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October 4, 2022

Ask Lisa Podcast - Episode 88

How Do I Get My Son to Give Up Pot?

Episode 88

How do you help a teen who won’t stop smoking marijuana? When does a family need to step in? A mom writes in asking for help for her son who has been caught smoking marijuana both at school and at home. Dr. Lisa explains what parents should know about substance abuse, and Reena asks how best to explain the risks of marijuana to kids, especially in light of widespread legalization. The conversation also covers the concept of “self-medicating” and why some kids think it’s okay to use marijuana to cope with pain.

October 4, 2022 | 31 min

Transcript | How Do I Get My Son to Give Up Pot?

Ask Lisa Podcast, Ep. 88: How Do I Get My Son To Give Up Pot?


The Ask Lisa Podcast does not constitute medical advice and is not a substitute for professional

mental health advice, diagnosis or treatment. If you have concerns about your child’s well-being,

consult a physician or mental health professional.


REENA: Alright, so some people might be feeling a little bit of the pressure, school’s in full swing now. 


LISA: Yep, yep, no. We are, hopefully, feeling settled into these routines. You know, it’s never easy but it’s always you know, it’s always nice when they do really take hold. 


REENA: Yeah. There’s always, for parents who might be feeling it, sometimes some unexpected little things thrown your way that you’re trying to navigate. One of these, a letter we got stood out, about drug use, pot use. I want to read it to you, it says ‘Dear Dr. Lisa and Reena, last fall, my 15-year-old son was put on probation for smoking pot in his high school bathroom. He seemed to take the consequences seriously. His school does random drug testing, so he knows that if he tested positive, he would be kicked out of school. He recently passed a random drug test to my great relief. Then last night, I caught him smoking in his bedroom. I feel as though I’ve tried every method to reach him and express the risks of this path that he’s starting on. I’ve talked to him about brain cells. I’ve talked to him about being an example for his younger brother. I’ve talked to him about his amazing personality that most kids would kill for. I ask him about his stress and anxiety, and if this is the cause of his experimentation. I don’t want to scream at him, because I know it does nothing, but what can I do to reach him?’ Oh my gosh I love this letter on so many levels, but bottom line Lisa, how does this parent deal with this?


LISA: This is a tough one, there’s a lot to worry about here, and what’s also clear from the letter is that the parent’s already tried a lot of things. And, you know, asking questions about is this about stress, about anxiety, like where is this coming from. And the kid’s already gotten in trouble for it. Like he doesn’t really have room to work if he wants to stay at his school. And I think, let’s rest for a minute on the school’s role in this, which I have no problem with, it seems like they’ve handled it, from what’s in the letter, quite beautifully.


REENA: You mean about testing?


LISA: Yeah, so there’s a couple things that’s happened. So one is this guy was smoking marijuana in the bathroom at school, which is an interesting choice to make, right, to be smoking weed in the middle of the day at school, and they caught him and they put him on probation. And so, part of what I hear already in that is that this is a school where they’re trying to take a more restorative approach, you know, clinical approach. Like okay, you shouldn’t have done this but we’re not going to kick you out cold. A lot of schools, certainly private schools, would just kick a kid out cold on something like that. 


REENA: Wow. 


LISA: So they haven’t done that, but it’s also really interesting that the school engages in random drug testing. Because, that is not something that all schools do or can do, and the way I know schools tend to do that, if they do that, is through hair samples. 


REENA: Oh! Really?


LISA:  Because it’s not like you’re going to ask kids to pee in cups at school, right? So hair samples can be taken randomly that allow whoever takes them to get a very clear sense of what use has been in place, what’s been used. And, I have to say, I’m a huge fan of schools doing this. And I’m sure for some people it feels really intrusive or weird, but what I like about when schools can set this up, and I know some schools in my area who do this, is that it gets back to something we were actually talking about in the last episode, around being able to blame your good behavior on adults. It is such a gift for a school to give a kid, so if a kid’s at a party and someone’s like, do you want to smoke some weed, and the kid’s like, I totally would, but here’s the thing, my school does random drug testing, and so I can’t, because at any moment I could get caught. And that’s a real present to the teenagers in that school. Because then they again, they get to save face and they have this sort of universal way to be like, I don’t know if they’re going to test me or not but I can’t take my chances. 


REENA: I’m on the school soccer team, I’ve got grades, people can understand, I can’t go there, I’ve got too much on the line. 


LISA: Absolutely. So I just want to unpack that a bit because it’s a really important aspect of caring for teenagers is whether we’re going to have policies like that. Okay so Reena you just said something that I’m interested in thinking down that road about like, kids being invested in things and so not using in the name of protecting those things, right? So you said like, my grades, my soccer. So one way this parent might approach this boy is really from the standpoint of what does he want from himself? Like what are his own ambitions, whether they be academic or athletic or artistic. You know like, what does he care about? And I’d want the parent to dig into that a little bit, like, are there things he’s really caring about? Because another way to try to talk kids out of messing around with substances is to point out to them how substance use will undermine their performance in things. 


REENA: Yeah. 


LISA: Like separate from the legal or the moral, it undermines performance. 


REENA: How do you explain that to them?


LISA: It’s tough. I mean, the first pass it to just say, look, I know you have ideas about where you want to go to college, they require certain grades, it’s going to be harder for you to get those grades if you mind’s all fuzzy from smoking pot, or you know full well that you’re not actually as capable on the soccer field if your sleep is disrupted by smoking marijuana, which often, marijuana can be quite disruptive to sleep. So making that case, so it’s not about the parent, like do it for me or do it because I say or do it because it’s not legal, and by do it I mean stop smoking weed. Do it because there are things you care about and the weed is going to get in the way. So that’s our first pass at it. What is tricky, and I think, it’s not always comfortable for adults to grapple with this, is that the teenager may either think, they will certainly almost think it, and maybe will say, yeah, okay but the kid who’s getting the best grades at school, that kid’s smoking plenty of weed, right? Or the star athlete, I know full well, on the weekends, is getting high or drinking. So when we say to kids, you have things you care about, you don’t want to mess those up, part of what we sometimes come up against is they’re like, yeah, but I’m working with a different dataset than you are and it’s not clear to me that what I’m doing is actually going to get in the way of my performance.


REENA: I want to go back for a second, why do you, I mean I know you don’t know the circumstances, but what makes a kid smoke pot in the bathroom? Like in this letter the mom said, I asked about anxiety and stress, like why, I guess is the question I have. 


LISA: Yeah, well it’s a great question, and I will tell you, you’re flagging something that I also had a whoah about. I know that kids use marijuana at school, and often what they’re doing is they’re using vape pens, they’re using dab pens, as they call them. So it’s, no kid today, unless they really want to get caught, is smoking a joint anywhere basically. 


REENA: Okay.


LISA: I mean, because they smell, they’re messy, exactly. So it’s very easy for kids to use marijuana in a stealth way, either through edibles or through vape pens that are pretty easy to hide and don’t really, you know, there may or may not be any smell at all. So one question, I don’t know the answer but I think you’re asking a really important question, is why does this kid need to be high during the school day? What it makes me think is does this kid really want to be at this school? And especially given that he’s now he’s smoking marijuana again knowing full well he’s on probation, and knowing full well that his school does random drug testing, I think another angle this parent may have on this is saying, buddy, you’re doing a really good imitation of somebody that doesn’t want to be at that school. Like, should we talk about that? Because he really is pushing it in terms of his ability to stay at the school, and so maybe the explanation for why he’s getting high in the middle of the day and the explanation for why he’s really rolling the dice on whether he can stay, maybe those are both explained by him not wanting to be there at all, and being miserable during the school day and so getting high to get through it and then being so miserable that he’s like, kick me out please. Like, I don’t want to do anything really naughty or really destructive to other people, I’ll just keep smoking weed until you show me the door. 


REENA: Yeah.


LISA: Right? So I think that’s a conversation worth having. 


REENA: Interesting, because the mom says, this kid’s got a great personality, like that kids would kill for. So it’s not like this is some wilting flower who doesn’t have much going for him, right?


LISA: Well we don’t really know, right? Because that’s the other thing, like it may be that in some settings he’s able to really be this awesome kid that he is, but maybe he gets to school and things aren’t okay, you know. I think there’s so many variables in this that would be important to unpack, but I would definitely, if we kind of think of these are balls coming across the plate, like what are the swings we have available to us, one is, do you care about stuff, this is going to get in the way of stuff you care about, another is, do you not want to be at this school, are you trying to make that happen?


REENA: Interesting.


LISA: But I think there’s a few more, I think there’s a few more. 


REENA: So, you know, the mom says she’s tried everything, she doesn’t want to be the yelling mom, she’s trying to get him to understand and rationalize with him and say you should be a great example for the younger brother, but it just seems like this mom is doing everything in her power to get it right. Is there anything else you could help her strategy-wise with? 


LISA: Well there’s something else in the letter, and I’ll tell you, it was the thing that was actually the biggest red flag for me in this letter, was that he’s smoking alone in his room. It’s a really different profile, Reena, and you’ll instantly see this, kids drinking or smoking with their friends on the weekends, versus kids drinking or smoking alone at any point. 


REENA: What does alone mean to you, when you hear that about substance abuse? 


LISA: It means there’s something bigger going on. It’s not unusual, and it’s never been unusual, I mean Reena, we were teenagers too. 


REENA: Yeah, of course. 


LISA: That when kids get together on the weekends, they’re like yeah sure we’ll do it. And I’m not saying, that’s fine, that’s a sign of great health, but it’s not nearly as concerning because it feels like it’s driven by a wish for belonging, it’s driven by a sense of enjoying one’s friends and being a bit naughty together, like there’s a lot in there that I’m sort of like, yeah that’s adolescence. Like it’s scary to grownups but it’s not outside the normal range of what we expect to see in teenagers. WHen I hear about a teenager that’s using on their own time, and it’s not in a social context, what I think is, ah that kid’s in pain. That kid’s going through something and they are using the substances to manage it. 


REENA: Oh interesting. 


LISA: So, I think another pass on this might be to say, buddy, you’ve got to be in pain about something if you’re in your room smoking alone. Like that is concerning. I’m going to get you evaluated, I want you to talk to somebody. And then what I would have this parent do is check in with their pediatrician or their resources in the community and find the clinician, and there’s usually, hopefully, one or two in the community if not more who’s very good at evaluating substance abuse concerns in adolescents. That’s a specialized thing. 


REENA: That’s a specialty?


LISA: Yeah. 


REENA: That specialty matters, finding that particular person?


LISA: Absolutely. And I would say, I need you to talk to this person, like I need you to have an evaluation with this person, and hopefully they’ve got a good person they can find, and I’ve got my people, in town, where I will refer out. And what I like about these people, they do a few things, one is, they’re good at getting kids to talk about their use in honest ways. It’s no surprise, people of all ages, if they’re being asked about their substance use, if it’s’ a problem, they’re not usually all that honest, it’s not a place where they’re like, I’m so glad you’re asking, let me tell you the whole story. So they are very skilled as interviewers in terms of going about the situation, where they can usually get pretty decent information. And what they can do, is they can start to tease apart, is this about an underlying depression, is this about an underlying anxiety disorder, is this about a past trauma, is this about something else? And then what they can be very good at is thinking about order of treatment. Right? Would it help to get this kid into psychotherapy, and if they got help around the mood or anxiety or any other diagnosis, would that then reduce the necessity of using? Or, does this kid actually need to be in a program where the use goes away? Like, they have to go cold turkey because we can’t even begin to assess what’s going on while they are still using, or they’re not going to get better for whatever mood or anxiety or whatever diagnosis we’re concerned about if the marijuana is still in the picture.  


REENA: So, you know, one of the things we hear over and over again, and one of the huge reasons you wanted to start this podcast is it’s hard for people to find the right help sometimes, right? And being able to talk about these issues helps parents deal with it. But I’m thinking, I don’t really want to go to the school psychologist, and my kid probably doesn’t want that dealt with at school, even if it would be private. What do you recommend, if people might need this help, what’s the best way to find resources to deal with this? 


LISA: Yeah, so definitely your pediatrician is a good place to start. Sometimes parents can use their own general practitioner, so they might reach out to their own physician and say who do you like for this in town? Because, often they’ll have a good sense. You can certainly look online, in your community, for substance abuse evaluation for adolescents, that’s how I would search it. You could also feel something out. Like you could see if you could meet with the person first, and get a feel for it. So there may be ways to triangulate on this. Now, the other way, Reena, this conversation, I would not be shocked if it went this way, is if the parent said to the boy, you know you’re smoking alone in your room, I think you’re really sad, or something’s not right, and he’s like yes, this is how I self-medicate. That’s often what adolescents will say about their own marijuana use, is, no, this is me self-medicating. And, I have to tell you Reena, it bums me out so much that the term self-medication lends itself to the use of it being a good thing. You know what I mean?


REENA: No, explain that. 


LISA: Well, I think, when clinicians use the term “self-medication,” like this person has taken it upon themselves to reduce their anxiety by being high a lot, implicit in that is, we don’t think this is a good way to medicate. Like if you’re going to medicate that anxiety, like, don’t use drugs to do it. 


REENA: Right, right. 


LISA: We have other ways to treat it. But I have seen, in some teenagers, taking that up as like, this is me taking care of myself. This is me addressing the problem.


REENA: They think it’s positive. 


LISA: Yeah, I’m self-medicating, I’m handling it. And unfortunately, that word medication, and I’m not blaming anyone in this, I’m just sort of noticing the ways in which it can lend itself to the use of addressing the problem, medicating the problem, taking care of the problem. And so, what I’m trying to think through is, what does this mom do if the kid’s like, yeah, I am bummed, and no I don’t want to leave my school, but I’ve been down and this is me self-medicating. And they say it in that kind of like, so what’s it to you, kind of way. 


REENA: Right, wow. 


LISA: And so then, I think what we’d want is a parent to say, it really really matters you are in pain. 


REENA: Acknowledging the pain is what you’re saying. 


LISA: Absolutely.


REENA: It’s important to say, I get it, I see that you’re in pain, I acknowledge it. Why is it so important to say that?  


LISA: Because I think we can get stuck on the reaction to the pain, like you can’t smoke weed. 


REENA: Totally, totally. 


LISA: So I think you want to align, you want to say, okay, you must be in a lot of pain, because you are not the kind of of kid that wants to get kicked out of school, I know you, you’re a great guy, you’ve got this fabulous personality, you’ve got to be in quite a bit of pain to be smoking marijuana in your room by yourself. Like I hear that. And then Reena, I think what we take it back to is, coping coping coping. Which is, marijuana does provide coping. Right, if you get high or drunk, you will not feel as much pain. We have to acknowledge that. But then I think what we need to make clear for teenagers, is the goal here is to cope with our pain in a way that doesn’t have downsides. And there’s a lot of downsides to smoking marijuana. 


REENA: And so with that in mind, what else can the mom do at this point?


LISA: She may have to articulate the downsides again, I hate to say it. 


REENA: Yeah. 


LISA: And I think part of it, I mean this is so interesting to me Reena, teenagers are like, weed, alcohol, what’s the difference? And they’re not entirely wrong, like we’ve done studies on societal harms, and you know, they’re not altogether wrong, but they can see it as sort of a nothing-burger, like eh, everybody smokes weed, you guys drink wine on the weekend, like what’s the big deal. So I think to just say, let’s be clear, you are coping with pain in a way that has neurological implications for your learning and your attention, that could get you kicked out of school, that may be undermining whatever it is you want for yourself, in terms of performance on any front, and also, let’s also remember, is not even legal. 


REENA: Yeah, yeah. 


LISA: So, you know, you could really end up in a bad spot here. So, this can’t be how you cope with pain, there are too many costs. But let me put some options on the table for how you could cope with pain. We can get you a therapist, if you don’t like that idea, we can, you know, you can put some other things on the table that could help you feel better. Is there something we could be doing differently at home, is there a program you want to sign up for, is there something we could do to help you feel better, you know? It’s not about the pain, it’s about how it’s getting managed, and finding a way to manage it that brings relief but doesn’t cause harm to this kid is, I think, the next goal. 


REENA: So finding relief that doesn’t bring harm to this kid, okay, that’s really good. What else do you think parents need to know about being in this situation? 


LISA: Well, I could also see a kid who’s like, eh, I’m not in that much pain I just don’t want to stop smoking weed. I just like it. 


REENA: Really?


LISA: Oh totally, I could totally see a kid who’s just like, I like it, and like, what are you going to do about it? And that, I think, would be the hardest route in many ways, and I think that’s where the parent has to make a decision about how, bluntly, aggressive they want to be in preventing this kid’s ability to use. And they could say something like, you know what, I love you, and your 15, and I am sticking up for the 18-year-old version of you, who I think really would have wanted me to throw down about this, and really would have wanted me to get you off of this path, and so, here’s the deal, you can’t smoke anymore, and we’re going to start testing you weekly.


REENA: Wow. 


LISA: And you know, families can do that. They may need to call their pediatrician and figure out what that’s going to look like, and that would probably involve urine sampling, but the family may say, you know, we’re not budging on this, there’s too much at stake, it is too potentially costly, like I see right now it doesn’t feel like it’s costing you a whole lot, and that may feel true for the kid, but you’ve got one brain for the rest of your life and we don’t feel like we’re doing our job as a parent if we knowingly allow you to continue, so we’re going to start testing you once a week and you can’t use. And that might be a place to start. 


REENA: So this might be an incredibly inappropriate question, but, I think kids are looking and seeing marijuana legalized in many states across the country, how do you come back to a kid who’s like, look, I’m not doing molly in my bedroom, it’s just pot. 


LISA: That’s exactly, it’s not inappropriate to say it all, that’s exactly what kids will say. Like are you kidding me, and they’ll often say, and I’m getting good grades, like why are you making such a big deal of this, like that can be a position a kid can take. 


REENA: Well I guess the way I felt it was inappropriate was, is there a point where you’re like, you know, you’re like, eh, they’re just doing pot, it’s okay for a teen. 


LISA: I can’t say yes. 


REENA: I know, this is a tough question. 


LISA: Yeah, but there are degrees of worry, right? Like if you stop me on the street, like a random person stops me on the street and is like, okay Lisa, let me paint a picture. Here is a teenager who twice in high school, or on alternate months, on the weekend with friends, occasionally smokes what they know is definitely marijuana, and you know, they do it under incredibly safe circumstances, is that okay? And I’d be like, well, they’re not going to burst into flames, like this is likely not going to derail their universe if this is going on. Like that is the honest answer. At the same time, we’ve got to mention, the weed is different now than it’s ever been. The concentration of what’s available to kids is much much higher than has ever been available in the past. And so, I think it really then further clamps down on that question of like, is any use okay? Because, even if they know for sure they’re smoking marijuana, and of course, who really knows what they’re smoking, like that’s the other thing, like they’re not getting this at their pharmacies, like they don’t really know what they’re getting, so that’s a whole other ball of wax, not even worth it to get into today. But let’s just say they are smoking marijuana, the marijuana they’re smoking is very very powerful, very very intense, so we can reasonably extrapolate that whatever brain damage we know marijuana can cause, it’s’ not going to take as much marijuana as it used to to get you there. Right, so, that’s a conversation to have. But you said the essential thing Reena, and that is kids are watching legalization all around them, which makes it really hard for parents to be like, actually, this is a big deal. And so one way that a parent might kind of finesse that, is to be like, I would not be okay with you drinking in your room, I would not be okay with you drinking at school, like this is about you being altered, this is about you using a substance to change your mood. This is not okay. So that might be a way that the parent can say, look, legal schmegal, like you’re using this in a way that’s very worrisome to me, and I can’t ignore that. 


REENA: So much to unpack in this episode, and this topic just went so many different directions that I didn’t know things to discuss and think about. So what do you have for us Lisa, for parenting to go?


LISA: I think that the overriding framing we want on this, is that we are raising our young people to take good care of themselves. And we are handing over the work of caring for them. Like we used to care for them, and then we increasingly expected that they will take good care of themselves. And, when they aren’t, as teenagers, we really do need to wade in and get in their business, and so often in these interactions around like this letter, and things like it, the kid’s like, why are you in my business, like I am handling things. ANd one way a parent can address that is to say, look, I don’t want to be in your business, like I want to stand back and watch you take incredible care of yourself, but if you’re not doing that, I’m not doing my job if I let you not take good care of yourself. And the minute you’re taking good care of yourself, I’m out, I don’t want to be here. But you are sending me engraved invitations to be in your business when you are smoking marijuana in your bedroom and I’m not going to turn down that invitation. 


REENA: So letting them know that this is not a position you want to be in, you want to give them independence, and that might resonate. 


LISA: Hopefully, hopefully, but these are tricky ones for sure. 


REENA: Glad you’re here to help us think it through. In next week’s episode we’re going to talk about how do you help kids who don’t take initiative, to get them to do things on their own. 


LISA: Wonderful, I’ll see you next week.


REENA: I’ll see you next week. 


The advice provided here by Dr. Damour and the resources shared by her AI-powered librarian, Rosalie, will not and do not constitute - or serve as a substitute for - professional psychological treatment, therapy, or other types of professional advice or intervention. If you have concerns about your child’s well-being, consult a physician or mental health professional.