teens high risk for addiction

What teens are at high risk for addiction?

Would you say inner city, poor, abused, homeless?

This study : Adolescents from upper middle class communities: Substance misuse and addiction across early adulthood. which I first saw in WebMd, says that the privileged upper middle and rich children are at higher risk  for addiction than many of their peers.

350+ teens in New England were studied.

Drug and alcohol use was higher than across country norms, including inner city.

Rates of addiction diagnosis by age 26 were
19%-24% for girls
23%-40% for boys
These rates are two to three times the norms across the country.

Rates for addiction diagnosis by age 22 were
11%-16% for girls
19%-27% for boys
These rates are close to the same in girls, but twice as high in boys as peers across the country.

The teens were often popular high achievers who are A students. Parents tended to drink more in those cohorts than the norms.

Also: “Findings also showed the protective power of parents’ containment (anticipated stringency of repercussions for substance use) at age 18; this was inversely associated with frequency of drunkenness and marijuana and stimulant use in adulthood.” That is, parents who sent a clear message that consequences for illegal and underage substance use including alcohol and marijuana would be serious, provided protection for their teens.

A second article: Children of the Affluent: Challenges to Well-Being says this:

“Results also revealed the surprising unique significance of children’s eating dinner with at least one parent on most nights. Even after the other six parenting dimensions (including emotional closeness both to mothers and to fathers) were taken into account, this simple family routine was linked not only to children’s self-reported adjustment, but also to their performance at school. Striking, too, were the similarities of links involving family dining among families ostensibly easily able to arrange for shared leisure time and those who had to cope with the sundry exigencies of everyday life in poverty.”

Other children’s perception of parenting examined included:

felt closeness to mothers
felt closeness to fathers
parental values emphasizing integrity
regularity of eating dinner with parents
parental criticism
lack of after-school supervision
parental expectations

This aligns with my observations both in my town and with patients. I see parents “check out” sometimes when their children are in their teens. “I can’t control him/her. They are going to use drugs and alcohol.” I told my children that if they partied I would NOT be the parent who says, “Oh, he needs to play football anyhow.” I would be the parent who would be yelling “Throw the book at him/her. Bench them.” And I saw parents of teens going out to the parking lot to smoke marijuana at a church fundraiser when it was still illegal. And saying “Oh, our kids don’t know.” I thought, “Your kids are not that dumb.” They invited me along. I said, “No.” And I really lost respect for that group of parents. What example and message are they sending to their teens? Yeah, cool, do illegal things in the parking lot, nod, nod, wink, wink.

Meanwhile, my children keep me honest. “You are speeding, mom.”

“Yeah,” I say. “You are right. Sometimes I do.” And I slow down.

watch out

For the Daily Prompt: ghoulish.

Hey, wait, watch out! Who is that man in the back, with a knife?

I took this in 2012. This is a school trip at the end of 8th grade, taking everyone who can go to Mount St. Helen’s. The man with the knife is a fellow physician, who also has an 8th grader on the trip. Though he does internal medicine. The man on the right is the surgeon…..

We camped for three nights and explored Mount St. Helen’s. It rained and rained and rained. Some tents flooded. I wore my foul weather sailing pants. People ribbed me about them the first day, but by the second they looked cold and damp and envious….

Thanks to the teachers and all the parents and the students too!

 

dark as pitch

For the Daily Prompt: ghoulish.

I took this in 2012 in the Ape Caves at Mount St. Helen’s. The Ape Cave is a lava tube. When Mount St. Helen’s erupted, lava flowed hot. As the outside cools, the inside continues to flow, leaving a cave. The cave is 2.4 miles long and we are instructed to bring 2 or three light sources and back up batteries: because if lights are out, it is truly black as pitch inside. We all turned our lights out together, and stood in the darkness.

enter the dark

For photrablogger’s Mundane Monday #133.

I took this in 2004, in the spring. My daughter and a friend are in the tent, having a tea party, with spray whipped cream and a china tea set. The tree is just budding out. There is a ladder up to the tree platform, built with the help of my daughter’s grandfather. He is 91 now.

Is this mundane? What is mundane? We are entering the dark part of the year hear, wet and cold. We hope that spring will return. Happy Halloween……

gratitude!

I took this in the early morning at the Northwest Maritime Center.

For the Daily Prompt: gratitude.

I am full of gratitude this morning, for friends, for love, for living near the water and the boats. My daughter was home for college this summer teaching sailing at the NW Maritime Center to children who were here visiting and to children who live here. She says that some of them had hardly been in a boat before. If one child got scared in the pair out in sailboats, they might get others scared and crying. Still, she felt that they had enough staff and good training and were very safety conscious in this cold water.

One week half the kids said that their favorite thing the whole week was when one of the instructors went overboard. Honestly, he was pretty cold after that but learned to bring extra clothing.

My daughter took the Level One Sailing Instructor Course in Seattle before she started teaching. The instructors here at the Maritime Center got to know each other and work as a team.

The small land pirate ship is on the water side of the Northwest Maritime Center and is popular all summer, during the Wooden Boat Festival and for the younger Messing Around in Boats program in the summer. Small pirates ho! Gratitude for imagination and cameras and play and the sunrise and sunset.

 

Health care mandate in the United States

At a health care town hall last year, our representative said that US citizens have not given Congress a mandate for health care.

I raised my hand. “I beg to differ. The mandate is already law. The law says that no person in the US can be refused care at any emergency room. We have the mandate. Unfortunately the emergency room is the most expensive and cruel and last minute care that we could possibly choose.”

Expensive: any ER visit costs more than a whole day of visits to my rural family medicine clinic.

Last minute: the emergency room doesn’t do chronic care. Their purpose is to 1. try to stop someone from dying and 2. decide if the person should be hospitalized or should follow up in clinic. They do not do prenatal care, treat high blood pressure, treat diabetes, depression, high cholesterol, alcoholism. They do not do chronic care and aren’t meant to.

Cruel: you can go to the emergency room to try to keep from dying. Say you go coughing blood. They find a lung cancer. Now, you have a choice: be treated and maybe you will survive or maybe you will die anyhow and your house will be sold to pay for the medical care. Do you choose to go home instead and die so that your family inherits the house?

The United States spends twice as much per person as the next most expensive health care system in the world and they have universal health care and we don’t. We care more for corporate profit then US citizens and visitors health. I cringe when the discussion is about health INSURANCE not health CARE.

I am a physician but I also own my own business. As a small business owner, I think that I will soon have to close. Why? I am in my 50s with a daughter. I think that within two years my HEALTH INSURANCE will cost more than I pay myself. And I will close the clinic.

We need health CARE not health INSURANCE. The Obamacare law said that health insurance companies can ONLY keep 20 cents of every health care dollar they collect, down from 22.5 cents. They have to spend 80 cents on health care. For medicare the overhead is 2-3 cents per dollar.

Medicare for all, single payer. Put 97 cents of every health care dollar to health care instead of only 80 cents. Or shall we continue down the road to small business and local government collapse and citizen health collapse?

Congress, you can’t wheel and deal your way out of this one. We want health care for our dollar not insurance.

For the Daily Prompt: wheel.