The most damaging physical effects of stimulant use appear to be tied to their effects on sleep. According to Dr. Hart, “Low to moderate doses of amphetamine can improve mood, enhance performance, and delay the need for sleep. Repeated administration of large doses of the drug can severely disrupt sleep and lead to psychological disturbances, including paranoia.”*18 It’s sleep deprivation, not crack or meth, that makes some people crazy.
What about meth mouth? We all know what that looks like, we’ve seen the photographs! The pretty white girl with blond hair and blue eyes, turning before our eyes into a haggard crone with a mouthful of snaggly brown stumps. Methamphetamine restricts salivary flow, leading to xerostomia—dry mouth—which, if left untreated, can cause tooth decay. But so do all stimulants, including Adderall! Adderall and other stimulants are among the hundred most prescribed drugs in the United States, and yet we don’t have an epidemic of “Add mouth.” One of my kids has ADHD and has a prescription for Vyvanse, an amphetamine that works just like Adderall. Not only can this child finally sit still through a test, but he has gloriously sparkling teeth, a function of his profound commitment to dental hygiene—the best, according to his dentist, of any teenager she’s ever treated. According to Dr. Hart, “The physical changes that occurred in the dramatic depictions of individuals before and after their methamphetamine use are more likely related to poor sleep habits, poor dental hygiene, poor nutrition and dietary practices.”*19 As hard as it is to believe, “meth mouth” is a myth, a function of media sensationalism.*20 Some even theorize that the hype around meth mouth is actually an expression of horror at the loss of white privilege, a warning that if whites are not careful they will descend into “white trash.”*21
The addiction rates of stimulants are high, but not as high as those of heroin or nicotine, and most people who take methamphetamine will never become problematic users. Research*22 shows that the number of users of methamphetamine who go on to develop an addiction to the drug is 17 percent.*23 Yes, you read that right. Only 17 percent of people who use methamphetamine end up addicted to the drug. But here’s the thing. A rate of addiction of 17 percent is high. It only sounds low because the drug warriors and their media mouthpieces have led us to believe in the “one and done” myth. We’ve been told that a single dose of methamphetamine, a single puff of a crack pipe, a single injection of heroin, is enough to make an addict. But that’s simply not true in the vast majority of cases. Had we not been exposed to an aggressive campaign of misinformation that led us to expect something like a 99 percent addiction rate, we would be able to recognize that it is a very big deal if nearly a fifth of methamphetamine users and nearly a quarter of heroin users become addicted. Instead, we see those numbers and are confused.
From now on, when I talk to my kids about methamphetamine, I’m going to stop doing a Google image search for “meth mouth.” Instead, I’m going to be candid with them about the drug’s high potential for abuse (“If you and nine friends try meth together, one or even two of you could end up addicted”) and about its negative effects. I’m also going to tell them what I always tell them about drugs: one of the worst “side effects” of drug use is arrest. If you are arrested for using drugs, our system can come down on you like a ton of bricks. Though of course my children share a quality that makes it unlikely that they will be arrested: they’re white. When they’re walking down the street, they will probably not be stopped and forced to turn out their pockets. Their black friends, however, face a very real risk of this.
In addition to providing my kids with accurate information and having in place a system of consequence-free party pickups (made especially easy now with the advent of Uber and Lyft), our family harm-reduction policy has, since the incident at Wesleyan University when the group of students nearly died taking a drug they thought was Molly, included stocking a cupboard with drug testing kits, so if the kids try Molly or another club drug they can be sure they aren’t inadvertently taking poison. We also stock their bathroom cupboard with condoms, though recently one of our daughters has taken over this role, becoming a member of Berkeley High School’s “Condom Club,” distributing condoms to her friends. She’s a little Johnny Appleseed, but with johnnies.
All this frank talk about risks and rewards can make a parent uncomfortable, even afraid. Abandoning the question of whether my kids use drugs, and focusing instead on minimizing the chances of their being hurt by drugs, feels sometimes like abdicating responsibility. But it isn’t. It’s actually a hell of a lot of work. You can’t just say, “Don’t smoke pot!” You have to go out and do the research. You have to explain to your kids that some studies have shown that marijuana can affect the developing brain in negative ways, so they should put off smoking pot for as long as possible.*24 You have to explain to them that alcohol is even worse for their brains than marijuana.*25 All this can be exhausting. So here’s an alternative: print out a copy of Safety First: A Reality-Based Approach to Teens and Drugs, a thoughtful, research-based harm-reduction guide for teens, parents, and educators, written by Marsha Rosenbaum, Ph.D., and published by the Drug Policy Alliance.*26
A harm-reduction approach to parenting need not be permissive. My kids know how I feel about the risks and rewards of drug use. They know that there are drugs that I hope they will put off using until they are older (marijuana and alcohol), drugs I hope they will use only when they are older and under very circumscribed conditions (MDMA, psychedelics), and drugs that I hope they never use (methamphetamine, cocaine, heroin).
But what about this experiment of mine? Although having a harm-reduction policy means that I don’t lie to my kids about drugs, it doesn’t require me to discuss anything I don’t feel comfortable sharing. I get to decide what I tell them about my own life. Though I have to admit that it feels dishonest, I’m not ready to be open with them about this. For now, I’m going to stick with “taking a walk.”
* * *
*1 ?This is an actual excuse I once gave my mother after, I believe, the first time I smoked pot.
*2 ?The best-known example of a drug-related harm-reduction policy is a needle exchange program, in which drug users are provided with clean needles so they do not share dirty ones and thus expose themselves and others to potentially fatal diseases. According to the World Health Organization, needle exchange programs “substantially and cost effectively reduce the spread of HIV among intravenous drug users and do so without evidence of exacerbating injecting drug use at either the individual or societal level.” Dr. Alex Wodak and Allie Cooney, “Effectiveness of Sterile Needle and Syringe Programming in Reducing HIV/AIDS Among Injecting Drug Users.”
*3 ?If you listen closely, you can hear the sound of my children’s play dates and prom dates shriveling up and blowing away.
*4 ?Sara Bellum, “Real Teens Ask: How Many Teens Use Drugs?”