Help for teens may be as close as a school campus

Editor’s note: This is the third and final installment of a series looking at a new face in teen drug use, prescription controlled substances. For the first part look to the May 18 edition, with the second in the May 19 edition. All three parts can be accessed online at

Teen drug use doesn’t always involve a dealer. In fact, the source for “a good time” these days can be as close as the medicine cabinet, the supermarket, the Internet, even a school friend.

And while drugs are by no means a new problem, the trends these days among high school students make access less of an obstacle to experimentation.

“The beer is in the fridge next to the milk, and you’ve got the prescription drugs in the medicine cabinet,” said Theresa Koki, the county’s anti-drug coordinator.

Dr. Gerald McKenna, director of Kaua‘i outpatient treatment program Ke Ala Pono, says all types of substances are freely exchanged among teens — regardless of whether they’re found at home.

“If (the drugs) were not in the house ever, teens would still have no problem getting access,” McKenna said.

Last year the National Center on Addiction and Substance Abuse at Columbia University studied online drug access and found that 84 percent of Web sites selling controlled prescription drugs did not require a prescription. Of those, 33 percent clearly stated that no prescription was needed, 53 percent offered an “online consultation” and 14 percent made no mention of their requirements.

It’s still not known where 15-year-old Colin Mathews obtained the OxyContin that is believed to have caused his death on March 28. Police have declined comment, and toxicology reports have yet to confirm the dosage and whether it was officially to blame.

However, Koki said she believes most of the prescription meds abused by Kaua‘i teens come from the home, not a dealer. An exception, she said, is when teens become dealers by selling their own prescriptions at school, often for Adderall or Ritalin.

According to a 2003 study by the Hawai‘i Department of Health, the most recent available, almost 17 percent of Kaua‘i high school seniors said they had sold illegal drugs.

This hasn’t gone unnoticed by educators.

Bob Springer, head of Island School, which spans kindergarten to 12th grade, says he’s concerned.

“The ease with which students can get drugs and alcohol is quite amazing to me,” Springer said, adding that “pop culture seems to glorify” this type of behavior.

Outreach to teens

In the classroom, William Arakaki, Board of Education Kaua‘i Complex superintendent, says school presentations are an important way to disseminate information to students and parents on the new trends in drug use.

Outside the classroom, the Office of the Mayor’s anti-drug efforts include a comprehensive plan of drug prevention, enforcement, treatment and community integration.

Koki, the plan coordinator, says questions from parents or teens about their options are always welcome. But despite an open door, as well as efforts to bring information to the community, she says the parents and kids who need to hear the message are not typically the ones who seek it.

After 20 years in addiction medicine, McKenna suggests that different, not more, programs are needed.

He said genetic counseling, or identifying family patterns of addiction, has been conspicuously absent from school and county education efforts.

With no family history of alcoholism, a nasty hangover may be enough to deter a teen from drinking again for months. But for someone with a genetic predisposition to the disease, there’s more of a chance that they’ll pick up the bottle again the next weekend.

Once a pattern is established, it’s a fast track to alcoholism, McKenna said, and knowing the family patterns are key to avoiding them.

Treatment is as close as campus

For Kaua‘i teens who seek treatment, voluntarily or otherwise, help may be as close as their school campus.

Teen CARE, a state-funded program run by substance abuse clinic Hina Mauka at Kaua‘i public middle and high schools, allows students to receive individual and group counseling during the school day.

Teens often join the program on referral from a teacher, counselor or the courts. But peers, too, can recommend a friend, and minors can agree to treatment without parental consent.

Each 16-week session usually has about 15 to 18 clients, according to Vonn Ramos, Hina Mauka’s teen clinical supervisor. Drastic changes are not expected nor common by the end of the Teen CARE semester.

“You plant the seeds and hopefully it comes to fruition,” Ramos said.

For teens who require more than the school-based option can provide, Ke Ala Pono often steps in with a more rigorous outpatient treatment. It sees about 50 teens each year for substance abuse and refers at least as many on to residential treatment.

McKenna, who founded the program, said treatment is usually mandated in connection with some type of offense or school suspension. Teens don’t come in on their own, he said.

Adolescent outpatient treatment meets three times a week and lasts several months, as many teens are initially resistant.

Ke Ala Pono drives home to teens that their decisions are important and integrates their counseling with adult participants to show the consequences of unchecked drug use further along in life.

For adolescents, the biggest lesson is in good decision-making and understanding consequences.

The program stresses that drugs can unravel any relationship, and that the people who encourage or enable bad habits don’t have a place in the recovery process.

Another key component to Ke Ala Pono is addressing all manifestations of addiction, no matter how small they may seem. McKenna asks all participants to stop smoking, saying 80 percent of people who continue to light up during the recovery process will relapse.

“You can’t stop using one addictive drug and be using another one and have success,” he said.

Ramos and McKenna both share the philosophy that success is relative to the addict. Rehabilitation cannot be quantified in black-and-white terms, they say, as impulsive teens often relapse after treatment.

“If a teen cuts back, that is success for them,” Ramos said. “Recovery is a life-long thing.”

Parents are the linchpin

Overwhelmingly, county, school and treatment officials say parents have the biggest opportunity and responsibility to foster a healthy lifestyle for their teen or teens. And drug counselors agree that parental involvement is key to strengthening the foundation for a solid recovery.

Parents should watch their own behavior and patterns of abuse, officials say.

“(Parents) have to behave appropriately as well,” Koki added. “Don’t let your kids see you get smashed.”

In addition, parents have to set limits for their teens — know where they are, who they’re with and when they are coming home.

Such communication can extend to a teen’s online social life via networking Web sites such as Friendster, MySpace and Facebook.

While a glance at Colin Mathews’ MySpace page would have alerted his family or teachers to drug use, the Web site allows users to filter who’s able to view their personal page.

“MySpace Safety: 51 Tips for Teens and Parents,” a book by Kevin Farnham and Dale Farnham, suggests that parents ask for passwords to their teen’s account, or as a lesser measure, open their own and join their child’s “friend” list so they can monitor photos, comments and invites.

The assumption may be that the teens messing with drugs and alcohol are also delinquents and failing out of school, but Koki said honor roll students and athletes do it, too.

“It doesn’t matter how good a parent you are, you can be in the next room and the kids aren’t afraid to experiment,” she said.

Each year, Koki said, there’s a high school graduation ceremony with an empty seat dedicated to a peer who died. The schools always recognize the student and the surviving family members.

“I wish students would pay attention to that,” she said. “They should really think about that empty seat and how empty the parents’ hearts are that night.”

• Blake Jones, business writer/assistant editor, can be reached at 245-3681 (ext. 251) or


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