Attitudes on Drug Risk 2: Lies to Children

I’m following up on some blogging resulting from a recent post of mine on the effect Len Bias’ death (apparently) had on population level perception of the riskiness of trying cocaine. This will verge on the type of link-vomitus that is much despised by the PhysioProf, so consider yourself warned!

[Update 2/6/08: Overmistress Ginny is running a survey on “scared straight”, go play on Page 3.14]
Abel Pharmboy started off with a meaty followup to his comment on a news article reporting on the abuse of diphenhydramine, the active ingredient of Benadryl®. He then used that to discuss some other trends in abusing over-the-counter cough-suppressant preparations containing dextromethorphan. Abel next made the mistake of musing on the topic of how parents might want to deal with the topic of recreational drug use and risk so as to appropriately guide their children.
Game on, my friend, game on.
First, despite Abel’s supposition, I have no special insight. I recognize at the outset that we typically have N=1-4 experiments available to us, the consequences are high, the variance is tremendous and we are seriously contaminated by our own adolescent substance-use experiences. The population-level experiments are of use, but only limited use, in shaping our parental choices. I am perhaps more likely than average to obsess think about this stuff, but I’m searching for the answers that I will quickly require as much as anyone.
I had a few thoughts on this awhile ago under a post entitled “Lying to Children About Drugs“. I think the biggest problem in this area was expressed as this:

My difficulty is that when teenagers catch you in the lies-to-children you tend to lose credibility. Thus, if they figure out you are lying before you update the lies-to-children to lies-to-adolescents or lies-to-non-scientific-audiences, you may have lost your opportunity to do so.

I think many of us parents who are scientists with a reflexive orientation that “the truth will always win out” and those of us ex-adolescents who feel that “nobody, nowhere, nohow was tellin’ us what to do and btw, all that DARE and Just-Say-No was transparently false and manipulative” may share some element of this problem.
DuWayne Brayton lays down a very well-considered parental approach on his Inalienable Rights blog. I may not agree with everything he has to say but there is lots here to launch that internal conversation with yourself or that conversation with your spouse, or even your pre-teen. In truth, this whole post was an excuse to direct you to that post so go read, eh?
I think perhaps the one major concern I have is with DuWayne’s approach to being totally honest and communicating realistic assessment of risk to your kids. And it is more a concern of application rather than the fundamental approach. He would apparently like to be able to say things such as “If you absolutely are going to get high, try smoking weed rather than huffing glue, would ya?”. I would like to be able to do this as well, I for damn sure have a preference list of things I’d really, really, really rather my kids didn’t choose to ingest, given that they are going to seek to get high. I’m sure most of you have your scales as well.
My concern has to do with our inability to really understand “rare” events on the scale of 10%, 1% or .1% incidence. This is combined with the pronounced adolescent lack of appreciation for mortality. Take the Len Bias affair. Before and after this event, the state of scientific knowledge about cocaine and acute cardiac arrest was probably the same. I.e., that in some cases cocaine can cause death, yes even when taken in some reasonable approximation of a “normal” recreational dose. At the time there was a lot of discussion about the extent of Len Bias’ experience with taking cocaine but my memory on that is pretty hazy. Parents’ conversations across the US, if not the world, regarding the risks of cocaine most certainly changed. Because their appreciation for the “rare” outcome of acute heart failure was changed due to the all-penetrating media attention. Likely to an overestimate, one would hypothesize. The Leah Betts / MDMA story in the UK has some similar features- you might as well Google it because you’ll need to assemble an impression yourself from all the advocacy-site complaining about the PR on this one.
Getting back to the point, DuWayne’s approach relies on the assumption that we, as parents, actually understand the “real risks”. As they apply to our children. In the context of their actual lives in society. Acute death is only one factor. As DuWayne’s post notes, the potential for lasting cognitive impairment following interference with normal brain development is another risk. Becoming dependent on drugs. Secondary risks for acute trauma (car accident, diving into shallow water, ..). Other associated risks like, say, unprotected (or “protected” for that matter) sexual activity.
Lucky for you, DearParents, you have employees out there working as hard as they can to give you better and better answers to your questions. Those employees are, of course, your taxpayer funded scientists.