Magazine article Clinical Psychiatry News

Strive for Confidentiality in Talks about Drugs

Magazine article Clinical Psychiatry News

Strive for Confidentiality in Talks about Drugs

Article excerpt

SCOTTSDALE, ARIZ. -- Physicians need to talk seriously with adolescents about raves, the drug scene, family, and school to detect dangerous problems, an Arizona pediatrician advised physicians attending a pediatric update sponsored by Phoenix Children's Hospital.

Talking with adolescents without their parents present is essential, said Randal C. Christensen, M.D., medical director of the hospital's Crews 'N Healthmobile, a mobile medical unit serving homeless adolescents and children. "This should start at about 11 or 12 years of age.

"It's surprising how open [preadolescents and] adolescents can be about their lives," he said.

"Some things should be kept confidential, but nothing that could be harmful to the patient."

The latest fad in the teen world is raves, dusk-to-dawn dance parties with fast music, techno sound, and light shows. "They are often promoted as alcohol-free, high-security events," he said.

What more could parents ask for?

"It's a cover-up," he said. "There is a dark side to these events." What isn't advertised is that club drugs, such as ecstasy, methamphetamine, rohypnol, and [gamma]-hydroxybutyrate (GHB) are often free-flowing at these functions. The Internet has provided easy access to these events by advertising, state by state, the locations and times, Dr. Christensen said. "All you have to do is type in 'rave' and your city."

"We're talking about promoters making millions of dollars just on the cover charge and the legal stuff that is sold there," he said.

But many times, the latest drugs are easily available at these events.

One of the most popular is ecstasy, or methylenedioxymethamphetamine (MDMA). "It enhances the sight, sounds, and touch," he said. It also raises the body temperature and causes teeth clenching--so bottled water, flavored pacifiers, and candy necklaces are sold at these events to help ease these symptoms.

Although the use of ecstasy peaked in 2001, it continues to be high, with close to 2 million youths admitting to using the drug. And while ecstasy use has decreased among eighth graders, the use of inhalants is rising at an "alarming rate" among this age group, he said.

Now 12th graders are increasing their use of prescription drugs, with 1 in 10 admitting to use of oxycodone on at least one occasion, Dr. Christensen said.

Physicians need to be savvy about what drugs are in use, he said. This easily can be done by looking at Web sites that explain not only the effects but also the popular usage of these illegal drugs.

"Physicians need to ask questions to open the lines of communication. …

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