Mediate Michigan

Many years ago, when I was a resident in pediatrics, an adolescent patient asked me if I had ever smoked pot. It wasn’t a friendly question, more an oh-yeah-says-you response to my own inquiries, warning me off.

No patient has asked me that for decades. But recently, I have found myself in several all-pediatrician conversations about the topic.

Doctors, and the parents who look to them for advice, need a way to integrate their standards of honesty with what we know about preventing substance abuse — and with new research that makes it clear we know a lot more today than anyone did when we were young. (Which may help explain some of the dumb decisions made by so many of us, including me.)

In particular, scientists understand much more about the neurobiology of the teenage brain and the risks of experimenting with drugs and alcohol during adolescence. While we used to think the brain was relatively mature by 16 or 18, in fact it is still developing into the mid-20s.

What does develop early is the pleasure-seeking area, the nucleus accumbens. The regions that help with abstract thinking, decision-making and judgment are still maturing, and therefore less likely to inhibit the pleasure-seeking behavior. So drugs and alcohol can actually lead to permanent changes in the way the brain works — in particular, many experts think, a greater likelihood of addiction in adulthood.

But giving sage advice to the young has never been a simple task, and when a parent’s own history is brought up, it gets even more complicated.

via 18 and Under – Q. Did You Ever Smoke Pot? A. It’s Complicated. – NYTimes.com.