't swallowing it make it even better because then it would go all throughout our body? Well, no, because toothpaste is actually, even though it's inside of our mouth, it's a topical thing. If we swallow it, it gives us an upset tummy, it makes us feel kind of yucky, and it's not good for us.

For kids that are a little bit older, If you pick up a prescription bottle, that's on the counter. This is why in the Addiction Inoculation, I offer tons of scripts because I learned

Helen:Yes, the scripts are awesome. I've got the book up here.

Jessica Lahey: I learned nothing from The Gift of Failure, it's that, and I had no idea to the extent this would be the case, that people want, like, no, no, no, tell me exactly what to say.

Yes, exactly, prescription bottle on your counter. And we know that kindergarten and first grade kids love pattern recognition. They love identifying letters and numbers, say, can you find the letters in mommy's name? Well, why do you think mommy's name is even on this label? If you were sick with the same thing I'm sick with, couldn't you just take my medicine? Of course not. You and I are different shapes, different sizes, different ages. We may have different ways our bodies work.

You can never take someone else's medicine. Especially when their name is on the label.

Kisha: I love that.

Jessica Lahey: And as they get older, as you said, organically, these conversations will come up. Why does grandma make Uncle Ted go outside to smoke or vape? Well, if it's about secondhand smoke and that not being good for us, what is it doing to Ted's lungs? Why do you think Ted would take time away from the family in order to be outside by himself? P. S. in the rain or the sleet in order to do that thing. You know these kind of conversations about the stuff we see in our lives and then as they get older we start taking advantage of things like advertising.

One of the favorite games we had when my kids were adolescents was talking about how companies like to manipulate people in order to sell them products and how much it's worth to get brand loyalty from a young person. So say to kids, things like what do you think they're trying to sell to you in this ad? Yeah, they're drinking a beer, but that seems to be behind, beside the point. They're like frolicking on the beach and they're attractive and they have lots of friends and it's romantic. You know, what are they really trying to sell you here? Kids do not like being manipulated. Kids, especially younger kids, have an intense sense of justice. So  taking advantage of those things is really important.

Helen: I really appreciate those scripts in the book. I want to stay on that theme for a little bit and pick up on the Uncle Ted piece. Cause I think one of the junctions that for many families, including my own, even with a young child, that's an organic opportunity, but a very awkward one is when there's a family member with addiction issues. So, you don't want to throw your family member under the bus, but you need your kid to understand it's wrong. What's your advice for helping parents navigate that dynamic and talk to their kids about what's going on?

Jessica Lahey: You are so timely. I've been helping a friend who is dealing with this exact issue with family members who are binge drinking and getting really out of control at family gatherings. And so I told her a story and my story about this is that I happened to get recovery before my parent got recovery.

So, my particular situation was incredibly painful. My parent, who had stopped drinking for a while, relapsed at Christmas. My sister had flown in. I had traveled a long distance to get to this Christmas, and the parent relapsed, and this was something that my sister and I had allied ourselves very tightly.

We had since a very young age, about this particular topic and my sister left, got a hotel room. I left, I said, we're leaving. This is something that as parents, we can't expose our children to. I talk about getting to a place where, you know, you need help for substance use disorder as a, like a 100 piece puzzle. You need Pieces 1 through 99 to be there before Piece 100 is going to click into place. And P. S., you hardly ever get to be Piece 100. It's really cool when it happens, but it hardly ever happens. But this was Piece 100, for that grandparent who said, oh my gosh, I can't have access to my grandchildren if I continue drinking. And I'm so grateful to my parent for that.

And after that Christmas, by the way, we did not say, Oh, we're going home because someone is sick and I don't want to expose you to that. We were very clear. We are leaving because your grandparent has a problem with alcohol. That is an example that I chose to remove from this family by getting sober. As a parent, I know the most important thing I can do for you is give you good role models. And if we were to stay, even though it would be easier for everyone, I would not be doing the right thing as a parent. I care more about you than a little bit of tension with another family member. And is that hard? Oh man, yeah, it's really hard.

Kisha: Yeah, that's what I was thinking. That's super hard. And as Helen said, I think all of us have been in those situations.

Jessica Lahey:  It doesn't have to be all or nothing, by the way. I made it sound like it does, but it can be about, it can be about, your Uncle Ted is making some decision. Well, talk about those things. Ted is a person with substance use disorder. He is abusing nicotine or THC or whatever the thing is he's vaping. And talk to your kids about why that happens, what's happening in the brain.Uncle Ted is, is vaping THC out on the front porch, and you need to understand that he's making adult choices. What it's doing in his brain is a little bit different from what it would do in your brain, because your brain doesn't finish its cognitive development doesn't finish forming until you're in your early to mid twenties. And so the damage it's doing to Ted's brain is nowhere near the damage it would do to your brain.

The message needs to be delay, delay, delay for two reasons. The younger a kid is when they first try substances. The higher their lifelong risk of substance use disorder. So for if a kid in eighth grade tries a substance, let's say alcohol, their lifelong risk for substance use disorder hovers somewhere around 50 percent. If we can delay that until 10th grade, we cut it about in half. And if we can delay it until 12th grade, we cut it in half again. Number two, so from a substance use disorder prevention, it's incredibly powerful to delay. From a brain perspective, which is what I'm actually most interested in as an educator, the further out we can push first use, the more we protect their brain. And I'm only starting in talking about memory formation and consolidation in the hippocampus, and the prefrontal cortex and frontal lobe stuff. That's just the tip of the iceberg.

Kisha: It is very captivating to hear and also very illuminating when talking to my son, who's seven, he's very sensitive to things. So we've gone through a whole group of celebrities. That's like, ‘Oh yeah, they're not alive. Oh yeah, no. And so it's like, they're dead too. Was it drugs?’

Jessica Lahey: Can I add to that? That's an important conversation because I do list some of those people in the book, but I also have a massive list of celebrities who are in recovery. Chrissy Teigen was a great example. A bunch of years ago, she tweeted about the fact that she had a conversation with her doctor about just what alcohol does in the body.

And she said, I've just decided to stop drinking, not because I think I have a problem, but because alcohol is a carcinogen. It's a poison in the brain and body, blah, blah, blah, blah, blah. Those examples are really important. Look at Macklemore, look at a whole bunch of people who decided this is just not the best thing for myself and my family. So yes, those negative examples are important, but, I contend even more important are the positive examples, role models kids need.

Kisha: I love that because now I can point to some of those other people that he may know that are in recovery and have been in recovery.

Jessica Lahey: The reason I mentioned these positive examples is that if a kid gets used to us being the constant arbiter of doom and gloom, They'll turn the volume down and turn us into those Peanuts characters parents, where we're all won't want, won't want. And they're like, Oh, here she goes again, as opposed to having these conversations that go in a positive direction toward positive role models.

Helen: And now for a quick break

Helen: Youth e-cigarette use remains a serious public health problem in the United States. Over 2.5 million kids use e cigarettes, and more are addicted every day to these flavored, nicotine loaded products.

Even if you don't think your kids are vaping, they're very likely to be exposed to these highly addictive nicotine products. Early conversations from parents can have a huge impact in helping kids make healthy, informed decisions. We must protect our kids from a lifetime of nicotine addiction.

The Campaign for Tobacco Free Kids is a proud national sponsor of National PTA. To learn more, join us at tobaccofreekids. org.

Kisha: I wanted to ask another question because we've been talking about alcohol and some drugs, but also we hear from a lot of families of teens and preteens about vaping. And how easy it is for kids to conceal that. What signs should parents be looking for, and what recommendations do you have in maintaining that open dialogue about vaping?

Jessica Lahey: Yeah, remember, kids can be vaping THC. They can be vaping nicotine. They can be vaping just flavors. We are definitely seeing especially in younger people, we're seeing some damage being done to the lungs. It's not innocuous.

Yes. It can be for adults a great way to curb smoking when accompanied by cognitive behavioral therapy, when accompanied by all kinds of other guidance from professionals. But just switching to vaping isn't necessarily an answer to that question. So the positive gains are within a larger perspective of getting help  for nicotine addiction.

I think unfortunately, because we were posing it in so many positive ways,. kids seem to think that it's not a big deal. What I like to do is look at the bigger picture. What should we be looking for in kids around substances in general that we can pick from, to say, ‘Oh, something is going on.I like the big picture perspective, any sudden change in your child. And that includes for the positive needs to raise some questions.

If I have a child who has been chronically tired, depressed, down, and suddenly my child is up and optimistic and excited all the time. I am going to be, as a parent, unlikely to look a gift horse in the mouth. I just want to look at that and say, Oh, I'm doing everything right, good. Things are headed in the right direction. That can be a real signal that your kid has started self administering, whether that's amphetamines, whether that's nicotine things that will help them with that depression, and on the other side, if your kid is normally, you know, sleeping well, eating well, all of these things, and you see a sudden change in that, that is a real indicator that you need to be asking the why.

And I know it's so hard to look at a perceived positive change and ask the why, but nicotine can be one of those things. If suddenly your kid has more energy and is generally a little bit more positive. But this is a great opening, right? You know, sweetie, I have noticed, in the last six months, they may have been tough for you. And I really want you to be able to come to me and talk to me about that stuff. But I've noticed suddenly that you're really in a more positive place. Why is that?

I'm excited for you and I'm happy for you. And I want to hear about why that's happening. So again, rather than focusing on only the negative changes, let's just look for changes in general and capitalize on those as conversation starters. So any change, especially around appetite, sleep and mood are three things that you're going to want to get on top of right away.

Helen: That is very good advice. And I appreciate the frame of like any substance use because I think – you could check me on this – but as a parent, my assumption is that, you don't wake up one day, all of a sudden have a child like using heroin every day. Like there's often other risk taking things. In my mind, tobacco is one of the first steps on that ramp. You know, the research, is that true?

Jessica Lahey: So we have what we used to call the Gateway Hypothesis, and there's all kinds of problems with it, and it's been misused in the past, and it's not universal. There is a different gateway hypothesis, for example, for young black males than for young white females. And I think it's really important to talk about that mainly because research tends to skew to  the white, you know, male perspective, but there are different pictures. So for example, whereas a young white male is going to be more likely to go from beer to harder alcohol. A young black male may be more likely to go from beer to marijuana, and it's not that one is worse than the other. It's that they're different trajectories. So we can't just talk in blanket terms about gateway hypothesis. However, I do need to talk about one very scary thing that has messed with this, which is Fentanyl.

I just got off of a conference recently, where a physician said, look, if you are using a club drugs, ecstasy, MDMA,, or cocaine in any form, you have likely already used fentanyl.

 And so in the last year, I personally have had close brushes with two kids who are now dead because because he wanted to celebrate graduation with a bar of Xanax and he's dead. It had fentanyl in it and two because the other one was two cousins, 18 years old, wanted to celebrate by taking MDMA and they are both dead from fentanyl. I do want parents to be aware that it's increasingly into the drug supply.

Some reporters went down to Mexico and got over the counter at official pharmacies in Mexico over the counter because you can get opiates over the counter there from pharmacies and tested them. And there was fentanyl in that as well in an official supply chain. So I think it's really important to balance – not being the arbiter of doom and gloom, not freaking out, not getting ahead of ourselves in terms of risk factors, but understanding objectively that there are things in the drug supply like fentanyl that are incredibly dangerous, and if we don't understand that, then we're just brushing it under the rug and, and we can't afford to do that.

Kisha: I mean, it's really good information.

Jessica Lahey: And can I add one last thing also about that is here's where the dovetail of the gift of failure and the addiction inoculation has become really important.I can tell you right now, the crowds aren't as big for my addiction inoculation content as for my Gift of Failure because the addiction stuff is scary. So what I have started to do when I go to schools or when I'm talking to PTAs about how to get the most people to come to this, is to couch the addiction stuff within the gift of failure stuff.

So when I go and give a gift of failure talk that also happens to be about substance use prevention is this. The dopamine cycle is a really powerful thing, and some kids need it more than others, but dopamine is not just about joy or thrills or happiness. Dopamine is about drive, human drive.

It's what gets us out of bed in the morning.What kids get from drugs and alcohol is a really abrupt boost of various chemicals in the brain, one of them being dopamine. Unfortunately, the way the brain works is it really craves homeostasis, so the brain will try really hard to compensate for that sudden rise in dopamine by overcompensating and sending us lower than we were in the first place. So we end up at baseline lower than we were before we took the drug.

But one of the best ways to help kids get their own dopamine boost is through competence. When kids gain a skill, when kids figure something out, when kids get through something they didn't think they were going to be able to get through on their own, they get an amazing and very important rise in their dopamine levels, and it's a natural rise in their dopamine levels that does not land them in a lower place than where they started.So when we help kids work through struggles so that they can get that incredible, so important need for that dopamine boost after the fact, pushing them towards positive risk, things like trying out for a play, trying out for a sport, doing something that they've not done before. That is an incredibly important way to quote unquote self medicate their dopamine cycle, to give them that boost of dopamine that their brains crave without having to resort to the artificial sources like nicotine, like marijuana, like all those different things that they will rush to if they can't cope with that on their own.

Helen: Well, I feel like I've gotten so much good advice from you today, Jess.

Jessica Lahey: Oh, I'm so glad.

Helen: Really appreciate you sharing information on what can be, really an intimidating topic for parents. So, my question back to you is, out of all the great advice you've shared, what do you really want the one main takeaway of your message  for parents about this issue to be?

Jessica Lahey: Substance use prevention starts really, really young. It is made up of evidence based information, not magical thinking, not fear mongering in the news. It is made up of us getting the best possible information, which is frankly why I wrote the book so that we can share that information with kids so that they are moving forward from a place of knowledge and not fear or optimism, but from real evidence. People are scared by the conversation around substance use and substance use disorder, especially when they're dealing with their own demons. And that's why this topic was so scary to me before I dealt with my own stuff. So a friend of mine about a year ago said, if it's hard to get people to come sometimes to your addiction stuff because they're scared, why don't you make daily videos where you share all of this information on a daily basis so that people can watch it from the privacy of their own home.

So for 170 episodes, I went through daily on my Instagram reels and on my Tik Tok. I'm at Instagram at @TeacherLahey and I'm on Tik Tok @JessLahey. I went through the entire Addiction Inoculation book, the big popular myths I get the most pushback on, which is, you know, like, I want to raise my kids like those European kids. So if I just give them sips at home, blah, blah, blah, I break that down and I got so much pushback there. You can go and watch those videos on your own or, read the book on your own because it doesn't have to be scary. It really, really doesn't and the only reason it's scary is that we don't know the information. Once you know the information, it becomes a lot less scary.

Helen: Yeah, you are just a gem. I'm so glad that our season opener has been this conversation with you. Thank you so much, Jess.

Jessica Lahey: Oh my gosh. And again, thank you to the PTA across the country, in general. It's how I get to do what I do and go talk to kids and parents and teachers in schools. I'm so grateful to the PTA. So thank you so much.

Kisha: Thank you so much, Jess. This has been just a wonderful conversation as Helen said, and to our audience listening, thank you for joining us as well. For more resources related to today's topic or to listen to other episodes, check out notesfromthebackpack.com.

We also wanted to let you know that this Fall, National PTA and the Campaign for Tobacco Free Kids are partnering to provide resources for PTAs to educate their school communities about youth tobacco use, tobacco prevention efforts, and to host tobacco prevention advocacy events.

To learn more about this funding opportunity and hundreds of other grants available to your local PTA, go to pta.org/grants.

Thank you for tuning in and join us next time.