Q&A with Hazelden’s Dr. Joseph Lee: Adolescent Abuse of Synthetic Drugs

Join Together: What trends are you seeing in adolescent abuse of synthetic drugs? Which designer drugs are becoming most widely used?

Dr. Lee: Most often, Hazelden doesn’t see young people who are addicted primarily to synthetic drugs, but we do see a lot of experimentation. Of synthetic drugs, marijuana seems to be the most popular agent, with bath salts and hallucinogens used less frequently.

The majority of these young people who come in for residential care at Hazelden are admitted due to use of another substance, but many have tried synthetic drugs at some point. There are many cases, however, where synthetics became the primary drug of choice.

Join Together: Why is the increasing use of synthetic drugs so worrisome?

Dr. Lee: These drugs are particularly dangerous because amateur laboratories manufacture them and no one knows enough about the chemicals used to make these substances. There are a lot of chemicals marketed as synthetic cannabis that actually have different components. No one would really think about smoking a bath salt or potpourri on its own. The contaminants in these chemicals alone should raise concern. Each time someone uses a synthetic chemical, they have no way of knowing what they are putting into their body.

Reports from emergency room admissions and overdoses indicate that many kids are experiencing very serious negative reactions to synthetic substances, including heart problems, psychosis and agitation, and in rare cases, death. Personally, I have seen many kids develop psychotic symptoms that do not improve for months. Also, synthetic drugs are often manufactured to escape detection from standard urine drug screens.

Join Together: How are teens getting access to these drugs?

Dr. Lee: In the past, kids would buy these drugs from the same head shops where they get paraphernalia for marijuana and tobacco. Now, increasingly kids are going online to buy drugs to avoid getting caught.

It is tough to monitor the Internet for illegal drug sales because state and federal laws are not all-encompassing. If the state or federal government bans one substance, manufacturers can make a small change to the chemical so the new product is no longer illegal. This challenge mirrors the difficulty of regulating the sale of other drugs online.

Join Together: Which types of teens are most likely to experiment with synthetic drugs and why?

Dr. Lee: Anyone can experiment with synthetic drugs. However, there are at least three demographics that parents should be particularly aware of:

• Young people are intrigued by synthetic drugs because they are experimental by nature at this age. Many don’t intend to get addicted, but decide to use drugs simply because their “friends are doing it, too.” There was a case in Blaine, Minnesota where kids ordered an ingestible, synthetic hallucinogen called “2 C-E” online and as a result of using it, one 19-year-old died and 10 more young people were hospitalized. This group may not have been addicted to drugs, but were “just” experimenting.
• Young people who are already in trouble with the law and are being monitored use synthetic drugs because they are often undetectable by standard screenings.
• Young people who seek peer-approval, perhaps a little more than what would be considered normal, are attracted to the idea that they can know more about synthetic drugs than others. This group receives a certain sense of authority and credibility among their network by being the person who is either well-connected or has an arcane knowledge of obscure drugs. They will often try chemicals that others might not try in order to demonstrate their mastery.

Overall, we are making a dangerous mistake by waiting for kids to show the signs of addiction before we educate children about synthetic substances. These drugs can have a severe, detrimental impact right away. Many kids have problems with synthetic drugs who are not necessarily addicted to anything else. Addiction is not a prerequisite for having a problem with synthetic substances.

Join Together: Are these drugs being used alone or together with other drugs? Are they a “gateway” to other types of substance abuse?

Dr. Lee: It is normal, though not healthy, for kids to experiment with substances. That is one of the differences between young people and adults with drug abuse problems. However, this behavior is dangerous because they might find that one drug is more rewarding than another. It’s just like ice cream: once they try and like chocolate ice cream, they wonder what strawberry ice cream tastes like. That’s really their approach.

Often times, the fact that kids mix chemicals together with alcohol, cigarettes or other substances multiplies the risk of having a bad reaction. We see many examples of overdoses with alcohol and pain medication, but it can also occur with other substances. Kids are often falsely reassured by the amount of potentially bad information they get from online and other resources.

The so-called “gateway hypothesis” is controversial. Researchers cannot prove that the use of one drug does something in the brain that encourages the use of other drugs. However, we do know that when you track young people who use alcohol, marijuana, and other substances before the age of 15, they are more likely to experiment with and use other substances later on. We also know that the earlier a child abuses drugs, the more likely they are to develop an addiction later in life.

Many of the kids who use synthetic substances also seem to have behavior problems or other mental health issues at a young age, so it is important for physicians to screen for those kids who display risk factors for addiction. But, we also see very high-functioning kids who succumb to addiction due to experimentation, so every parent and physician must be cautious.

Join Together: Are there any tactics you think would be effective in reducing the abuse of synthetic drugs?

Dr. Lee: Strong messaging about the dangers of synthetic drugs (and other drug and alcohol abuse) is very important for family members to use with their children at a young age. It is also equally essential that family members act in an open-minded and tolerant way with their children, so they feel comfortable coming to older family members with questions or problems.

It is true that parents who don’t have strong messages about not using drugs often have kids who use more. Parents who are firm with expectations and limits, but who are also available emotionally have the most success. This is called authoritative parenting.

Parents also wait too long to screen their kids for drug use, and specifically synthetic drug use. They need to have regular screenings with their pediatrician and other health professionals, beginning at an early age.

Parents should take a close look at their family history. If they have a predisposition to substance abuse, they need to pay attention for their children. Additionally, if they have an older child who uses substances, that increases the risk that the younger child will use drugs, as well.

There are many other things that parents can do to help their child and plenty of comprehensive resources for them to access in their community and online.

Joseph Lee, MD works at Hazelden’s Center for Youth and Families as a child and adolescent psychiatrist. Drawing upon his expertise in medicine, individual and family therapy, Twelve Step models, and the evaluation and treatment of adolescents, Dr. Lee works with teenagers and young adults from ages 14 to 25 who are struggling with addictions to drugs and alcohol. Please see more information on Hazelden’s website: www.hazelden.org.