In a world of social-media noise and dark drugs, how do we warn kids how dangerous experimenting with them is?

Illustration by Michael DeForge, The New York Times

How do you talk to your kids about fentanyl, xylazine, or meth? How do you warn them how dangerous a simple party could become? At the risk of sounding like the old Alan Parsons Project, perhaps it's time to say, "Where do we go from here?" In answer to that question, addiction journalist Maia Szalavitz gives her thoughts on talking to kids about dark drugs in an opinion piece for The New York Times.

It can start with knowledge of what can happen when kids take risks. "In September, two 15-year-old Los Angeles girls overdosed on fentanyl, one of them fatally, after they purchased what they thought were prescription opioid‌‌ pills. . . . Teen opioid fatalities have doubled in recent years, even as opioid use among adolescents has plummeted. . . .Street fentanyl and its derivatives can be dozens to thousands of times more potent than the oxycodone in Percocet. Street synthetics are typically found in drugs sold as heroin or prescription pills, but they are sometimes present in party drugs like cocaine. This has exponentially increased the risk of even one or two ‌‌youthful experiments."

Young people are assailed with social media and messaging all day long. How do parents and caretakers cut through the noise? "Two key themes emerge in effective approaches. One is that reaching adolescents requires earning trust by being truthful, rather than simply trying to instill fear. The second‌‌ is that school-based programs must recognize that not all drug use can be prevented. ‌‌Instead of focusing only on abstinence, they aim to prevent the highest-risk behaviors and ‌address the personal and environmental factors most likely to lead to addiction.

Today there is a greater recognition of the need for accuracy‌ over hype. New videos and radio spots from the Advertising Council, which has been making public service announcements for the government and nonprofits since the 1940s, confront the dangerous new reality directly. They feature former drug dealers — not cops — speaking plainly about fentanyl. They also provide information on how to reverse overdoses with the opioid antidote, naloxone."

What has been working? "Rhana Hashemi, who has helped pilot an evidence-based program called Safety First, says teens are more likely to listen when they recognize they are given accurate information about genuine dangers. . . . Hashemi said that she always stresses that abstinence is the safest option and that in reality, most teenagers abstain from illegal drugs. She also provides information on harm reduction. This can include using tests that can detect fentanyl before taking any pill or powder not prescribed by a doctor, never using alone and having naloxone nearby. . . . Hashemi said a common response is for students to recognize how serious the danger is and decide that in light of the effort needed to reduce risk, using isn’t worth it right now. For those who aren’t deterred, however, the hope is they are armed with ways to protect themselves."

Some people are born with temperaments that are more likely to lead to addiction. "In 2016, I wrote about one program called PreVenture, which targets ‌problematic coping strategies by teaching children better ways to manage their particular temperaments. By acting early, ‌‌the program aims to prevent predispositions from becoming disorders‌ and obviate the desire to use drugs to self-medicate. Programs like PreVenture that teach self-regulation and coping skills have been shown to have lasting effects, unlike those that focus only on refusing drugs."

Where do we go from here? We keep kids alive. "Effective addiction prevention requires social change to prevent or at least intervene early in childhood trauma, creating communities conducive to mental health with safe, nurturing schools, stimulating extracurricular activities and access to comprehensive health care. ‌‌But first, we need to keep ‌‌young people alive, which means having uncomfortable, honest conversations about ‌the dangers of drugs and the ways to minimize the risk for those who use them. . . . .No one has yet found a way to eliminate youthful risk-taking and impulsiveness — probably for the best because these can also drive learning and creativity. We can, however, reduce the odds that the unwise things kids do will kill them."