Parents in the Dark About Teens' Drinking and Drugging

ST. LOUIS, Sept. 25 -- Asking parents about adolescents' substance use and abuse is essentially a waste of time, found a researchers team.

About half of parents surveyed knew that their teens smoked, or used alcohol or marijuana, but only a handful know when that use had crossed the line into abuse or dependence, reported psychiatrist Laura J. Bierut, M.D., of Washington University here and colleagues at three other centers.

After surveying 591 adolescents and at least one parent of each teen, Dr. Bierut and colleagues concluded in the October issue of Alcoholism Clinical and Experimental Research that parental reports added only minimal information about adolescent substance use.

She recommended that "investigators could save time and resources by limiting the number of questions asked of parents so that only basic information regarding substance use is obtained, or by omitting parent reports about substance use altogether, particularly for older adolescents."

More than half of the teens (54.4%) said they had consumed at least one drink of alcohol and 23.6% told Dr. Bierut and her colleagues of at least one bout of intoxication. By their parents' reckoning, however, the teens' lifetime alcohol use was 30.5% and the intoxication rate was 8.1%.

Based on their responses to the child version of the Semi-Structure Assessment for the Genetics of Alcoholism questionnaire, 8.5% of the adolescents surveyed met the diagnosis for alcohol abuse or dependence. But parents who answered the parent version of the survey identified alcohol use or dependence in just 3%.

The disconnect was similar for rates of marijuana use and for use of other drugs. Parents were more aware of cigarette smoking, probably because cigarette smoking is "a repeated behavior likely to be noticed by parents."

Parents who had a personal history of substance abuse or dependence were better at spotting problems with their offspring, but this adult group was also more likely to see signs or abuse or dependence in children who denied it.

While parents didn't always know whether their children were using or abusing substances, they were very much in synch with children who didn't smoke, drink, or use drugs, so that "when an adolescent reported never using a substance, the probability was very high that the parent report would agree."

But the likelihood that parents and children would agree when asked about substance use or abuse was lower for the youngest adolescents, they wrote, possibly because "12- to 13-year-olds may be less reliable reporters than the older adolescents."

Dr. Bierut and colleagues enrolled adolescent and parent pairs in the study beginning in 1991 and continuing through 1998. There were some sibling pairs in the study, so a total of 428 parents reported on 591 adolescents.

There were 438 parent-adolescent pairs from families with a history of alcoholism and 153 parent-adolescent pairs were recruited from the community. All adolescents were ages 12 to 17 at enrollment and 51% were boys. About three-fourths of the sample were European-American and 22.5% were African American.

Among the limitations of the study was its reliance on biological mothers (85.5%) as the surveyed parent.

Another limitation was that the study was a "he-said-she-said" of parent and child. Dr. Bierut and colleagues assumed that the most accurate report came from the adolescent, but they pointed out that it is possible -- although they don't think probable -- "that adolescents are exaggerating their use of substances and that parental reports are more accurate."

The study was support by grants from the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse and the National Cancer Institute.