The Deadly Teenage Heroin Epidemic

The Deadly Teenage Heroin Epidemic

ABC 20/20 did a very good show the other night about the epidemic of heroin use in the United States. If you did not see it, you can probably find it on their website. Parents this is a show you need to see because many teenagers I work with are not afraid or concerned about how dangerous heroin can be.

According to ABC 20/20, 129 people die every year from a heroin overdose. A majority of these deaths are teens and people in their twenties. Heroin is used by people in the lower income level and by people who are the wealthiest in the country. It is used by whites, blacks, Hispanics basically every ethnic group. It is also used by males and females. Therefore, for the families in Lafayette, Walnut Creek and Danville who say we don’t have that problem here, yes you do. Also for parents and educators who think that if their child is in a private school they are less likely to use, you are wrong too. Heroin crosses all ethnic and economic boundaries. The epidemic is so severe some schools are teaching children in the 6th grade how to use Narcan. This drug can reverse an overdose of heroin if administered in time.

Therefore, parents in the Bay Area, you need to pay attention to this issue and these facts. You might be saving the life of your child or someone else you love.

As stated Heroin use to to be a drug of the past but it is now very popular with teens. Heroin is a cheaper alternative to many other drugs. For $10 a teenager can buy a capsule of heroin. This is much cheaper than other drugs.

Heroin is still mainly snorted or injected. Because it is injected teens are exposing themselves to HIV and Hepatitis C. Both are life threatening conditions with no cure. Also many girls who use heroin get pregnant but don’t realize they are pregnant until the 4th or 5th month. The girls stop but it is too late. The babies will be born drug addicted and if they live through withdrawals, these children will have on going health issues and learning disabilities. In addition to exposing themselves to diseases most teens use Heroin with other drugs such as alcohol. This makes the probability of overdosing on Heroin even higher. Heroin lowers a persons breathing rate and the drugs they are combining it with lower the breathing rate even more making an accidental over dose more likely. The rate of overdosing from Heroin has quadrupled over the years.

Why is Heroin coming back and very popular with teens? Heroin is very similar to the Opioid based pain killers that teens have been using for years. However, with the cost of pain killers rising on the streets and becoming harder to get due to new prescription laws, heroin is easier to get and cheaper. Also teens tend to like the high better. It is not uncommon for someone to get addicted after using heroin one time.

In the last few years heroin use has doubled in teenagers. What teens are at the highest risk? Those who have been using Opioid pain killers, those abusing marijuana and males. Remember it is very common for teens to combine heroin with other drugs and they are unaware of the impact it has on their breathing. They may collapse and not know why and by the time their friends get them to an emergency room it’s too late. Also teens may go to sleep after using and their breathing rate is so shallow they never wake up.

This is a very dangerous drug. If it doesn’t kill when the teen uses it the drug can kill when the teen contracts HIV or Hepatitis C. The rate of teens using this drug has doubled and the amount of people dying from an overdose has quadrupled over the last few years. Again, parents you cannot ignore this issue. Heroin is being used by upper class children and poor children, athletes, and all races. So it is impacting all teens.

The other major issue with this drug is stopping. Someone cannot just go off heroin. People can die from withdraw. However, finding a treatment center that is affordable or with an open space is very difficult. They may have to wait four months to get into a rehab center. This is very dangerous. When someone decides to stop heroin, they need to enter rehab immediately. If they have to wait even 2 days, they may not make it because they cannot stand the withdrawal symptoms.

If we get involved we can hopefully stop teens from using this highly addictive killer. I have attached a link to a handout by the CDC with facts, warning signs and suggestions to help your son if you think he is using heroin. http://www.cdc.gov/vitalsigns/heroin/
http://www.cdc.gov/vitalsigns/heroin/

Dr. Michael Rubino is a psychotherapist who has been working with teens for over 18 years and he is considered an expert in this field. For more information about Dr. Michael Rubino and his private practice visit his website at http://www.rcs-ca.com

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When do I Have My Child Assessed for ADHD?

School will be starting soon and many parents will receive reports from their child’s teacher that will cause them to ask, “Does my child have ADHD?” I hear this very often and do many assessments on children to determine if a child has ADHD. Yes ADHD is a really disorder, but too many teachers and schools rush to the conclusion that a child has ADHD.

According to statistics by the American Psychological Association, five percent of children in the United States have ADHD. It is also more common in males and it does tend to run in families. However, not every child who has ADHD requires medication. Many children can be treated with psychotherapy and behavior modification. Therefore, if your child is diagnosed with ADHD do not rush to medicate your child. There are different subtypes of ADHD and different severities of the diagnosis.

If you feel your child may have ADHD or their school suggests the idea make sure you have your child appropriately assessed. In the past schools would often diagnosis children with ADHD. Schools are no longer supposed to make this diagnosis. If they feel a child might have ADHD, they are supposed to have your child evaluated.

If you are going to have your child evaluated for ADHD, make sure you take your child to a mental health clinician who specializes in children and in doing assessments. The assessment for ADHD is not very difficult and an appropriate evaluation by an appropriate mental health clinician should cost around $250 depending on where you live. I have seen some parents who have spent thousands of dollars getting CT scans, MRIs and PET scans. You do not need an expensive scan of your child’s brian to diagnosis ADHD.

The DSM V, the diagnostic manual that mental health clinicians use, list the criteria needed for the diagnosis. I am including a link to the Center for Disease Control which list the criteria for the diagnosis and other information about ADHD, http://www.cdc.gov/ncbddd/adhd/diagnosis.html. Typically the diagnosis can be made by a clinician interviewing the parents, having a play session or two with the child and observing the child at school or consulting with the teachers. However, remember if you are going to have your child evaluated for ADHD, you want a mental health clinician who specializes in treating children and assessing children for ADHD. Your child’s pedestrian should be able to refer you to someone or if you call your insurance they will probably have referrals.

Before you rush to have your child assessed, remember some basic facts. Most children between the ages of two to five are very active. They also have very short attention spans. Sometimes you need to give a child some time to mature especially if you have a boy. Remember boys mature slower than girls and tend to be more active than girls. It is important to keep these facts in mind when you are wondering if your child has ADHD.

Now if you child is more hyperactive than other kids his age or his attention span is shorter than most kids his age, there might be an issue. Also if there is a strong family history of ADHD in the family such as his father had ADHD as a child and paternal and maternal uncles all had ADHD as children, there might be an issue. Also if your child was born premature or there were complications during the pregnancy or child birth, there might be an issue. Premature babies or babies with a difficult pregnancy or birth are more likely to have ADHD and learning disabilities.

Bottom line, if someone suggests that your child has ADHD don’t rush to the pedestrian seeking medication. Compare your child’s behavior to other children and consider the risk factors. If your child doesn’t have many risk factors for ADHD maybe wait six months and reassess the situation. The most important thing to remember is if you decide to have your child assessed for ADHD, make sure you go to a mental health clinician who specializes in children and ADHD. You want a mental health clinician who specializes in treating children with ADHD and assessing children for ADHD. Also remember you do not need any expensive scans like a CT scan.

Dr. Michael Rubino specializes in treating children and assessing children. He has over 18 years experience treating and assessing children and teenagers. For more information about Dr. Michael Rubino’s work visit his website at http://www.rcs-ca.com or his Facebook page http://www.Facebook.com/Drrubino3

What Parents Should Know about IEPs and School

Parents here is important information about Individualized Education Plans (IEP) and 504 agreements. Besides ensuring that your child receives a good education, you do not need to pay for items such as special computer programs that the school district should be paying for not you. If your child has an IEP the school district is responsible for most educational expenses even a private school if necessary. Please read this article so you understand your rights and your child’s rights.

The beginning of the school year is fast approaching. Besides the mad dash to get ready for school and schools are going to start assessing students to determine if they qualify for an Individualized Educational Program (IEP). I am already hearing from parents how school districts are misleading them and pressuring them to sign an agreement for a 504 before the parents clearly understand the difference between an IEP and 504 plan. The definition for both is further down in this article. An IEP and 504 are not the same. An IEP is legally enforceable and has legal guidelines and time frames. An IEP follows a student from school to school or state to state. A 504 is not legally enforceable and doesn’t follow a child nor are there legal guidelines.

An IEP will not stop your child from getting a job or from getting into college. In fact and college because they still would be entitled to assistance and the State of California may pay for their books. Also educational records are confidential therefore, no one would know your child had an IEP in school.

Many schools say your child must be two grades below in order to qualify for an IEP. If you said your child had a math or reading disability this is true. However, if they have ADHD, Bipolar, school anxiety etc. they can qualify under OTHER HEALTH IMPAIRMENTS. All your child needs is a diagnosis such as ADHD which would interfere with their ability to fully benefit from their learning experience in the classroom. The 2 grade below level qualification doesn’t apply to this category.

Also if you have a child in private school and they would benefit from additional assistance, contact your child’s public school district. Even though they attend private school the public school district is legally obligated to provide your child with services.

One more issue, never pay for outside testing before the school district tests your child. They have the right not to accept any outside testing until they test the child. If you disagree with the district’s testing then you can request an objective testing from an outside professional and you can request that the school district pays for the testing and you can select the evaluator.

An IEP or an Individualized Education Plan is a document that outlines the specialized education services that a student will receive due to their disability. It ensures the student will receive the assistance necessary so they will receive an education.
When most parents hear disability, they usually think of a person in a wheelchair or a student wIth a learning disability. There are various condItions that can qualify as a disability. Depression, Bipolare Disorder or even diabetes. The disability is any condition that will interfere in the student receiving the same education as other students. The students who qualify for an IEP need accommodations which meet the criteria of needing specialized education. As I stated above their are numerous conditions which may qualify a student for an IEP.
if a student does qualify for an IEP, they also qualify for Special Education. Many parents hear this and are afraid or embassies. There is nothing to be afraid of or embossed about. If a student qualifies for Special Education, if the student needs speech therapy or special computer programs, the school district is obligated to provide the services to the student at no expense to the student’s family.
There is also an option called a 504 Plan. This was established in the Rehabilitation Act of 1973. The 504 plan ensures that a student with a disability will receive accommodations so they will receive the same education as other students. However, the 504 plan does not qualify a student for Special Education services and It is not overseen as closely as an IEP plan.
Currently, many districts are telling parents that their child does not need or qualify for an IEP and a 504 plan is just a good. This is not true. Many school districts are telling parents that their child does not qualify for an IEP because the IEP is more expensive for the district and most districts are trying to save money.The districts take advantage of the fact that as parents, you do not know all the differences between an IEP and a 504 so they can talk a family into a 504 plan easily.
If you find that your child is having difficulties at school due to a learning disability, health issue or emotional issue, consult an outside professional before you automatically assume that the school is giving you the appropriate recommendation.
I see many parents who have been told that their child is better with a 504 plan and that is not the truth. You can consult an educational consultant or a therapist who works with children. You can contact me at drmike@rcs-ca.com. I help many families at their child’s IEP meeting. The main thing is, do not be afraid to ask if your child should have a 504 or an IEP. Also don’t let the district make you feel guilty because you want time to think and investigate the options. This is your child and you should never sign anything until you are sure it is in your child’s best interest.
I have added a link to a chart that will help you compare the two and understand the differences.

504 Plan vs. IEP – Education Centerwww.ed-center.com/504This pages lists the differences between an IEP and a 504 plan.

I have also added a link to a video which helps to explain the differences between an IEP and 504 plan.

Dr. Michael Rubino has over 18 years experience working with children and teens. He also has over 19 years experience working with children in Special Education and was an Intern for the AB3632 program which works with children in Special Ed and IEPs. For more information about Dr. Rubino’s practice visit his website at http://www.rcs-ca.com

What to Expect as Your Teenager Starts High School

As your teen enters high school they are also starting to enter the adult world. This is now a time for them to start to take on new responsibilities and to consider the reputation they are creating for themselves. As parents your responsibility is to help guide them, not tell them exactly what to do. It is important that the teen develop life skills on their own. You will not always be there as the parent to help.

The first step is for you to allow them to earn your respect. Explain that they are no longer little kids, that they are now young adults, and part of being an adult is earning people’s respect. You also have to be prepared to respect them and allow them to be young adults and not treat them like little children. This does not mean you are giving up control. Your teen still needs you for money, permission to do things at school and to sign the consent for the all important driver’s permit. So relax, you still have all the control you need.

The first place to start with respect is their rooms. Allow them to have their rooms as their own private space. Do not worry if it is dirty or if their are clothes all over, it is their space and they have the right to live in it how they choose. Set the limits that as long as you can close the door and there are no odors coming from their room, you will respect their privacy. If these agreements are broken, then you have the right to go in and clean as you like. You also have the right to inspect the room if there are obvious signs of drug use. As a parent you have to balance your teen’s right to privacy, but at the same time you need to ensure their health and safety.

Homework is another big area of concern. Make your life easy. Set a minimum GPA such as 3.0 or 2.0 based on your teen’s ability and then allow your teen to manage their homework. If they ask for help, obviously help them. If they do not, let them handle their homework until progress reports and grades come out. You need to have an agreement as to what will happen if they fail to maintain the minimum GPA set and they never ask for help. If they fail to maintain the minimum GPA, then the consequences you agreed to are implemented. The consequences occur not because you are being mean, they occur because the teen failed to live up to their part of the agreement – they made the choice. This is important to reinforce so you are not labeled the bad guy and the teen learns a lesson in making choices.

Finally, you and your teen need to sit down a draw up a contract concerning the house rules, school performance and your expectations regarding their behavior in general. If you have it in black and white and there is a conflict then all you need to do is refer back to the contract and the problem is resolved. It is very important that you abide by the contract too. So you cannot increase a consequence, if you agreed to something else already with your teenager. It is essential that you honor your word. If you want your teen to be responsible, you must be responsible.

One last thing – no one is perfect. If you make a mistake, model appropriate behavior and apologize. If your teen makes a mistake and comes to you right away to apologize, thank them for their honesty and compliment them on their maturity. Remember, they want to know that they are important in the world. By treating them with respect and as maturing adults you are validating the fact that they are important and loved and you are encouraging them to keep trying.

Obviously, it is not always that easy and there are various parenting situations. The above suggestions are a guideline to get started with as your teen enters high school.
Dr Michael Rubino is an expert in providing psychotherapy to teenagers and their parents. He has over 19 years experience working with teenagers. For more information on Dr. Michael Rubino’s work or private practice visit his website at http://www.rcs-ca.com or follow him on Twitter @RubinoTherapy

Dr. Michael Rubino has over 18 years experience working with teenagers & their parents and is considered an expert regarding teens. If you would like to contact Dr. Michael Rubino or would like more information about his private practice, visit his web site at http://www.rcs-ca.com

Tell Your Teenager I Love You

It’s the 4th of July weekend and many teenagers will be involved in various activities. It’s a popular weekend for teenagers to be out drinking and also swimming with friends. Most people assume these are every day activities and everyone will have a good time.

However, this is not reality. Every year 5,000 teenagers are killed in motor vehicle accidents and 400,000 are injured (CDC statistics). These injures may range from cuts and bruises to someone being paralyzed.

Also regarding swimming, there are 3,500 accidental drowning every year. And out of these drownings 1 out of 5 are teenagers (CDC statistics). This is the number who die. It doesn’t include brain injuries due to lack of oxygen to the brain or breaking a neck by diving. A broken neck can result in death, paralysis or being in a Halo Brace for 6 months. Again this is an activity we assume is safe and nothing would happen swimming in a friend’s pool.

With it being the Fourth of July weekend and there are going to be a lot of parties and drinking. There are also going to be a lot of drunk driving accidents, drownings and accidental overdosing. You have no way to know if you or your family might be one of the unlucky families this weekend. It could be your teen who is killed or it could be you.

You never know what is going to happen in life. Especially given everything that is happening all over the world. Also there was a threat against San Francisco that authorities are saying is legitimate, however, some say it’s not.

A mother experienced this fact when her son committed suicide. After that she wrote the following poem to her son. She also encouraged all parents of teenagers to remember to say “I love you,” to your teenager. You may not get another chance.

I Love You

How could you?
They asked you,
How could you?
But you could not answer
As you were not here.
Why would you?
They asked you,
Why would you?
But their questions fell onto
The world’s deafest ears.
I loved you!
They told you,
I loved you.
But they told you too late,
Through their tears.
I’ll miss you,
They told you,
I’ll miss you.
And in death now
They hold you more dear.
The point is don’t take the risk. Since you never know what may happen and many teens feel unloved or that their parents don’t care, take the opportunity while you have it to express your feelings. Don’t spend the rest of your life regretting I never told him I loved him or wondering if that would have made the difference.

Dr. Rubino is a therapist is Pleasant Hill with over 18 years of working with teens. To find out more about his work or to contact him visit his website at http://www.rcs-ca.com.

Getting Respect from Teenagers

High school and the teenage years are a very difficult time for many teens and parents. This time of life has become even more difficult with the advancement of social networking, smart phones and computer technology not to mention the increase in drugs that are available to teens. These drugs are designer drugs such as ecstasy and spice as well as prescription drugs such as Vicodin or Concerta can easily be obtained on any middle school or high school campus today. And yes, this is the truth.

Things are advancing and changing so fast that life is becoming overwhelming and confusing for teenagers and for parents too. Not to mention society in general. One thing that has not changed, is that parents are a child’s main role model and parents provide their teens with cellphones, laptops, cars etc. However, with the rapid changes in our society, a lot of parents have forgotten that they are their teenagers primary model and primary source for obtaining all the things teenagers feel they cannot live without.

One major issue is that parents don’t feel respected by their teenagers. However, very often, parents don’t require teenagers to be respectful. Many parents may set rules and their teenager blatantly ignores their parents and nothing happens. Parents tell me this often and I suggest suspending their teenager’s phone service or now that it’s summer not taking them on the family vacation. Many parents looked at me and say they cannot do that to their teenager. Their teen relies on their cellphone or has been counting on the vacation. Parents also tell me if they take such actions their teen will become very difficult to live with and might break things in the house.

So who is in charge? Your teenager is in charge. Remember they know you very well. They know you will be anxious or feel guilty about imposing tough consequences. Therefore, they are not afraid to disrespect their parents and do what they want because they know there will be little to no consequences.

Therefore parents if you want respect don’t be afraid to impose consequences. Remember your teenager needs you to pay their bills and give them consent to get a drivers license. Parents have more power than you realize. Also if you don’t expect respect and allow disrespect that is what you are going to get.

Any time I have explained how much their parents do for them and what would happen if mom and dad stop, I have never had a teenager not stop and think. If the teen still chooses to test the limits as soon as they see mom and dad will stand by what they say, they soon learn to respect mom and dad. Parents you must remember to only set limits that you are willing to see it through. If you don’t, teenagers will not respect your word or authority.

Parents it is also remember that you cannot just start this when your teenager turns 15 years old. By this point is that you have established patterns of disrespect. You need to start taking to your children at age 5 years old about following the rules mom and dad set and respecting mom and dad. It is a process that takes time. It is important that you remember this fact.

Since your child was born, s/he have been watching you and studying you about how to act and what actions are appropriate. They have been listening to what you have been saying to them about how to act as a responsible, decent member of society. I know many parents feel that once their child started middle school that their child stopped listening to them, but that is not true. They may act like they are not listening or that they don’t care about your opinion but they do.

I have teens come into the office all the time and complain that they feel like their parents do not care about what they do. Often teens make this assumption because they say their parents set no boundaries for them or they feel that the parent cares more about their careers than their children. At times parents do focus more on careers or stop setting limits because they feel that their child doesn’t listen to them. Parents often feel this way because their teen will say, “I don’t care what you think or I don’t care what you do”. However, they do care and often they say these things or act this way because they feel hurt.

Every child, no matter what they say, wants to know that they are important to you, that you care about what they say and you care about what they do. One major problem that I encounter with parents is that many parents do not practice what they preach. Yes you are an adult and you have a right to drink alcohol or engage in other adult behaviors, but you need to do so responsibly. If you drink alcohol, do so responsibly. Yes you are an adult but using marijuana is illegal no matter how old you are. Also watch how you speak to your teen and others. Do you do so in a respectful manner or are you rude to people?

A lot of parents will come in and tell me that their behavior doesn’t matter and that their child has no idea what they do so they can do what they want. The truth is, your behavior does matter and your children know what you are doing even if you think they do not know.

I have had eight year old children complain that “my mommy drinks too much wine”, or “my daddy smokes pot in the garage” or “my daddy talks mean to people”, or “my parents fight too much.”. When I try to talk to a teen about their behavior after they have said something like this, the teen responds if my parents can do it, why can’t I? This is difficult to argue with if the parents are using illegal drugs or abusing alcohol. Also the fact that eight year old children also make these comments demonstrate that if you want your teen to act respectful, then as a parent you need to model respectful behavior starting when they are born. Also children want to know that they are important to you and setting rules and enforcing rules communicate to your kids that you care about them.

The bottom line is that as a parent you have the most significant role in your child’s life. If you want your child to grow up to be a mature, responsible adult, then you have to act like a mature, responsible adult and you need to do so from the day they are born.

In this world where things are changing over night, children need to know they can rely on their parents to protect them and guide them. Again given how fast society is changing, this is not an easy job for a parent. The easiest way to sum it up is to remember to practice what you preach.

Dr Michael Rubino has over 18 years experience working with teenagers and their parents. Dr Rubino is considered an expert in this area. For more information on Dr Michael Rubino and his private practice visit his website at http://www.rcs-ca.com.

An Epidemic in Teenagers who Cut

Suicide is the third leading cause of death in kids 10 to 18 years old. In this article we are going to explore a teen behavior that can result in suicide and that is cutting. This is a very common behavior among teenagers and many parents know little about it. Cutting is usually used as a method to deal with emotions, but it can lead to permanent damage or suicide, if the teen is not aware of what they are doing.

Cutting is any behavior which results in self-mutilating. Therefore it could be cutting oneself, scratching, burning, erasing ones own skin etc. Anything that results in damaging ones own body. It is also a behavior that is on the rise in the teenage population.

A recent study by Rhode Island hospital found that 46% of high school students admit to engaging in some form of cutting over the past year and 20% of college students admitted to it. ABC news found that 1 in 12 teens engage in cutting. Girls are more likely to cut than boys, but boys still do cut. I have both teenage boys and girls admitting to some form of cutting. The CDC has found between 20% and 30% of teenagers engage in some form of cutting or self-mutilating behavior. One of the major treatment centers for cutting has found 1 out of 5 girls engage in cutting and for boys the statistic is one out of 7 engage in cutting. Most studies, including the CDC, report the average age for a teenager to engage in cutting or self-mutilating behavior is 14 years old. Furthermore, research studies indicate without treatment, 40% of teenagers who cut or self-mutilate will continue the behavior as an adult. This is a very serious condition and research is showing it is increasing every year. One study showed 30% of teenagers cut. Think about how many teenagers that is in reality. Also then consider without treatment most of that 30% will continue the behavior as adults. We need to address this issue.

You may ask, why would someone cut themselves? Most teens engage in self-mutilating behavior because they find it easier to deal with the physical pain than the emotional pain they are experiencing. Some teens prefer just to cut and that helps release the pain and others need to watch the blood or watch the act of cutting or erasing as a way to deal with the pain.

This behavior is very common now among teenagers. Most teens have engaged in one form of self-mutilating behavior as a way to deal with their feelings.

What they do not think about when they are engaging in this behavior is the risk. If they cut too deep or in the wrong area they can cut a major artery and bleed to death. They can cut a nerve or tendon and lose control over their arm or leg. The site they cut or erase can become severely infected and lead to a number of medical issues. Most teens who cut are not suicidal but they are looking for a way to cope with their emotional pain.

Signs that your teen may be engaging in cutting are personality changes, where long sleeves or not allowing anyone to see their body. They often cut on their stomachs, chests or thighs because it is easier to hide. Picking at scabs is another sign. Changes in their appetites and sleeping pattern. Also a tendency to withdraw from family and friends. They also have a tendency to act depressed.

If you feel your teen is cutting, don’t be afraid to ask. However, if you do ask don’t act shocked or like they are doing something bizarre. Teens who cut are very afraid of being shamed. If you act like you cannot cope with their behavior they will not tell you.

Obviously if your teen is cutting there are emotional issues going on. The first thing to do is to have them examined by their pedestrian. You want to make sure there are no infections or damage that needs medical attention. The next step is to have them see a therapist who specializes in teenagers and especially one who specializes in cutting. Again if the therapist acts uncomfortable with the subject the teen will not talk. The good news is that with appropriate care most teens learn how to deal with their emotions in a healthy manner and stop cutting.

Dr. Michael Rubino has over 18 years experience working with teens and specializes in cutting and self-mutilating behavior. For more information about Dr Rubino and his private practice visit his website at http://www.rcs-ca.com