Teaching Children About Drugs

I have been asked to write an article about drugs and teenagers from an emergency physician's perspective. It is a difficult undertaking. How do you paint with the written word the tragedy, humiliation, and degradation that too often finds its way to the emergency department? Perhaps, I should just give you the statistics and let you figure out how devastating drugs are to our youths and our society. I think instead, I'll tell you a couple of stories.

Troy is 14 years old. He has been "huffing" octane booster for 3 years. He is in the Emergency Department (ED) tonight because he can't move his legs. He has a silvery colored ring around his face where the bag is held to get as tight a seal as possible. He tells me he's been weak for several days now and hasn't been to school in a week. That's okay, he tells me, because he doesn't get much out of school anyway. I am impressed by the dull, glazed look in his eyes and the slouch of insolence as he sits on the gurney. I do a physical exam and note the flaccid weakness in his legs, and the lack of patellar reflexes. He performs the mental status exam as well as my dog. I send off blood samples to the lab and order a CT scan of his head. The CT is impressive: he has the brain of an 80-year-old from the amount of atrophy on the scan. No wonder he's slow. His blood tests return from the lab and reveal a profound hypokalemia (low potassium) which is the culprit for his weakness. Easily treated, this unfortunately indicates that his brain is not the only organ injured by his drug habit. His kidneys have been damaged and are not able to maintain an adequate electrolyte balance. His weakness will return. I begin counseling Troy about his abuse problem. He tells me, "Don't worry, it's not a problem." Anyway, he tells me, the only reason he came in was because his little sister accidentally drank some of the octane booster and is being seen at Children's ED because she was breathing funny. I call over to Children's to find out about his little sister. Chanel is 3 years old. Or rather, was.

I was working the night shift at Ben Taub, the county hospital in Houston. In my memories, I seem to always be working the night shift. The Houston police brought in John. They had chased him after witnessing him purchase some crack cocaine. During the chase, he swallowed the baggies containing the "rocks". By the time he got to the ED he was just starting to feel a little jittery. I had seen this before. Any minute now, his blood pressure was going to go through the roof, he would become very agitated and then seize. I immediately placed 2 intravenous lines so I would be able to administer medications when he went down, which I knew he would inevitably do. I put a tube down his nose into his stomach and poured activated charcoal through it in the hopes it would bind some of the cocaine and decrease the toxicity. I talked to John as I worked. He's worried. He's afraid his mom and dad are going to find out about this. He hasn't been doing crack long. He was at a party with some of his High School friends and someone had a couple of "rocks". He was talked into trying it. It burned going into his lungs but he felt great in a few minutes. He was able to forget the problems he was having at home and school. He tried some more. Over the next few months he went from smoking crack on the weekends to every couple of days to several times a day as his tolerance grew and he craved that "high". The greater the "highs" became, the worse the intervening "lows" became. Things went from bad to worse at school and home. He had to "borrow" money from his parents for the crack. He told himself he would pay them back before they missed the money. I watched as the sweat built up around his face and his speech became more pressured. His agitation increased and his blood pressure started to climb. He suddenly had a grand mal seizure that seemed to go on forever. He spewed charcoal across the room as his stomach rejected its contents. He couldn't cough and sucked charcoal and stomach contents into his lungs. I paralyzed him and fed a tube into his trachea to breathe for him. He died two days later in the intensive care unit.

How does this happen? What is the allure of drugs? Clearly, teenagers usually don't start off with heavy drugs like cocaine, heroin, methamphetamines, and others. The most frequently abused drug and the starting place for the heavier ones, is alcohol. Over half of all car accidents are associated with alcohol. Unfortunately, the victim is not always the intoxicated one. Acute intoxication with alcohol and other drugs results in impaired reasoning and motor skills. People acutely intoxicated tend to attempt things they would never consider while sober, due to inhibited impulse control. No one has "the" answer for why certain young people will try alcohol and other drugs. It is clear that some contributing factors include unstable family situations, single parent homes, low self-esteem, peer pressure, and parental example. There are some clues for parents who are worried their children may be experimenting or addicted to drugs. Is your child "hanging" with the wrong crowd? Peer pressure can be devastating and be the final shove that pushes your child over the edge. Have your child's grades suddenly dropped without explanation? Has your child lost their sense of responsibility regarding schoolwork, house chores, and personal hygiene? Have they withdrawn themselves from the family, become introverted or secretive? I don't have any magic answers. If you are worried about your child, you need to let your child know. Discuss your worries with them. Allow them to discuss the pressures they feel with you. Address the problems they are having during this difficult time of their life. Help them work through the temptations that hit them from every direction. Use God's word to work through your problems and show them how they too can accomplish this.