How to prevent substance abuse in our children? Part 2 with Jess Lahey!

Jessica Lahey returns for a part 2 discussion!  On last weeks episode we discussed her book, "The Gift of Failure: How the Best Parents Learn to Let Go So Their Children Can Succeed" and on this weeks podcast we discuss her second book, "The Addiction Inoculation,  Raising Healthy kids in a Culture of Dependence. "  This podcast episode is an important episode for parents raising children ---as she gives clear, evidence based information on how to help our children avoid substance abuse.  Her book is an incredible and pertinent book for parents to read.

In addition to being an accomplished, New York Times best selling author, Jessica received her law degree, and she spent many years as an English and writing teacher.  She also cohosts a writing and creativity podcast, #amwriting.  

Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children.  Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner. 

Do you have a future topic you'd like Dr Jessica Hochman to discuss?  Email your suggestion to: askdrjessicamd@gmail.com. 

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The information presented in Ask Dr Jessica is for general educational purposes only.  She does not diagnose medical conditions or formulate treatment plans for specific individuals.  If you have a concern about your child's health, be sure to call your child's health care provider.

Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children. Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner.

Do you have a future topic you'd like Dr Jessica Hochman to discuss? Email Dr Jessica Hochman askdrjessicamd@gmail.com.

Follow her on Instagram: @AskDrJessica
Subscribe to her YouTube channel! Ask Dr Jessica
Subscribe to this podcast: Ask Dr Jessica
Subscribe to her mailing list: www.askdrjessicamd.com

The information presented in Ask Dr Jessica is for general educational purposes only. She does not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your child's health care provider.

Transcript

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Hi everybody welcome back to ask Dr. Jessica the podcast where I interview experts with a goal to help you along your parenting journey. I'm your host and paediatrician Dr. Jessica Hochman. On today's podcast. It is part two of my interview with Jess Leahy. Last week we talked about her first book The Gift of Failure. And this week's episode we will talk about her more recently published book, the addiction inoculation raising healthy kids in a culture of dependence. Now, as parents I know we all want to raise independent healthy children. But this can be frankly hard to do in a culture that in many ways encourages alcohol use. So in this episode, Jessica talks about her own experiences and alcoholic. And she also uses evidence based medicine to share ways we can prevent substance abuse in kids. I personally think this topic is so important, and I'm so thankful to have Jesse Leahy here today. Also, if you're enjoying this podcast, I would be so grateful if you would take the time to leave a review from an ever podcast platform you are listening. And now welcome back. Jess Leahy. I'd love to talk with you about the second book that you wrote the addiction inoculation. I love the book. I think it's such important information that I think would benefit so many people. And so I just wanted to start by asking you can you can you describe your story? I know. Yeah, it's a personal story. But yeah, so I, I actually was born to an alcoholic. And I knew that's the one thing I never wanted to be. And so I was one of those kids who like, so is the designated driver and all that sort of stuff. And it was really difficult to not be allowed to talk about my parents drinking, that was like the thing, you know, we were supposed to pretend everything was fine and not talk about it, there was a lot of gaslighting, blah, blah, blah. So I knew that that's what I never wanted to be. And yet somehow in my forte in my late 30s and early 40s, it just crept up on me like, you know, that glass of wine while I was cooking became you know, two, which became four, which became, you know, me pre gaming and making sure I had a really good buzz on before my spouse got home. And finally, as I mentioned before, June 7 2013, I got just blackout drunk at my mom's birthday party. And my husband had to take me upstairs, it was very messy. And my husband and my dad came upstairs the next morning, and he hates conflict, hates upsetting me. And yet he put that all aside to tell me that I needed help. And I was 100%. I was there. I luckily, those moments came together of me being ready and his intervention with me. And so I've been sober since then. And thank God thank you might actually think I know. And actually my parents. Yeah, and my parents got sober after I did too. So that's, you know, and the other parent that didn't really have an issue with drinking just sort of decided it wasn't, it didn't make them feel great anyway, so why not just kick it to so you know, my both of my parents are sober and but I'm now left with a situation where I know that I have two children who may or may not, I don't know, I didn't know the research then be have a predisposition for substance use disorder. And what does that mean? And so you know, when the experts say substance use disorder is a preventable public health problem. What does that word preventable mean? And what works? And what doesn't work? And what's a myth and what's real and what's not? And there's all this research, but I really needed to read it all. Without having a horse in any one race, and figuring out what's true and what's not, and what's statistically significant and what's not. And, you know, sort of distil that down so I could know, what was best from a prevention perspective as a parent. And I was teaching in a rehab for adolescents. I was teaching kids who, you know, were in rehab as young adults, and how could we have prevented them from landing there? So all of that came together to be the addiction inoculation. Amazing, and are you still doing work with the in the rehab centre? So unfortunately, the rehab that I used to teach in they decided to not admit kids anymore. So unfortunately, now in Vermont, if your kid needs inpatient rehab, there is no place for that. However, I do work at a evidence based medical detox and recovery centre called Santa at Stowe, in Stowe, Vermont. And my job there is as a prevention coach, and I'm sort of there just as a resource. I go and I spend time with the residents and help them understand how I continue to navigate my sobriety and then we talk about prevention stuff as well for their own families. That's true. I think you know, it's also part of service for my own, you know, my own recovery. I think it's so wonderful that you talk about it. Because what I find as a physician, when I talk a lot in the room with parents, there's a lot of drinking that happens that people don't admit to. I mean, I think we all we all see it socially, people will go out and have a drink or two. But I think that it's a lot more of an issue than people like to admit or realise. So I think it's so important that you're bringing this to light. And we're in a really cool place right now, though, where yes, drinking, while drinking over the past decade drinking and drug use among kids, people under the age of 18. And young adults for that matter has gone down for the past decade. And we did see a little bit of a plateau right before COVID hit and then maybe a little bit of a bump during COVID. But for adults, it's been going up a little bit, especially during that's interesting, but but well, and especially in the areas of cannabis and psychedelic use, and drinking. But the interesting thing is, it is suddenly okay to talk about being sober, curious, or elective sobriety, or, you know, there's there are all these books now that have made it okay to say, I don't know if I'm an alcoholic or not, but I know it makes me feel like crap. So I'm going to do dry January, or I'm going to do sober October, or I'm going to just take a month where I reassess my relationship with alcohol, whatever that is. There's a lot of books by women about women and alcohol. Actually, alcohol reacts differently in women's bodies than than men's. And it's, you know, I don't care why you stopped drinking, or at least give it a shot. You know, a lot of people find that they feel a lot better when they're not drinking, they definitely tend to lose a little bit of weight and get better sleep, and then their anxiety can drop. So, you know, alcohol does a lot of things to us that over the long term are really detrimental. I drank because I have anxiety disorder, unfortunately, anxiety increases with alcohol use over time. So, you know, that was inconvenient. I also wasn't sleeping. And unfortunately, you know, that's inconvenient to when you have essentially three full time jobs if you include the drinking. So include the drinking, I know it's I think it's a it becomes a cycle, right? I mean, you you feel anxious, so you drink and then you drink and then you feel more anxious. Yeah. Because it works in the short term. It's like those extrinsic motivators we were talking about with gift to failure. They're tricky because they work really well in the short term, but they do not work over the long term. And I drank the, you know, to fall asleep, which messes with your sleep and wakes you up in the middle of the night. You can't go back to sleep. And for me, I was having panic attacks and anxiety attacks. And I drank to sort of quiet my anxiety, but over the long term, it actually increases your anxiety. So that's a bit of a bust. At least it was for me. I'm so curious, though, the work that you did at the rehab centre. Did you find that a lot of the kids had childhood trauma i I've read I'm starting a book by a man named Gabor Ma Tei. And he in the hungry ghosts? Yes. Yes. And he had believes that the root of all addiction stems from childhood trauma. Yeah, what is that there are a lot of so there are a lot of camps in in substance use prevention recovery, you know, research. Gabor Ma Tei is squarely in the trauma camp and he is right on so many counts. That is, you know, he's fantastic. I would also beg you to read the deepest well, by Nadine Burke Harris and well, reading Gabor Mateos great reading Nadine Burke Harris is really important. But I think the reason it's so important to read Nadine Burke Harris is that her take is the CDCs list of adverse childhood experiences is incomplete. Yes, we need to talk about, you know, physical and sexual violence, we need to talk about living in a violent community, we need to talk about what they're losing a parent, we need to talk about divorce and separation. But we also need to be talking about things like systemic racism and other things that are uncomfortable to talk about, like adoption. I mean, there's a lot of research going on right now about adoption and the risk of substance use disorder. You know, people don't like hearing that divorce and separation or an adverse childhood experience and are all divorces the same? Absolutely not is sometimes divorce and separation the right move? Absolutely. So when I talk about this stuff, stuff with adults, I have to make it really clear. I'm not saying that you I never want people to feel shame and guilt over the stuff that has happened to their children or has happened to them. We need to be able to assess risk accurately so that we can more specifically use the Prevention's available to us. So if I know my kids are genetically predisposed, or if I know my kids have gone through a divorce and separate recent experience, that kind of thing, then I can be a lot more specific about helping them with the stuff they need. And you know, there's a lot of that in addiction inoculation, because I've put my kids through some stuff. And I, there's no use my feeling guilty and shame and guilt or shame about it. I just need to go from where we are, and, you know, give them as much prevention as possible to outweigh that trauma. And I like how you talk about genetics has definitely influenced but it's not the writing on the wall. No, it's 50 to 60% of the risk picture, according to Mark shook it. So yeah, 50 to 60% is is not the writing on the wall, it is not destiny. You know, my husband was raised in a family with a lot with definitely with genetics for substance use disorder, and he has a I hate using the word normal, but you know, he, he doesn't have an issue with moderation. So if you could give advice to parents listening, what's the best way to help prevent substance abuse in children, the clearest sort of evidence out there is that the younger child is when they first try drugs and alcohol, the higher their lifelong risk of developing substance use disorder. And when we talk about terminology, you know, substance abuse, so we're supposed to be using person first. So like I am a woman with alcohol use disorder, I also use the term alcoholic. So there we are. The younger kid is when they first tried drugs and alcohol, the more likely they are to have substance use disorder during their lifetime. If they started in eighth grade, they have about a 50% chance of developing substance use disorder during their lifetime. 10th grade, it goes down a lot. And then if we can get them to like 18, or 21, we can really get it down to like 10%, which is what it is a general population. 90% of people who have substance use disorder in their adulthood report that they started before age 18. So delay, delay, delay is the message and that means we've got to kick a few of the myths to the curb like that whole, well, kids are going to drink anyway. So they might as well do it in my basement, I'll take all the keys away. We know that kids parents who have a permissive stance on kids using drugs and alcohol, though their kids are have a much higher risk of developing substance use disorder, we know that parents who have a consistent and clear message of no not until two things either it's legal for you, which I'm less worried about than frankly, the fact that their brains aren't done developing until the early to mid 20s. So the longer a kid's brain can grow and develop and make the connections and do all the things that it has to do unimpeded, the more, the better their brains are going to be. And the lower their lifelong risk of substance use disorder is. And so as a parent, who has two children, raised with different rules, before I did the read the research for this book, my 23 year old was raised with the hole, of course, you can have your own sips and maybe your own glass of wine at dinner, because oh, those European families who raised their kids, but I want my kid to be like that, well, the European Union has the highest levels of alcohol consumption and the highest levels of deaths attributable to alcohol consumption in the entire world. So if we're going to hold any place up as our end all be all mythological, romantic vision of moderation, it really should not be the European Union. So we had one kid who you know, was allowed to have sips and stuff. And then after I learned this stuff, I went to my younger kid and I said, Sweetie, I screwed up. I raised your brother using one set of rules. And I'm really sorry to do this, but we're going to change the rules for you. Because based on what I know now, no, you can't have beer or wine or alcohol, any drugs or alcohol until your brain is done developing. And it's not done yet. And for me to do anything else, either because it's easier for me or more convenient for me or fulfil some romantic fantasy on my part, wouldn't be doing the right thing for you. And so I, you know, I'm just going to do the best I can based on the information I have now. What I love about that approach is that you're, you're still you're trusting your child like you're you're, you're educating them on why you're concerned, but you're trusting them. So like Why worry is if my kids go to their friend's houses. I don't know that I want to be that parent that's asking who's there? Is there alcohol there? You know, it's hard to be that parent. I'm not too intrusive. Yeah. Yes, yes, that's true. Yeah, I'm just gonna Yes. However, I wrote a book on this. I mean, what am I going to do not do that thing and not that I'm like, and and I also wrote a book called The Gift of Failure about not spying on my kids reading their emails or reading their texts. And so where's that line? For me, and so what we know about the best prevention science is that when we give kids real information about how their brains develop how drugs and alcohol mess with their brain development, and give them really good information based on the best science we have, and we support them, and we give them a really clear message of No, not until your brain is done developing, those kids are far less likely to have substance use disorder during their lifetime. And then part of that is trusting kids to make good decisions based on that information. Are they going too all the time? Of course not. But we also have warped perceptions about how many kids are drinking, like, you know, I wasn't even going to stick a college chapter in this book, like, why bother everyone drinks in college? Turns out, I was totally wrong. We do this misperception thing as human beings where we overestimate a how much everybody drinks and be how much how invested they are in having alcohol around. And that skews our perceptions and drives the way we operate. Like, would you have a Super Bowl party without alcohol will? Of course not you have to have booze when it's football. But it turns out that, like, it turns out that we're people are less invested in having alcohol available at every single function than we than we would think. And, you know, if you tell your kid, you know, the classic retort, you know, hear Have a sip of this beer, you know, to your eighth grader, and they say no, and then the person is like, the other kid is like, Oh, come on. It's no big deal. Everybody does it. But if your eighth grader knows that that's not true that less than 25% of eighth graders admit to having had a sip of alcohol before. By the time they graduate eighth grade, then at least your kid knows in their head, huh? Well, that's not true. You know, giving them real information is so important to prevention. Okay, so I like this delay, delay delay. Real information. Yep. And then from a clear messages. Yeah. consistent and clear messages. No, I and I think when you talk about educating your kids, I think that's so valuable, because I think if I think parents want to shy away from these conversations, but they're actually so important to be had. Well, and the key to those conversations and ask anyone who writes about difficult topics, like Peggy Orenstein who writes about boys and says she has two wonderful books, boys and six girls and sex. And she will tell you the same thing, these challenging conversations, these embarrassing, humiliating, uncomfortable squirmy conversations. The more you have them, the easier they get. I mean, in our house, it is absolutely totally normal to talk about drugs and alcohol. Is it still a little squeegee to talk about sex? Sure. I'm not an expert on talking to kids about sex. But you know, the more we have these conversations just we've just crossed there in our family. I'm glad to hear it gets better. And it's not just one conversation. It is a bajillion conversations and really effective substance use prevention starts in preschool and kindergarten, do you have any recommended resources for parents? Of course, your book, but do you have any websites or reading materials that you think parents should go towards? I know, we were talking, I heard you say that dares is not not that effective? Well, so there have been various iterations of dare the problem with Darrow originally was that it came out of a law enforcement perspective. And it was a lot of sort of Scared Straight sort of stuff. And we know scared, straight doesn't work. Don't just say no, doesn't work, that kind of thing. But there has actually revamped their, their materials and their the way that they handle that stuff. So the thing that I do in the addiction inoculation, especially in the chapter about education is, you know, we I found out that only 57% of schools in this country have any substance use prevention programme. And of that 57%, only 10% of those programmes were based on evidence of efficacy. But there are organisations out there that actually evaluate these programmes to find out over the long term if they work. So I outlined those and I tell you exactly where to look to find them. So look to see what's happening at your school, and then dig into it and find out okay, what's this programme called and then look it up. And I give you resources for places to look that are clearing houses for information on whether a programme is proven effective or not, or if it's just promising or if no one knows, or if it is, like early iterations of dare. Like I went to an ER through an early iteration of Dare and the early iterations of dare actually make kids more likely to pick up drugs and alcohol after they've gone through the programme. So I'm so curious, do you find that the more that you learn about drugs and alcohol, the more it helps you stay away? I want to say yes, but what I'm an alcoholic and my brain does, my brain tells me things I can't trust. My brain tells me a lot of things about how I would feel better if I had a drink, I could manage this situation better if I had a drink, I have learned that I have to rely on evidence that I can't always trust my brain. There's a fantastic episode of Doc's DAX Shepard's armchair expert called seven days. Dax was sober for 16 years before he relapsed on opiates, and lied to everyone in his life about it. And he is someone well acquainted with what drugs and alcohol can do to destroy his life. And yet, he explains, in that episode, how his brain tricked him into thinking it was okay again, and so, you know, I do a lot of relying on, you know, my community, the people I am, that rely on me to show up for them sober and, and so I try really, really hard to not think too much let my brain cogitate too much on whether I should drink or not, I just have to say I can't drink, period. So I would love to say that, yes, all this information changes the way I think about other people and how we prevent and stuff like that. But my best thinking is what got me drunk and kept me drunk in the first place. So I sometimes have to take a pass on on my brain and go over to evidence or my community to remind me of the deep doo doo, I can get in when I listen to my own way of thinking, sometimes. I'm so proud of you. It's hard to not be able to rely on your own best thinking, but there we are. Some of us can't. You're you're doing your honestly, it's very, it's inspiring. It's inspiring. And it's, and though and you're, and the work that you're doing from that I think is going to help a lot of people. I hope so. And you know, I hope for me that I can continue to show up every day for you know, whether it's the people at Santa at Stowe, or the kids that email me, I just got back from a school in Houston. And I was there to talk about gift to failure. But I made it clear that they could email me about substance use and whether it was about them or their parents or their family or whatever. And I have 20 emails sitting in my email box from kids wanting to talk about drugs and alcohol and themselves or people they love. And I have to be able to show up for those people. And I can't do that if I'm drunk. So. And what's so wonderful is that, I think there's a there's such power in someone's story. And so it's so meaningful when you can share your story. I mean, it's so it's such a gift to everybody that you share your story because it just makes it that much richer and deeper the advice that you're giving, there's so many different kinds of stories out there. And there's always something to identify with. And each one I love here, I mean, I wouldn't be a writer if I didn't love stories, or an English teacher, for that matter. Thank you so much. Thank you for your gift, it was such an honour to talk to you. And I look forward to continue to support everything that you do. Thank you so so much. I'm just really, really grateful to be able to have the opportunity to talk about this stuff. I'm grateful that people are willing to talk about this stuff. And tell people work, where do you want them to find you. I know you have an Instagram page, your podcast and hashtag writing. All of my stuff is over at Jessica lahey.com You can always find all this stuff including like oodles of book recommendations on a bibliography that's there under speaking there's a little thing that says Download speaking bibliography and all my favourite resources are there. I just started this thing figuring some people don't want to learn about this, this addiction stuff in public. I just started a new Instagram and Tiktok thing where every single day I post a 92nd video and I'm literally just making my way through the book beginning to end and we're on I think I'm on you know episode 13 or 12 or something like that and we'll just keep going until it's over and and we learn about this stuff privately. I'm happy to meet people wherever they want to learn this stuff and if it means it's just the two of us online that's that works for me too. Beautiful. Thank you so I'm adding I'm at teacher Leahy on at teacher Leahy on Instagram and act justly he on on tick tock thank you so much. I think anybody listening that wants to help prevent substance abuse and their children will find this really, really helpful. So thank you very much. Thank you so much for tuning in to this week's episode of Ask Dr. Jessica. I also wanted to say a big thank you to Jess Leakey for coming on and sharing her story. I really believe it is people like Jess that change lives for the better. And if you know anybody who may enjoy this episode, please share Eric You never know who will listen and benefit from the information see you next Monday