June 20, 2005
For Teenagers, a Tweak on 'Just Say No'
By DULCIE LEIMBACH
LET'S face it: teenage boys tend to take more risks than teenage girls do. This is both good and bad. Good if your son's penchant for graffiti translates into designing the school yearbook; bad if you're lying awake at 1 a.m. wondering why he is not home after the midnight gong.
When it comes to teenage temptations - from sports stunts to daredevil driving to experimenting with alcohol, tobacco and marijuana - parents are right to be more concerned about boys than girls, said Dr. R. Andrew Chambers, an assistant professor of psychiatry at Indiana University School of Medicine. With drugs and alcohol in particular, epidemiological studies broadly suggest that boys are twice as likely as girls to become addicted, Dr. Chambers said.
So listening anxiously for your son's key in the front door may be reasonable behavior and not obsessive (as your husband may imply). Part of boys' risk-taking behavior is driven by the constant changes chugging away in their brains as they grow. (Everyone's brain matures by about age 25.) Risky behavior also seems more likely with teenagers in groups. And studies have shown that the earlier adolescents dabble in tobacco, alcohol or drugs, the harder it is for them to kick the habit later.
Which raises the question: can parents abandon the "just say no" slogan of the Reagan era for a new mantra that says "just wait" - until you are old enough to know better?
Maybe. Psychiatrists, scientists and others who study teenagers and their ways offered a range of responses, from endorsing "just wait" to shying away from any encouragement to imbibe.
One factor in this debate is that scientists understand more about how the adolescent brain works. Two years ago, a study led by Dr. Chambers, then an assistant professor of psychiatry at Yale, found that because of continuous neurological developments in adolescence and young adulthood, increased preferences for risky behavior and novelty seeking emerge, predisposing teenagers to experiment with drugs and ending up with addictive behaviors.
The neural circuits that release chemicals that link new, adultlike experiences with the motivation to repeat them develop more rapidly during the teenage years than do the mechanisms that control these urges and impulses (which depend on exercising reason and judgment at the conscious level, basically knowing right from wrong). As a result, teenagers are not only more likely to feel enticed by drugs than older people are, but the effects on their brain can also be long lasting.
Teenage smoking, which continues to decline but slower than in the past, offers an illustration. A report published in 2000 said that just a few cigarettes could lead to addiction. The study, which tracked the smoking habits of 700 12- and 13-year-olds in Massachusetts for a year, revealed that addiction could begin within days of inhaling a first cigarette.
Children that young "have an extremely hard time quitting compared to 18-year-olds," said Dr. Joseph R. DiFranza, who led the study and is a professor of family medicine at the University of Massachusetts Medical School in Worcester.
A "just wait" message with tobacco, therefore, does not sit well with Dr. DiFranza because there is "no safe level of use with tobacco," he said, adding: "Even when tobacco use starts at an older age, the addiction rate is much higher. You're never old enough to smoke."
Frances Leslie and James Belluzzi, pharmacology professors at the Transdisciplinary Tobacco Use Research Center at the University of California, Irvine, discovered last year that rats tested during the earliest adolescent stage (equivalent to about 12 human years) developed a significant taste for nicotine after one brief exposure.
"Exposure to nicotine can modify crucial brain development during the teen years," said Dr. Leslie, particularly in areas like decision-making abilities.
Parents also worry, of course, about drugs and alcohol. The adolescent brain, Dr. Chambers said, is just as vulnerable to drug and alcohol addiction as it is to tobacco. "If you use a drug after 25," he said, "you are far less likely to get addicted than when you're 15."
Marijuana poses a deep challenge because it is more potent than it was 30 years ago, and children are trying it as early as 11 years old, said Scott Burns, deputy director of the White House Office of National Drug Control Policy. "There are more kids in treatment for marijuana addiction than for alcohol treatment," he said.
Dr. Marc N. Potenza, an assistant professor at the Yale University School of Medicine who specializes in addictions and worked on the 2003 Yale study with Dr. Chambers, said more research into the causes of specific addictions was necessary before endorsing a "just wait" approach. "There are critical periods when a lot of changes are occurring in the brain, and adolescence is one such period," Dr. Potenza said. "And the changes are quite dramatic."
What motivates one teenager to take risks, he said, depends on the individual. The transition from childhood to adulthood is fraught with biological and social needs to differentiate oneself and experiment. But parents can still hold significant sway over their children's behavior.
"It may not feel that way to a parent," Dr. Potenza said, but teenagers are sensitive to parental nudges and advice, including information about their health.
So if you are lying awake waiting for your son to come home, try thinking creatively, like ways to keep him and his pals hanging out in the living room on Friday nights rather than at the pizza parlor or worse. Even exercising their brains. Have they ever played Scrabble?