Quick Clips with Dr. Kilmer: 06. Thoughts About Risk and Substance Use Initiation

In this series we talk with Dr. Jason Kilmer, professor of psychiatry and behavioral sciences at the University of Washington School of Medicine. He specializes in the development, implementation, and evaluation of substance use prevention and intervention efforts on college campuses and among 18–25 year olds.   

While Dr. Kilmer focuses on college campuses, his insights are universal and particularly helpful for parents with teenagers of any age. Share these recordings with your parenting peers as you all navigate this exciting time in human development (ages 14–25) and work to help your kids navigate away from alcohol and other drugs.

This podcast is brought to you by the Substance Abuse and Mental Health Services Administration (SAMHSA). The views expressed here are not necessarily those of SAMHSA or the U.S. Department of Health and Human Services. For questions or comments about this podcast, please contact WhatParentsAreSaying@gmail.com. 

Transcript

Quick Clips with Dr. Kilmer: 06. Thoughts About Risk and Substance Use Initiation

[00:00:00] Debbie: Welcome to Quick Clips with Dr. Kilmer. Today we're talking about risk. So those 18-year-old to 22 year olds in college and or other scenarios, is there greater risk or risk points for them? 

[00:00:22] Dr. Kilmer: I mean, the short answer is yes, and I could end it right there, but that probably is not as helpful as a bit longer answer, which is that the younger people are, when they start using substances, the more risk does go up.

[00:00:32] There's issues of brain development. You know, the brain develops throughout life, but particularly because of what we see important development and growth through the age of 25. We're very, very mindful about doing all we can to delay the initiation of use. I have a friend and colleague, Dr. Amelia Aria at the University of Maryland who often says, this is one of the behaviors where practice doesn't make perfect trying to start young, even with supervision.

[00:00:58] It is not the way to go from a science and from a health standpoint because the younger people are, when they start, the more it does elevate the likelihood of risk of a substance use disorder or addiction, depending on the substance, there's even risk of other mental health issues that we wanna be mindful of.

[00:01:14] There's a very famous study by Hall and Deon Heart that shows that those that use cannabis 10 or more times by the age of 18, two to three times more likely to develop schizophrenia. Later in life, that's a fairly striking and very scary statistic. And so when we look at our efforts to delay the initiation of use, keep those who are abstaining, abstaining people, make the choice to use the later in life that they are to make that decision, the more that ultimately serves to reduce risks and reduce harm.

[00:01:47] Debbie: And I guess. Two, I don't think you just said this, maybe didn't, I just zoned out for a second. The, the decision to use early and then revert back to non-use is still important as well, right? 

[00:02:05] Dr. Kilmer: Yeah. If someone uses early and chooses this isn't for me and they stop, certainly that's more advantageous than someone who might choose to continue.

[00:02:12] But really the bottom line is, is that when people. Initiate use at a younger age, the likelihood of developing a substance use disorder later in life is higher. And we also do worry about developmental issues, especially because of impact to the brain before the age of 25. And there's nothing magical about turning 25 and one day old.

[00:02:32] It's not like, okay, I'm okay now, but the risks do go down once we get past that age. 

[00:02:37] Debbie: That's great. But the other thing I always think about as a parent. With high school kids and, and even, and probably less so with college kids, 'cause in high school it feels like you have a little bit more control, whether that's perceived or real.

[00:02:51] If you have a child that starts to use, I know some parents just. Not panic, but have a, well that was gonna happen anyway, kind of response. And that they might not encourage their kid to stop using. Mm-hmm. And I think I'm hearing that encouraging your kid to stop using is still very positive and it's something you want to do as a parent.

[00:03:20] Dr. Kilmer: Do 

[00:03:20] Debbie: I have that right? 

[00:03:20] Dr. Kilmer: Well, one of the previous Quick Clips we talked about the concept of. Messaging from parents matters that you do have a voice that matters and that can even get internalized. And so a message of, yeah, if I get a voice in this, my preference is that you not be using right now. Yeah.

[00:03:37] That's gonna stick for some students because there's so much research that shows that perceived parental permissiveness affects the decisions that college students make. There's research that shows that high school students, when they think my parent would be cool with this. They're more likely to use a substance when then than when they say, I know my parent's not cool with this.

[00:03:56] Debbie: Thank you, Dr. Kilmer.