When my daughter found a new circle of friends in high school, I saw it as a sign that she was exploring new directions. When she dropped out of activities she used to love, I thought she’d outgrown them. When her grades plummeted and she became increasingly moody, I decided she was depressed and got her into counseling.

 

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When she dropped counseling and moved in with a boyfriend at the age of 18, I thought she was seeking independence. When she started wearing long sleeves even in hot weather, I thought it was a fashion choice. When I noticed her nodding off in a restaurant, I told myself she must be sick, maybe from a bad diet or lack of sleep.

And when I voiced my concern to a friend who suggested that she might be using heroin, I replied, “Oh, no. She would never do that.” (As it turned out, my friend was right.)

Like a lot of parents, I was in denial about my child’s substance use. The signs were there, but I chose to ignore them. This isn’t completely surprising, since denial is a common response to things we can’t or don’t want to face. It’s easier to pretend that there’s no problem or hope that it’ll go away. The trouble is, when it comes to drugs, denial can be deadly.

The Centers for Disease Control and Prevention reported an estimated 108,000 drug overdose deaths in 2021. Fatal overdoses among kids ages 14 to 18 rose 94% from 2019 to 2020 and 20% from 2020 to 2021. Fentanyl, a highly addictive synthetic opioid, is a major driver of overdoses.

Fentanyl is 50 times stronger than heroin and 100 times stronger than morphine. Illicit drug manufacturers are reportedly adding it to counterfeit medications and targeting children and young adults with colorful pills or powder known as “rainbow fentanyl.”

The threat is so serious that the CDC and some public health experts are advising parents to keep naloxone—a medication that can reverse the effects of opioid overdose—in their medicine cabinets. It can be purchased from pharmacies without a prescription in most states.

But beyond keeping naloxone handy in case the need arises what can parents do to protect their children? First, let go of denial. Then, take action. Here’s how.

Don’t ignore signs of substance use. These include evasiveness; moodiness; bloodshot eyes or enlarged or pinpoint pupils; changes in appetite or sleep patterns; unexplained agitation or lethargy; impaired speech or coordination; loss of interest in school and activities; and a sudden change in friends. If your child exhibits these symptoms, start asking questions. Open up a conversation.

Do learn to recognize the “3 Ds” of substance use: Deny. Diminish. Deflect. Kids who are trying to hide their substance use will start with denial: “No, I don’t use drugs. I didn’t take anything.” If pressed, they’ll try to diminish the problem: “I only use a little bit. It’s not a big deal.” Then, they’ll try to deflect the focus elsewhere: “What about you? You drink wine.” By recognizing these tactics, parents have a better chance of keeping the conversation on track.

Don’t blame or shame your child. Many kids experiment with drugs and alcohol. Some, especially those with mental health issues or a genetic vulnerability to addiction, are unable to stop without help. Addiction is a disease, not a character flaw. Shame has no place in dealing with substance use.

Do explain the dangers of drug use, early and often. Prevention is the best policy when it comes to keeping kids safe. Educate them (and yourself) about the dangers of drug use. There is no way to tell if illicit medications have been laced with fentanyl. Even one pill can kill.

Don’t wait to get help. If you suspect that your child is using substances, get professional help for you and your child right away. Look for therapists and treatment facilities that specialize in addiction. Your family doctor may be able to guide you. Other resources include FindTreatment.gov, an agency of the U.S. Department of Health and Human Services, and the National Institute on Drug Abuse (NIDA). Many state governments maintain lists of treatment options.

By letting go of denial and facing the challenge of substance use early on, parents can get their kids the help they need to prevent a problem from escalating.